After Squamous Cell Cancer Of The Skin Has Been Diagnosed Tests Are Done To Find Out If Cancer Cells Have Spread Within The Skin Or To Other Parts Of The Body
The process used to find out if cancer has spread within the skin or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment for squamous cell carcinoma of the skin.
Basal cell carcinoma of the skin rarely spreads to other parts of the body. Staging tests to check whether basal cell carcinoma of the skin has spread are usually not needed.
The following tests and procedures may be used in the staging process for squamous cell carcinoma of the skin:
Basal Cell Carcinoma Squamous Cell Carcinoma Of The Skin And Actinic Keratosis Often Appear As A Change In The Skin
Not all changes in the skin are a sign of basal cell carcinoma, squamous cell carcinoma of the skin, or actinic keratosis. Check with your doctor if you notice any changes in your skin.
Signs of basal cell carcinoma and squamous cell carcinoma of the skin include the following:
- A sore that does not heal.
- Areas of the skin that are:
- Raised, smooth, shiny, and look pearly.
- Firm and look like a scar, and may be white, yellow, or waxy.
- Raised and red or reddish-brown.
- Scaly, bleeding, or crusty.
Basal cell carcinoma and squamous cell carcinoma of the skin occur most often in areas of the skin exposed to the sun, such as the nose, ears, lower lip, or top of the hands.
Signs of actinic keratosis include the following:
- A rough, red, pink, or brown, scaly patch on the skin that may be flat or raised.
- Cracking or peeling of the lower lip that is not helped by lip balm or petroleum jelly.
Actinic keratosis occurs most commonly on the face or the top of the hands.
Is Skin Cancer Genetic
40-50% of Americans who live to the age of 65 will have skin cancer at least once. The most common types of skin cancer in the United States are basal cell carcinoma and squamous cell carcinomas. These are referred to as non-melanoma skin cancers and are generally the result of sun exposure. Learn more about the effects of UV exposure.
Approximately one in 60 people will develop invasive, cutaneous melanoma during their lifetime. Malignant melanoma is a cancer that begins in the melanocytes, the pigment-producing cells in the skin. In fair-complexioned individuals worldwide, the majority of melanoma cases are related to environmental factors such as excessive ultraviolet radiation . However, about 5-10% of melanoma cases are inherited in an autosomal dominant fashion. In other words, parents with a defined genetic mutation have a 50/50 chance to pass on the susceptibility to each of their children regardless of gender. Learn more about melanoma.
Learn more about genetic testing or make an appointment with our experts at the Skin Cancer Program.
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What Are The Signs Of Skin Cancer
The most common warning sign of skin cancer is a change on your skin, typically a new growth, or a change in an existing growth or mole. The signs and symptoms of common and less common types of skin cancers are described below.
Basal cell carcinoma
Basal cell cancer is most commonly seen on sun-exposed areas of skin including your hands, face, arms, legs, ears, mouths, and even bald spots on the top of your head. Basal cell cancer is the most common type of skin cancer in the world. In most people, its slow growing, usually doesnt spread to other parts of the body and is not life-threatening.
Signs and symptoms of basal cell carcinoma include:
- A small, smooth, pearly or waxy bump on the face, ears, and neck.
- A flat, pink/red- or brown-colored lesion on the trunk or arms and legs.
- Areas on the skin that look like scars.
- Sores that look crusty, have a depression in the middle or bleed often.
Squamous cell carcinoma
Squamous cell cancer is most commonly seen on sun-exposed areas of skin including your hands, face, arms, legs, ears, mouths, and even bald spots on the top of your head. This skin cancer can also form in areas such as mucus membranes and genitals.
Signs and symptoms of squamous cell carcinoma include:
- A firm pink or red nodule.
- A rough, scaly lesion that might itch, bleed and become crusty.
Melanoma
Signs and symptoms of melanoma include:
- A brown-pigmented patch or bump.
- A mole that changes in color, size or that bleeds.
Are All Moles Cancerous
Most moles are not cancerous. Some moles are present at birth, others develop up to about age 40. Most adults have between 10 and 40 moles.
In rare cases, a mole can turn into melanoma. If you have more than 50 moles, you have an increased chance of developing melanoma.
A note from Cleveland Clinic
Your skin is the largest organ in your body. It needs as much attention as any other health concern. What may seem like an innocent cosmetic imperfection, may not be. Performing regular skin self-checks is important for everyone and is especially important if you are a person at increased risk of skin cancer. Skin cancer is also color-blind. If you are a person of color, skin cancer can happen to you. Check your skin every month for any changes in skin spots or any new skin growths. Consider taking skin selfies so you can easily see if spots change over time. If youre a person of color, be sure to check areas more prone to cancer development, such as the palms of your hands, soles of your feet, between your toes, your genital area and under your nails. Takes steps to protect your skin. Always wear sunscreen with SPF of at least 30 every day of the year. Wear UV-A/UV-B protective sunglasses, wide-brimmed hats and long-sleeve shirts and pants. See your dermatologist at least once a year for a professional skin check.
Last reviewed by a Cleveland Clinic medical professional on 11/19/2021.
