Should I Go To A Skin Cancer Clinic
Skin cancer clinics offer a variety of services and fee arrangements. They are usually run by GPs who have an interest in skin cancer.
Research shows that clinics may not offer a higher level of skill than your GP. In deciding whether to attend a skin clinic, consider:
- the qualifications and experience of the medical staff this includes whether they are members of a professional association related to treating skin cancer
- what you will have to pay and whether it is covered by Medicare some clinics bulk-bill the first consultation but require up-front payment for other appointments or surgery others require up-front payment for all services
- the range of services offered
- the follow-up provided.
Cancer Council does not operate or recommend any skin cancer clinics, and does not recommend any individual specialists.
Does Skin Cancer Affect People With Skin Of Color
People of all skin tones can develop skin cancer. If you are a person of color, you may be less likely to get skin cancer because you have more of the brown pigment, melanin, in your skin.
Although less prevalent than in nonwhite people, when skin cancer does develop in people of color, its often found late and has a worse prognosis. If youre Hispanic, the incidence of melanoma has risen by 20% in the past two decades. If youre Black and develop melanoma, your five-year survival rate is 25% lower than it is for white people . Part of the reason may be that it develops in less typical, less sun-exposed areas and its often in late-stage when diagnosed.
What Kind Of Doctor Treats Skin Cancer
At Banner MD Anderson, we recognize that no two skin cancers are alike. Therefore, our multidisciplinary team of experts works together to create the best treatment plans possible to meet the needs of every individual affected by skin cancer. The team may include a dermatologist, a surgical oncologist, a medical oncologist and other health care professionals.
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Find Out Whether You Need A Specialist For Your Skin Rash
A doctor who specializes in skin is called a dermatologist, However, there are several types of healthcare providers who can take care of basic skin conditions. Depending on the type of skin condition you’re dealing with, you may need to see a certain level of provider.
Causes Of Skin Cancer
Both types of skin cancer occur when mutations develop in the DNA of your skin cells. These mutations cause skin cells to grow uncontrollably and form a mass of cancer cells.
Basal cell skin cancer is caused by ultraviolet rays from the sun or tanning beds. UV rays can damage the DNA inside your skin cells, causing the unusual cell growth. Squamous cell skin cancer is also caused by UV exposure.
Squamous cell skin cancer can also develop after long-term exposure to cancer-causing chemicals. It can develop within a burn scar or ulcer, and may also be caused by some types of human papillomavirus .
The cause of melanoma is unclear. Most moles dont turn into melanomas, and researchers arent sure why some do. Like basal and squamous cell skin cancers, melanoma can be caused by UV rays. But melanomas can develop in parts of your body that arent typically exposed to sunlight.
Your recommended treatment plan will depend on different factors, like the size, location, type, and stage of your skin cancer. After considering these factors, your healthcare team may recommend one or more of the following treatments:
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Why Does Skin Cancer Occur In More Non
Scientists dont fully know why people of skin with color develop cancer in non-sun-exposed areas, such as their hands and feet. They think that the sun is less of a factor though. However, dermatologists still see plenty of UV sunlight-induced melanomas and squamous cell skin cancer in people of color, in skin tones ranging from fair to very dark.
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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What Can You Do To Prevent It
Skin cancer prevention is within your control. Follow these simple steps to reduce your risk:
- Wear sunscreen all year long.
- Avoid the sun at high points of the day.
- Dont use tanning beds.
- Wear protective clothing.
- Men and women, especially over age 18, should always request a skin exam during regular health check-ups.
- See your dermatologist regularly for thorough skins checks, early detection, and treatment.
What Are The Risk Factors For Skin Cancer
The most common risk factors for skin cancer are as follows.
- Ultraviolet light exposure, either from the sun or from tanning beds. Fair-skinned individuals, with hazel or blue eyes, and people with blond or red hair are particularly vulnerable. The problem is worse in areas of high elevation or near the equator where sunlight exposure is more intense.
- A chronically suppressed immune system from underlying diseases such as HIV/AIDS infection or cancer, or from some medications such as prednisone or chemotherapy
- Exposure to ionizing radiation or chemicals known to predispose to cancer such as arsenic
- Certain types of sexually acquired wart virus infections
- People who have a history of one skin cancer have a 20% chance of developing second skin cancer in the next two years.
- Elderly patients have more skin cancers.
