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Dermatologist examining the dark spots on the skin on the back of a patient

Living in not-always-so-sunny Portland, we can be lulled into a false sense of security about skin cancer. But whether you ski at Mt. Hood or Mt. Bachelor, when you hike the Cascades or hang out on the beach at Lincoln City, our outdoor Oregon lifestyles still result in plenty of sun exposure. And with that comes an elevated risk for developing skin cancer.

The key to beating skin cancer is to catch it early. Without treatment, skin cancer can cause death. Fortunately, skin doctors can detect and treat skin cancer, so skin cancer is responsible for fewer than 1 percent of all cancer deaths. Toward that end, the whole team at Center for Dermatology and Laser Surgery want our patients to be knowledgeable about the warning signs, so here is some additional information on skin cancer.

Who Gets Skin Cancer?

Doctors diagnose skin cancer in more than 3 million people in the United States, according to the American Cancer Society, making skin cancer the most common type of cancer in the nation.

Some people are very diligent about wearing sunscreen and otherwise protecting their skin, yet still seem to constantly find new actinic keratoses (pre-cancerous lesions) and even basal and squamous cell carcinomas. It all comes down to melanin. Melanin is the pigment in the skin that helps protect it from the sun.

People with fair skin have less melanin so they are less protected. The ultraviolet rays from the sun can alter the genetic material in skin cells, causing them to mutate into cancerous cells. It is estimated that 40 to 50% of people with fair skin (who live to be at least 65 years of age) will develop at least one skin cancer in their lives.

The 4 Types of Skin Cancer

There are four different types of skin cancer, each with their own characteristics.

1. Basal Cell Carcinoma

Basal cells are round skin cells located in the lower part of the epidermis. Approximately 80 percent of all skin cancers originate in basal cells; skin doctors refer to these cancers as basal cell carcinoma. This type of skin cancer develops most often on a patient’s head and neck, but the abnormal cells can develop anywhere on a person’s skin. Basal cell carcinoma is usually the result of exposure to the sun, although it can develop in people who underwent radiation therapy when they were children.

Basal cell carcinomas usually grow very slowly, and the cancer cells rarely spread to other tissues of the body. Left untreated, though, basal cell carcinoma can grow into nearby tissue and even invade the tissues beneath the skin or the bone. If not removed completely, the cancer cells can come back in the same place. Patients who have had basal cell carcinomas are also more likely to develop new skin cell cancers in other places.

2. Squamous Cell Carcinoma

A large percentage of the epidermis consists of flat, scale-like cells, known as squamous cells. About 20 percent of skin cancers develop from squamous cells; doctors refer to these cancers as squamous cell carcinomas. Anywhere between 2 and 5 percent of squamous cell cancers spread to other areas of the body, so it is more likely to spread than basal cell carcinoma.

Sun exposure is the main cause of squamous cell carcinoma, so this type of skin cancer can develop anywhere exposed to sunshine. Squamous cell carcinoma can also develop on burned skin, skin damaged by chemicals, and skin exposed to x-rays. Lips are a common location for squamous cell carcinoma; this type of cancer can also develop near long-standing scars and on skin outside the mouth, anus, or near a woman’s vagina.

Skin doctors can usually remove squamous cell carcinomas completely or treat the cancer in other ways. Squamous cell cancers are more likely than basal cell carcinomas to grow into deeper layers of skin or spread to other parts of the body.

3. Melanoma

Melanoma starts in melanocytes, which are cells situated in the part of skin where the epidermis meets the dermis. Melanocytes produce melanin, which is the pigment that gives skin its color.

While it is less common than basal cell carcinoma and squamous cell carcinoma, melanoma is the most serious form of skin cancer. This is because melanoma is more likely to grow and spread. Doctors diagnose about 106,110 new cases of melanomas each year; the disease will claim 7,180 lives each year.

4. Merkel Cell Cancer

Merkel cell cancer is a fast-growing, highly aggressive cancer. This rare form of skin cancer starts in special hormone-producing cells situated just under the skin and in hair follicles. Doctors most commonly discover it in the head and neck region.

Know Your ABCDE’s of Skin Cancer

These five letters can come in handy when looking for skin cancers on your skin.

  • Asymmetry— If one half of the mole doesn’t match the other half, that’s a concern. Normal moles are symmetrical.
  • Border— If the border or edges of your mole are ragged, blurred, or irregular, that is a reason for concern. Melanoma lesions often have irregular borders.
  • Color— Normal moles are a single shade throughout. If your mole has changed color or if it has different shades of tan, brown, black, blue, white, or red, then it should be checked.
  • Diameter— If a mole is larger than the eraser of a pencil it needs to be checked.
  • Evolving— If a mole evolves by shrinking, growing larger, changing color, itching or bleeding, or other changes it should be checked. Melanoma lesions often grow in size or gain height rapidly.

With skin cancer, early detection is key. Yearly skin checks are a good idea if you have fair skin or get a lot of sun exposure. Contact Center for Dermatology today to learn more about skin cancer evaluations and treatment options.