References
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Skin Cancer Of The Head And Neck Treatment
Many early-stage small basal cell cancers or squamous cell cancers can be removed by Mohs surgery, a technique that spares normal tissue through repeated intraoperative margin testing, removing only the cancer and leaving adjacent normal tissue. Tumors with nerve involvement, lymph node involvement or of a large size are not suitable for Mohs surgery. They require a multimodality approach to treatment, with formal surgical resection and adjuvant radiation or chemotherapy.
Melanoma is more likely to spread, and aggressive surgical resection with wide margins is required, in addition to radiation and/or chemotherapy.
Johns Hopkins Head and Neck Cancer Surgery
Johns Hopkins Head and Neck Cancer Surgery provides comprehensive surgical care and treatment for head and neck cancers. Our surgeons are at the leading edge of head and neck cancer treatment. You will benefit from the skilled care of head and neck surgeons, guiding clinical advancements in the field of head and neck cancer care.
Can Skin Cancer Be Prevented
Skin cancer is almost entirely preventable. Making a part of your life, avoiding sunburn, and checking your skin regularly will help prevent further damage to your skin.
Protect your skin from UV radiation and help prevent skin cancer by:
- slipping on sun-protective clothing: cover your shoulders, neck, arms, legs and body.
- slopping on sunscreen thats rated SPF 30+ or higher, broad-spectrum and water resistant.
- slapping on a hat that shades your face, neck and ears.
- seeking shade under trees, umbrellas and buildings from direct sunlight and reflective surfaces.
- sliding on sunglasses that wrap around your face to protect your eyes and surrounding skin.
- staying away from sun lamps, solariums or sunbeds, which emit dangerous levels of UV radiation.
UV radiation from the sun varies depending on time of day, season, where you live and cloud coverage. Protect your skin whenever UV Index levels are above 3. Use Cancer Council Australias free SunSmart app to check the UV Index for your area any time.
Most Australians will get enough vitamin D even with sun protection at UV level 3 or above. Babies and children should be protected from the sun, since they are particularly vulnerable to UV radiation harm.
While using fake tanning cream isnt harmful to your skin, it offers no protection from UV radiation. You still need to protect yourself from the sun.
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How Does Skin Cancer Become A Life
You may wonder how cancer on the surface of your skin becomes a life-threatening cancer. It seems logical to think you could just scrape off the skin with the cancer cells or even remove the cancerous skin lesion with a minor skin surgery and thats all that would be needed. These techniques are successfully used if cancer is caught early.
But if skin cancer isnt caught early, something thats just on my skin can grow and spread beyond the immediate area. Cancer cells break away and travel through the bloodstream or lymph system. The cancer cells settle in other areas of your body and begin to grow and develop into new tumors. This travel and spread is called metastasis.
The type of cancer cell where cancer first started called primary cancer determines the type of cancer. For example, if malignant melanoma metastasized to the lungs, the cancer would still be called malignant melanoma. This is how that superficial skin cancer can turn into life-threatening cancer.
Symptoms Of Skin Cancer
Skin cancers arent all identical, and they may not cause many symptoms. Still, unusual changes to your skin can be a warning sign for the different types of cancer. Being alert for changes to your skin may help you get a diagnosis earlier.
Watch out for symptoms, including:
- skin lesions: A new mole, unusual growth, bump, sore, scaly patch, or dark spot develops and doesnt go away.
- asymmetry: The two halves of the lesion or mole arent even or identical.
- border: The lesions have ragged, uneven edges.
- color: The spot has an unusual color, such as white, pink, black, blue, or red.
- diameter: The spot is larger than one-quarter inch, or about the size of a pencil eraser.
- evolving: You can detect that the mole is changing size, color, or shape.
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What Skin Cancer Looks Like
Skin cancer appears on the body in many different ways. It can look like a:
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Changing mole or mole that looks different from your others
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Dome-shaped growth
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Non-healing sore or sore that heals and returns
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Brown or black streak under a nail
It can also show up in other ways.
To find skin cancer on your body, you dont have to remember a long list. Dermatologists sum it up this way. Its time to see a dermatologist if you notice a spot on your skin that:
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Differs from the others
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Itches
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Bleeds
To make it easy for you to check your skin, the AAD created the Body Mole Map. Youll find everything you need to know on a single page. Illustrations show you how to examine your skin and what to look for. Theres even place to record what your spots look like. Youll find this page, which you can print, at Body Mole Map.
Who Is At Risk For Skin Cancer
Although anyone can get skin cancer, the risk is greatest for people who have fair or freckled skin that burns easily, light eyes and blond or red hair. Darker skinned individuals are also susceptible to all types of skin cancer, although their risk is substantially lower.
Aside from complexion, other risk factors include having a family history or personal history of skin cancer, having an outdoor job and living in a sunny climate. A history of severe sunburns and an abundance of large and irregularly-shaped moles are risk factors unique to melanoma.