Most basal cell carcinomas have few if any symptoms. Squamous cell carcinomas may be painful. Both forms of skin cancer may appear as a sore that bleeds, oozes, crusts, or otherwise will not heal. They begin as a slowly growing bump on the skin that may bleed after minor trauma. Both kinds of skin cancers may have raised edges and central ulceration.
Signs and symptoms of basal cell carcinomas include:
Signs and symptoms of squamous cell carcinomas include:
- Persistent, scaly red patches with irregular borders that may bleed easily
- Open sore that does not go away for weeks
- A raised growth with a rough surface that is indented in the middle
- A wart-like growth
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What Is The Role Of The Oncologist
An oncologist manages a patient’s care throughout the course of the disease. This starts with the diagnosis. Their role includes:
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Recommending tests to determine whether a person has cancer
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Explaining a cancer diagnosis, including the type and stage of the cancer
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Talking about all treatment options and your treatment choice
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Delivering quality and compassionate care
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Helping you manage symptoms and side effects of cancer and its treatment
A person’s cancer treatment plan may include more than one type of treatment, such as surgery, cancer medications, and/or radiation therapy. That means different types of oncologists and other health care providers work together to create a patient’s overall treatment plan. This is called a multidisciplinary team. Cancer care teams often include a variety of other health care professionals, including pathologists, radiologists, physician assistants, nurse practitioners, oncology nurses, social workers, pharmacists, and more. Learn about these and other possible members of a multidisciplinary team in another article on this website. Doctors from other areas of medicine can also be part of this team. For example, a dermatologist, which is a specialist in skin problems, may help treat skin cancer.
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.
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Sentinel Lymph Node Biopsy
As cancer cells spread, they can metastasize through the lymphatic system . The first lymph nodes the cancer cells come in contact with as they move from their tumor of origin are called sentinel lymph nodes.
Sentinel lymph node biopsy is surgery to identify, remove, and microscopically examine the lymph nodes directly in the pathway of spreading cancer cells. This way, only those lymph nodes that may be affected by abnormal cells are removed, increasing the potential to save lives while eliminating, in most cases, the need for a more complicated surgery.
Total Skin Electron Therapy
Rotational total skin electron therapy and static total skin electron irradiation are advanced approaches to treating this skin cancer. During TSEI, a patient’s entire skin is treated with low-energy electrons. This radiation penetrates very superficially, protecting internal organs and other structures.
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What Are Some Of The Lesser
Some of the less common skin cancers include the following:
Kaposi sarcoma is a rare cancer most commonly seen in people who have weakened immune systems, those who have human immunodeficiency virus /AIDS and people who are taking immunosuppressant medications who have undergone organ or bone marrow transplant.
Signs and symptoms of Kaposi sarcoma are:
- Blue, black, pink, red or purple flat or bumpy blotches or patches on your arms, legs and face. Lesions might also appear in your mouth, nose and throat.
Merkel cell carcinoma
Merkel cell carcinoma is a rare cancer that begins at the base of the epidermis, the top layer of your skin. This cancer starts in Merkel cells, which share of the features of nerve cells and hormone-making cells and are very close to the nerve ending in your skin. Merkel cell cancer is more likely to spread to other parts of the body than squamous or basal cell skin cancer.
Signs and symptoms of Merkel cell carcinoma are:
- A small reddish or purplish bump or lump on sun-exposed areas of skin.
- Lumps are fast-growing and sometimes open up as ulcers or sores.
Sebaceous gland carcinoma
Sebaceous gland carcinoma is a rare, aggressive cancer that usually appears on your eyelid. This cancer tends to develop around your eyes because theres a large number of sebaceous glands in that area.
Signs and symptoms of sebaceous gland carcinoma are:
- A painless, round, firm, bump or lump on or slightly inside your upper or lower eyelid.
Dermatofibrosarcoma protuberans
Do You Need A Specialist
For many, the decision to bring in a medical specialist is determined by ones health care plan. HMOs require patients to first see a primary care physician, who may then refer them to a specialist. On the other hand, PPO health plans require no referral, allowing patients to choose their own specialist.
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What Is The Staging For Skin Cancer
There is no specific staging system for basal cell carcinoma. If the tumor is wider than 2 cm , it is probably a more serious tumor. Basal cell carcinomas of the ears, nose, and eyelid may also be of more concern, regardless of the size.
