Skin Cancer

Wayne Health experts provide a full range of diagnostic services, specialty consultations, treatments and clinical trials for all types and stages of skin cancer with a focus on prevention.

Several types of skin cancer exist, depending on the type of cell in which the cancer starts. The most common types of skin cancer include Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC). The most aggressive types include Malignant Melanoma, which is relatively common, and Merkel Cell Carcinoma, which is very rare.

Wayne Health’s dermatology team will work with you on a treatment plan that meets your specific health care needs.

• Examination with dermoscopy to identify early stages of skin cancer before a biopsy
• Shave or punch biopsy, including nail biopsies for diagnosis
• Mohs micrographic surgery for high-risk areas of skin or cosmetically sensitive areas
• Wide local excision
• Electrodessication and curettage (burn and scrape)
• Photodynamic therapy (PDT)
• Creams for field therapy or thin skin cancers
• Cryosurgery (liquid nitrogen) to treat early precancerous actinic keratoses
• Sun protection, medication and supplements to reduce risk of skin cancer

Skin cancer happens when cells in your skin grow abnormally and out of control. The cancer cells can spread to other parts of your body.

Skin cancer may first appear as a new mole, a change in a growth or mole, a sore that doesn’t heal, or an irritation of the skin.

Exposure to the sun is the most common cause of skin cancer.

There are three major types of skin cancer:

• Basal cell skin cancer is the most common form. It grows slowly and seldom spreads to other parts of the body.
• Squamous cell skin cancer also rarely spreads, especially if it is found and treated early. But it’s more likely to spread than basal cell cancer.
• Melanoma grows and spreads rapidly and can invade other organs, such as the liver, lungs or brain.

Skin cancer, including melanoma, is curable if spotted early. A careful skin exam may identify suspicious growths that may be cancer or growths that may develop into skin cancer (precancers).

• Learn the ABCDEs of early detection

These are the changes in a mole or skin growth that are warning signs of melanoma.

• Examine your skin once every month

Get to know your moles and birthmarks. And look for any abnormal skin growth and any change in the color, shape, size, or appearance of a skin growth.

• Check for any area of skin that does not heal after an injury
• Ask your doctor to check your skin during health exams

Most experts recommend having your skin examined regularly.

Bring any suspicious skin growths or changes in a mole to the attention of your doctor

The single greatest risk is from ultraviolet (UV) radiation. This comes from exposure to the sun, especially during the middle of the day. It also comes from exposure to artificial sources of UV, such as indoor tanning. Where you live makes a difference. People who live closer to the equator get more UV radiation. And people who live at higher altitudes, such as in the mountains, get more UV radiation.

Your risk may also be higher if:

• You have light skin that sunburns easily. UV radiation affects people of all skin types, but especially those with light skin color, freckles, blond or red hair, and blue or light-colored eyes.
• You are male.
• You are over 40.
• You smoke.
• You have been exposed often to strong X-rays, to certain chemicals (such as arsenic, coal tar, and creosote), or to radioactive substances (such as radium).
• You have been infected with a certain type of human papillomavirus (HPV).
• Others in your family had nonmelanoma skin cancer, or you’ve had it before.
• You have an inherited genetic condition, such as xeroderma pigmentosum.
• You have a history of severe sunburns, especially during childhood.
• You have scars from severe burns or inflammatory skin conditions.

The risk of squamous cell carcinoma is higher in people who have weakened immune systems. This includes people who have had organ transplants and take medicines to prevent rejection of the new organ

To check for melanoma, your doctor may:

Do a physical exam of your skin

Your doctor will check your skin to look for melanoma.

Do a skin biopsy

Your doctor will take a sample of your skin and have it tested for melanoma.

Check your lymph nodes to see if they are larger than normal

This may be followed by a sentinel lymph node biopsy to see if the melanoma has spread to your lymph system.

 Do imaging tests

These tests include PET scan, CT scan, and MRI. These tests can show if the cancer has spread to other parts of your body, such as the lungs, brain or liver.

Other techniques may include total-body photography. A series of photos of the suspicious lesions may be taken. These photos can be used as a baseline to compare with follow-up photos.

To diagnose nonmelanoma skin cancer, your doctor can:

Ask about your past health

Your doctor will ask when the skin change occurred, if you have been exposed to substances that can cause skin cancer, and if you have any personal or family history of skin cancer.

Examine the skin growth

Your doctor can often tell what a skin growth is by looking at it. He or she may decide to watch for changes in the skin growth or take a sample of the growth for further testing.

Do a skin biopsy

In this procedure, a sample of the skin growth is removed, processed and examined under a microscope. It’s usually done when an area of skin has changed color, shape, size or appearance, or hasn’t healed, and the doctor suspects skin cancer. It also may be done if the cause of a skin problem isn’t easily found.

Treatment for melanoma is based on the stage of the cancer and other things, such as your overall health. The main treatment is:

Surgery

The doctor removes the melanoma and a border of normal tissue.

In some cases, the doctor may remove the first lymph node that the cancer may have spread to. If cancer is found, nearby lymph nodes may be removed and checked for cancer.

Other treatments may include:

Immunotherapy

• This treatment helps your immune system fight cancer.

Targeted therapy

• These medicines attack only cancer cells, not normal cells. They help keep cancer from growing or spreading.

Chemotherapy

• These medicines kill fast-growing cells, including cancer cells and some normal cells.

If melanoma has spread (metastatic cancer), surgery may be done. You’ll probably need other treatments too. Sometimes a clinical trial may be a good choice.

Your doctor will talk with you about your options and then make a treatment plan.

Your doctor will remove all of the cancer. The most common way is to numb your skin and then cut out the cancer. This surgery almost always cures the skin cancer. Other treatments include radiation, medicines that are put on the skin (topical therapies), and photodynamic therapy

Wayne Health specialists perform Mohs surgery to treat certain types of skin cancer in cosmetically sensitive or high-risk locations, such as the face. Mohs Micrographic Surgery is a specialized, highly effective technique for the removal of skin cancer. Mohs Surgery has been recognized as the skin cancer treatment with the highest reported cure rate.

Mohs Surgery differs from other skin cancer treatments because it allows for the immediate and complete microscopic removal and examination of cancerous tissue. This surgery allows for all “roots” and extensions of the cancer to be eliminated, including those not visible to the naked eye. Mohs surgeons have special training because they act as the physician, surgeon and pathologist at the same time.

Mohs Surgery is effective for treating many types of skin cancer and is most commonly used to treat basal cell carcinoma and squamous cell carcinoma – the two most common forms of skin cancer. Mohs Surgery is also used to treat a number of rarer skin cancers.

What is Mohs surgery for skin cancer?

Mohs surgery removes a skin cancer one layer at a time. The doctor checks each layer for cancer cells until no more cancer is found. This method lets the doctor save as much healthy tissue as possible.

This surgery is mostly used for areas of skin you can see or where scarring is a bigger concern, such as on the ears, nose, or eyelids.

It is also used for skin cancer that is likely to return, is growing fast, or has a high risk of spreading

Wayne Health physicians and researchers are also faculty at Wayne State University School of Medicine who conduct basic, translational and clinical research. This makes the latest treatments and clinical trials available to you sooner than other providers without a medical school affiliation.

Wayne Health providers also help to educate the next generation of physicians by teaching WSU medical students and resident physicians.

For more information, please visit the links below at the WSU School of Medicine.