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What Are The Symptoms Of Skin Cancer Of The Head And Neck
Skin cancers usually present as an abnormal growth on the skin. The growth may have the appearance of a wart, crusty spot, ulcer, mole or sore. It may or may not bleed and can be painful. If you have a preexisting mole, any change in the characteristics of this spot – such as a raised or an irregular border, irregular shape, change in color, increase in size, itching or bleeding – are warning signs of melanoma. Sometimes the first sign of melanoma or squamous cell cancer is an enlarged lymph node.
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Our head and neck surgeons and speech language pathologists take a proactive approach to cancer treatment. Meet the Johns Hopkins specialists who will work closely with you during your journey.
What Questions Should I Ask My Healthcare Provider
Questions to ask your dermatologist may include:
- What type of skin cancer do I have?
- What stage is my skin cancer?
- What tests will I need?
- Whats the best treatment for my skin cancer?
- What are the side effects of that treatment?
- What are the potential complications of this cancer and the treatment for it?
- What outcome can I expect?
- Do I have an increased risk of additional skin cancers?
- How often should I be seen for follow-up checkups?
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How Can I Help Prevent Skin Cancer
Nothing can completely undo sun damage, although the skin can somewhat repair itself, especially with on-going sun protection. So, it’s never too late to begin protecting yourself from the sun. Your skin does change with age — for example, you sweat less and your skin can take longer to heal, but you can delay these changes by staying out of the sun. Follow these tips to help prevent skin cancer:
- Apply broad-spectrum sunscreen with a sun protection factor of 30 or greater , zinc oxide , and iron oxide 20 minutes before sun exposure and every 2 hours thereafter, more if you are sweating or swimming. Check the label for directions.
- Select clothing, cosmetic products, and contact lenses that offer UV protection.
- Wear sunglasses with total UV protection and a wide-brimmed hat to shade your face and neck.
- Avoid direct sun exposure as much as possible during peak UV radiation hours . The UVA rays, which cause premature skin aging and initiate skin cancers, are out all day long.
- Perform skin self-exams regularly to become familiar with existing growths and to notice any changes or new growths.
- Eighty percent of a person’s lifetime sun exposure is acquired before age 18. As a parent, be a good role model and foster skin cancer prevention habits in your child.
How Can I Find Skin Cancer Early
- Talk with your doctor if you see any changes on your skin that do not go away within one month.
- Check the skin on all surfaces of your body, even in your mouth.
- Watch for a new mole or other new growth on your skin.
- Check for changes in the appearance of an old growth on the skin or scar .
- Watch for a patch of skin that is a different color and becomes darker or changes color.
- Watch for a sore that does not heal it may bleed or form a crust.
- Check your nails for a dark band. Check with your doctor if you see changes, such as if the dark band begins to spread.
When skin cancer is found early, it can be treated more easily.
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Knowledge Is Your Best Defense
What Is Skin Cancer?
Skin cancer is the out-of-control growth of abnormal cells in the epidermis, the outermost skin layer, caused by unrepaired DNA damage that triggers mutations. These mutations lead the skin cells to multiply rapidly and form malignant tumors. The main types of skin cancer are basal cell carcinoma , squamous cell carcinoma , melanoma and Merkel cell carcinoma .
The two main causes of skin cancer are the suns harmful ultraviolet rays and the use of UV tanning beds. The good news is that if skin cancer is caught early, your dermatologist can treat it with little or no scarring and high odds of eliminating it entirely. Often, the doctor may even detect the growth at a precancerous stage, before it has become a full-blown skin cancer or penetrated below the surface of the skin.
Americans will develop skin cancer by age 70.
Diagnosis Of Skin Cancer
It is important to check your skin regularly and check with your doctor if you notice any changes.
In the majority of cases, your GP will examine you, paying attention to any spots that may look suspicious. Your GP may perform a biopsy . In some cases your GP may refer you to a specialist, such as a dermatologist, if necessary.
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Visit Us Dermatology Partners
Whether youre worried a spot youve noticed is cancerous or youre just ready for your annual professional skin exam, the U.S. Dermatology Partners team would love to hear from you. You can get started scheduling your visit by completing our online request form. Once we receive your scheduling request, one of our local team members will be in touch to finalize the details of your office visit.
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What Happens During A Skin Cancer Screening
Skin cancer screenings may be done by yourself, your primary care provider, or a dermatologist. A dermatologist is a doctor who specializes in disorders of the skin.
If you are screening yourself, you will need to do a head-to-toe exam of your skin. The exam should be done in a well-lit room in front of a full-length mirror. You’ll also need a hand mirror to check areas that are hard to see. The exam should include the following steps:
- Stand in front of the mirror and look at your face, neck, and stomach.
- Women should look under their breasts.
- Raise your arms and look at your left and right sides.
- Look at the front and back of your forearms.
- Look at your hands, including between your fingers and under your fingernails.
- Look at the front, back, and sides of your legs.
- Sit down and examine your feet, checking the soles and the spaces between the toes. Also check the nail beds of each toe.
- Check your back, buttocks, and genitals with the hand mirror.
- Part your hair and examine your scalp. Use a comb along with a hand mirror to help you see better. It may also help to use a blow dryer to move your hair as you look.
If you are getting screened by a dermatologist or other health care provider, it may include the follow steps:
The exam should take 10-15 minutes.
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