Do the words “skin cancer” make you think of melanoma, an aggressive form of the disease that may spread to other body parts if it isn’t found early? A melanoma diagnosis may be worrisome, but it only affects a small percentage of people with skin cancer. Most people are diagnosed with something less invasive.

The three most common types of skin cancer

  • Basal cell carcinoma accounts for about 80% of all skin cancers.
  • Squamous cell carcinoma accounts for almost 20% of all skin cancers.
  • Melanoma accounts for fewer than 3% of all skin cancers.

Basal cell and squamous cell carcinomas are diagnosed much more frequently than melanoma, but people are more familiar with melanoma because it causes significantly more deaths. If you have melanoma, being diagnosed and getting treated early typically leads to better outcomes.

The average person who notices something suspicious on their skin can’t tell whether they have melanoma, a less aggressive form of skin cancer or something non-cancerous. That’s why you should visit your provider if you notice any changes to your skin.

Risk factors for skin cancer

The three most common types of skin cancer arise in the outermost layers of the skin (the epidermis). Squamous cells are closest to the surface of the skin. Basal cells are deeper within the skin. The melanocytes – cells that produce the skin’s pigment, where melanoma arises – are between the squamous and basal cells.

Skin cancer occurs most often in people frequently exposed to ultraviolet (UV) light. Ultraviolet light can damage skin cells, which enables cancer to develop. Activities that expose you to UV light, like sunbathing and using tanning beds, increase your risk of skin cancer. Limiting these activities should reduce your risk.

You can’t change certain skin cancer risk factors. You’re at increased risk if you have pale skin or light-colored eyes, if you have a lot of moles or if you have a family history of skin cancer.

Taking immunosuppressant medications or biologic therapies that treat conditions like Crohn’s disease or rheumatoid arthritis may increase your risk of squamous cell or basal cell carcinoma.

How different types of skin cancer affect the body

Melanoma, basal cell carcinoma and squamous cell carcinoma all behave differently in the body.

  • Melanoma is the most worrisome type of skin cancer because it can grow and spread quickly. It usually appears on sun-exposed skin, but it occasionally arises on non-exposed areas like the toes, underneath a nail or inside an ear canal. Melanoma may spread to the lymph nodes, and then to other sites throughout the body. If you treat melanoma before it spreads, the long-term survival rate is significantly higher.
  • Basal cell carcinoma is the least worrisome type of skin cancer. It usually arises on sun-exposed skin. It’s fairly slow-growing and isn’t likely to spread to other parts of the body unless it remains untreated for long periods.
  • Squamous cell carcinoma is less worrisome than melanoma but more worrisome than basal cell carcinoma. It typically arises on sun-exposed skin. It’s more likely to spread to other parts of the body than basal cell carcinoma but isn’t as invasive as melanoma.

How skin cancer is treated

If you’re diagnosed with skin cancer, providers surgically remove the affected area. If you have a small basal cell or squamous cell carcinoma, your dermatologist may remove it themselves during an office visit. For melanoma or larger basal cell or squamous cell carcinomas, your dermatologist may refer you to a surgical oncologist to remove the cancer. Surgical oncologists treat larger, more advanced cancers.

What happens next depends upon the type of skin cancer that you have and how advanced it is.

Melanoma treatments may range from simple surgical excision to more complex surgery that samples the lymph nodes to see if the cancer has spread. If melanoma is advanced, patients may receive chemotherapy or immunotherapy.

Some patients with advanced cases of basal cell carcinoma or squamous cell carcinoma may benefit from immunotherapy after surgery. In certain cases, patients with aggressive squamous cell carcinoma may receive radiation therapy.

The importance of early detection

Paying attention to your skin should help you recognize changes that could be skin cancer. If one of your moles changes in color, grows in size, develops uneven edges or becomes painful, it may be skin cancer. A suspicious mole isn’t an emergency that requires a next-day provider visit. It’s fine to get an appointment within the next few weeks.

Don’t worry if you notice a suspicious mole and don’t have a dermatologist. Primary care providers are trained to evaluate your skin. In some cases, they may refer you to a dermatologist for assessment.

If your provider is concerned that your mole could be cancer, they may biopsy it. The test results will confirm whether you have skin cancer and what type it is if you do.

Getting a diagnosis as soon as possible may be the best thing you can do for your health. Finding out that you have basal cell or squamous cell carcinoma may feel like a relief because they’re less worrisome than melanoma. If you have melanoma, finding out about it as early as possible is ideal; you may catch it before it spreads.

Arvind Sabesan, MD, FACS, is a surgical oncologist accepting new patients at the Helen F. Graham Cancer Center & Research Institute. Call today to learn more: 302-658-7533.