There is a staging system for squamous cell carcinoma. Large tumors that are thicker than 2 mm, invade the nerve structures of the skin, occur on the ear, and have certain worrisome characteristics under the microscope are of more concern. If the tumor metastasizes to a site at some distance from the primary tumor, the cancer is likely to be a dangerous tumor.
How Is Skin Cancer Treated
Treatment depends upon the stage of cancer. Stages of skin cancer range from stage 0 to stage IV. The higher the number, the more cancer has spread.
Sometimes a biopsy alone can remove all the cancer tissue if the cancer is small and limited to your skins surface only. Other common skin cancer treatments, used alone or in combination, include:
Cryotherapy uses liquid nitrogen to freeze skin cancer. The dead cells slough off after treatment. Precancerous skin lesions, called actinic keratosis, and other small, early cancers limited to the skins top layer can be treated with this method.
Excisional surgery
This surgery involves removing the tumor and some surrounding healthy skin to be sure all cancer has been removed.
Mohs surgery
With this procedure, the visible, raised area of the tumor is removed first. Then your surgeon uses a scalpel to remove a thin layer of skin cancer cells. The layer is examined under a microscope immediately after removal. Additional layers of tissue continue to be removed, one layer at a time, until no more cancer cells are seen under the microscope.
Mohs surgery removes only diseased tissue, saving as much surrounding normal tissue as possible. Its most often used to treat basal cell and squamous cell cancers and near sensitive or cosmetically important areas, such as eyelids, ears, lips, forehead, scalp, fingers or genital area.
Curettage and electrodesiccation
Chemotherapy and immunotherapy
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Referral To A Skin Cancer Specialist
Your GP should arrange for you to see a specialist if you have symptoms that could be due to certain types of non melanoma skin cancer. Depending on your symptoms and other factors, this might be an urgent referral.
Some GPs have had special training and are able to treat a type of skin cancer called basal cell cancer . So you might not need a referral to see a specialist.
Tests Or Procedures That Examine The Skin Are Used To Diagnose Basal Cell Carcinoma And Squamous Cell Carcinoma Of The Skin
The following procedures may be used:
- Physical exam and health history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patients health habits and past illnesses and treatments will also be taken.
- Skin exam: An exam of the skin for bumps or spots that look abnormal in color, size, shape, or texture.
- Skin biopsy: All or part of the abnormal-looking growth is cut from the skin and viewed under a microscope by a pathologist to check for signs of cancer. There are four main types of skin biopsies:
- Shave biopsy: A sterile razor blade is used to shave-off the abnormal-looking growth.
- Punch biopsy: A special instrument called a punch or a trephine is used to remove a circle of tissue from the abnormal-looking growth. Enlarge Punch biopsy. A hollow, circular scalpel is used to cut into a lesion on the skin. The instrument is turned clockwise and counterclockwise to cut down about 4 millimeters to the layer of fatty tissue below the dermis. A small sample of tissue is removed to be checked under a microscope. Skin thickness is different on different parts of the body.
- Incisional biopsy: A scalpel is used to remove part of a growth.
- Excisional biopsy: A scalpel is used to remove the entire growth.
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Skin Cancer Diagnoses Vary Widely Know Your Options
Skin cancer is the most common cancer in the United States, affecting about 3.5 million Americans each year. Non-melanoma skin cancers, such as basal cell carcinoma and squamous cell carcinoma, are not likely to spread and may require little more than minor surgery or topical treatment. Melanoma, which accounts for about 1 percent of all skin cancers but is responsible for most skin cancer deaths, may spread through the lymphatic system or bloodstream to other organs. Because occurrence of this disease varies so widely, turning to a team of experts may be essential to understanding your disease and the options available to treat it. The pathologists and oncologists at our cancer hospitals are experts in treating skin cancer.
At Cancer Treatment Centers of America® , our doctors treat cancer every day, giving them the knowledge and experience to help you make informed decisions about your care. Your oncologist may recommend surgery, immunotherapy or targeted therapy, and plastic surgery to restore your function and appearance, if necessary. Your care plan may also include evidence-informed supportive care therapies to help you address skin cancer-related side effects, such as sun sensitivity, skin dryness, itchiness and redness, fatigue, swelling or nausea.
Concerned about your skin cancer risk? Take our five-minute risk assessment, and get an action plan based on your answers.