Skin cancer is one of the common forms of cancer and the incidence is rising. While skin cancers can be found on any part of the body, about 80 percent appear on the face, head, or neck, where they can be disfiguring as well as dangerous.

The primary cause of skin cancer is ultraviolet radiation -most often from the sun. Researchers believe that an increase in outdoor activities and perhaps the thinning of the earth's protective ozone layer are behind the alarming rise we're now seeing in skin cancers.

Your risk of getting skin cancer is greater if...

By far the most common type of skin cancer is basal cell carcinoma. Fortunately, it's also the least dangerous kind--it tends to grow slowly, and rarely spreads beyond its original site. Though basal cell carcinoma is seldom life-threatening, if left untreated it can grow deep beneath the skin and into the underlying tissue and bone, causing serious damage (particularly if it's located near the eye).

Squamous cell carcinoma is the next most common kind of skin cancer, frequently appearing on the lips, face, or ears. It sometimes spreads to distant sites, including lymph nodes and internal organs. Squamous cell carcinoma can become life threatening if it's not treated.

A third form of skin cancer, malignant melanoma, is the least common, but its incidence is increasing rapidly. It is also the most dangerous type of skin cancer. If discovered early enough, it can be completely cured. If it's not treated quickly, however, malignant melanoma may spread throughout the body and is often deadly.

Two other common types of skin growths are moles and keratoses. Moles are clusters of heavily pigmented skin cells, either flat or raised above the skin surface. While most pose no danger, some-particularly large moles present at birth, or those with mottled colors and poorly defined borders-may develop into malignant melanoma. Moles are frequently removed for cosmetic reasons, or because they're constantly irritated by clothing or jewelry. Solar or actinic keratoses are rough, red or brown, scaly patches on the skin. They are usually found on areas exposed to the sun, and sometimes develop into squamous cell cancer.

RECOGNIZING SKIN CANCER

Basal and squamous cell carcinomas can vary widely in appearance. The cancer may begin as small, white or pink nodule; it can be smooth and shiny, waxy, or pitted on the surface. Or it might appear as a red spot that's rough, dry, or scaly...a firm, red lump that may form a crust...a crusted group of nodules...a sore that bleeds or doesn't heal.

Malignant melanoma is usually signaled by a change in the size, shape, or color of an existing mole, or as a new growth on normal skin. Any change in a pigmented lesion, rapid increase in its size, shape and color may serve as a warning sign of malignant change.

DIAGNOSIS AND TREATMENT

Skin cancer is diagnosed by removing all or part of the growth and examining its cells under a microscope by a pathologist. It can be treated by a number of methods, depending on the type of cancer, its stage of growth, and its location on your body.

Most skin cancers are removed surgically, by a plastic surgeon. If the cancer is small, the procedure is a simple excision, which usually leaves a thin, barely visible scar. It is done as an outpatient using local anesthesia.
If the cancer is large, however, or if it has spread to the lymph glands or elsewhere in the body, major surgery may be required. Other possible treatments for skin cancer include cryosurgery (freezing the cancer cells), radiation therapy (using x-rays), topical chemotherapy (anti-cancer drugs applied to the skin), and Mohs surgery, a special procedure in which the cancer is shaved off one layer at a time.

All of the treatments mentioned above, when chosen carefully and appropriately, have good cure rates for most basal cell and squamous cell cancers -and even for malignant melanoma, if it's caught very early, before it has a chance to spread.

A WORD ABOUT RECONSTRUCTION

The different techniques used in treating skin cancers can be life saving, but they may leave a patient with less than pleasing cosmetic or functional results. It may range from a small but unsightly scar to permanent changes in facial structures such as your nose, ear, or lip. Reconstructive techniques, ranging from a simple scar revision to a complex transfer of tissue flaps from elsewhere on the body, can often repair damaged tissue, rebuild body parts, and restore most patients to acceptable appearance and function.