Learn About Basal Cell Carcinoma (BCC)
Basal cell carcinoma is the most common form of skin cancer, appearing primarily on sun-exposed skin, though it may appear on covered skin. The risk of BCC increases with age and is most likely to appear as a non-healing, pearly nodule that occasionally bleeds, though it may also mimic scar tissue or eczema. While it rarely spreads to the bloodstream, if left unattended it can be very destructive, as it appears most often on the cheeks, nose, eyelids and ears.
Treatment: Includes simple surgical removal using electrodessication and curettage (scraping and cauterizing the area) or elliptical excision. Repair of large lesions may require skin grafts or skin flaps, which can be performed in the office. Difficult cases may require Mohs chemosurgery.
Squamous Cell Carcinoma (SCC
Squamous cell carcinoma represents 30 percent of all skin cancers and presents as firm, pink/red nodular growths typically on sun-exposed skin. They are frequently seen in patients whose immune systems are suppressed, such as patients who have had heart or kidney transplants, and those with severe chronic illness, such as patients on renal dialysis. Left untreated, SCC may metastasize, or spread, to other parts of the body, including major organs, and possibly cause death.
Treatment: In the early stages, SCC is easily treated by simple in-office surgical removal of the lesion before it is able to spread.
Malignant Melanoma
Malignant melanoma arises from the pigment cells in the skin called melanocytes. It may occur in pre-existing moles or spontaneously arise from normal-appearing skin. Unlike basal cell and squamous cell carcinomas, it may appear in young patients who are still in their late teens. Early detection is vital since the risks and morbidity are directly related to the progression of the cancer through the layers of the skin at the time of diagnosis. 50 percent of diagnosed melanomas are in "in situ," which means they have not penetrated beyond the epidermis or outer layer of the skin. Thus, it is important for patients to recognize the characteristics associated with melanoma. Is the mole new or has an old mole begun to change within the previous one to six months? Are the margins smooth or irregular? Is the surface even in color? Is the mole smaller than the eraser on a pencil? Asymmetry, border irregularities, color variations, diameter and evolving appearance are all important factors and should lead the patient to make an appointment. However, the final diagnosis can only be made by looking at the cellular morphology, or structure.
Treatment: If a mole appears suspicious on visual exam, it will be removed in the office and sent for examination by a pathologist who specializes in dermatology. If nothing is found, the patient will simply be encouraged to continue monitoring the skin. If a diagnosis of melanoma is made, and the depth of invasion is less than one millimeter, a wider excision will be performed. This is typically done in the office by Dr. Humeniuk. Patients with melanomas having invasion depths greater than one millimeter are sent to a general surgeon for wide excision and sentinel lymph node mapping. In any case, self-examination by the patient is extremely important.
