Understanding Skin Cancer | Types | Signs and Symptoms | Diagnosing | Stages | Resources
Skin cancer is the most common cancer in the United States. When it’s detected and treated early, the cure rate is high.
Fred Hutchinson Cancer Center offers comprehensive treatment from a team of experts who specialize in all types of skin cancers.
Skin cancers begin in cells that make up your skin. Different types start in different kinds of cells within the skin, such as basal cells, squamous cells or melanocytes.
The most common types of skin cancer in the United States are basal cell carcinoma, squamous cell carcinoma and melanoma.
Basal cell carcinoma, or basal cell skin cancer, accounts for about 80 percent of skin cancers.
Squamous cell carcinoma, also called squamous cell skin cancer, accounts for about 20 percent of skin cancers.
Melanoma can spread quickly to other organs. Though it’s uncommon compared to basal and squamous cell skin cancers, it causes 75 percent of the country’s skin cancer deaths.
The best way to detect skin cancer before it spreads and becomes difficult to cure is to carefully and regularly examine your own skin and to have routine exams by your health care provider.
Looking for signs of skin cancer can be a challenge because most of us have some brownish spots on our skin — birthmarks, moles, freckles — which are usually normal. But some may be skin cancers.
Other possible signs of skin cancer — such as a small sore that bleeds, scabs and heals or a reddish patch that crusts over and itches — can be a benign (noncancerous) condition or something more serious.
This type of cancer is usually found on sun-exposed areas of the skin like the scalp, forehead, face, nose, neck and back.
Basal cell carcinomas may bleed after a minor injury but then scab and heal. This can happen over and over for months or years with no visible growth, making it easy to mistake them for wounds or sores. They rarely cause pain in their earliest stages.
Appearance
In addition to the bleeding and healing, these are other possible signs of a basal cell cancer:
Generally found on the ears, face and mouth, squamous cell carcinoma can be more aggressive than basal cell. Untreated, it may push through the skin layers to the lymphatic system, bloodstream and nerve routes, where it can cause pain and symptoms of serious illness.
Appearance
Squamous cell cancer often starts as a precancerous lesion known as actinic keratosis (described below). When it becomes cancerous, the lesion appears raised above the normal skin surface and is firmer to the touch. Sometimes the spot shows only a slight change from normal skin.
Other signs include:
Many people have actinic keratosis (AK), also called solar keratosis, on their skin. It shows that you’ve had enough sun to develop skin cancer, and it is considered a precursor of cancer, or a precancerous condition.
Usually AK shows up on the parts of your body that have received the most lifetime sun exposure, like the face, ears, scalp, neck, backs of the hands, forearms, shoulders and lips.
Some of the same treatments used for nonmelanoma skin cancers are used for AK to ensure it does not develop into a cancerous lesion.
Appearance
This abnormality develops slowly. The lesions are usually small, about an eighth of an inch to a quarter of an inch in size. You may see a few at a time. They can disappear and later return.
Melanoma skin cancer is much more serious than basal cell carcinoma and squamous cell carcinoma. It can spread quickly to other organs and causes the vast majority of skin cancer deaths in the United States. Usually melanomas develop in or around an existing mole.
Appearance
Signs and symptoms of melanoma vary depending on the exact type and may include:
See more pictures and get details about different types of melanoma in our dedicated melanoma section.
Read about signs and symptoms of Merkel cell carcinoma, a rare type of skin cancer, in our dedicated Merkel cell section.
Self-Exams to Detect Skin Cancer
You may notice changes to your skin casually during your daily routine, such as when you put on lotion, look in the mirror or take a shower. Doing a thorough monthly exam is also important.
Learn how to examine your skin and the general warning signs to look for in Skin Cancer Early Detection
Skin cancer can usually be treated successfully if it’s detected early.
Fred Hutch offers comprehensive skin cancer care at the Multidisciplinary Skin Oncology Clinic, including advanced treatments and new options available only through clinical studies.
Examine your skin regularly to watch for changes and for new suspicious growths.
Call your physician if:
If you have an abnormal-looking growth on your skin that might be cancer, your doctor will:
Next you may have a skin biopsy, which involves taking a sample of suspicious tissue so a pathologist can examine the cells under a microscope to look for cancer.
Common types of skin biopsies include:
This is a procedure in which a radiolabeled substance and a blue dye are injected near your tumor. The substance flows through lymph ducts to the first lymph node or nodes where cancer cells are likely to spread (sentinel nodes). Your surgeon removes only the nodes where the substance appears. A pathologist checks the sentinel nodes for cancer.
Your physician might recommend other tests or scans to learn more about your condition, especially if your tumor is deep or your lymph nodes are involved. These may include a computed tomography (CT) scan, chest X-ray, positron emission tomography (PET) scan, magnetic resonance imaging (MRI) scan or bone scan and tissue, blood or urine tests.
The stage of your cancer helps your physicians determine the best treatment options for you. The process of staging tells us whether or not your cancer has spread and, if it has, how far. When skin cancer is diagnosed at an early stage, it is more likely to be cured.
Skin cancers are assigned a stage from 0 to IV, with 0 being the least advanced (in situ, found only in the outermost layer of skin) and IV being the most advanced.
There are many resources online for learning about your disease. Health educators at the Fred Hutch Patient and Family Resource Center have compiled a list of trusted sources to help you get started.
Whether you are newly diagnosed, or going through treatment, or know someone with cancer, our staff are available to tailor personalized resources and answer questions about support options in the community.
Our list of online resources provides accurate health information from reliable and reputable sources, like the National Cancer Institute (NCI), the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN).
American Cancer Society (ACS): Overview of Skin Cancer
If you have skin cancer or are a caregiver for someone who does, knowing what to expect can be helpful. Here you can learn about all types of skin cancer in adults, including risk factors, symptoms and how they are found and treated.
American Society of Clinical Oncology (ASCO) Answers: Cutaneous Squamous Cell Carcinoma
ASCO Answers is a collection of oncologist-approved patient education materials developed by ASCO for people with cancer and their caregivers. Here you can find illustrations and information on skin cancer.
National Cancer Institute (NCI): Skin Cancer (Including Melanoma)-Patient Version
The NCI is the federal government's principal agency for cancer research and training. Here you can find more information about treatment, research and coping with skin cancer.
National Comprehensive Cancer Network (NCCN) Guidelines for Patients: Squamous Cell Skin Cancer
This step-by-step guide to the latest advances in cancer care features questions to ask your physician, patient-friendly illustrations and glossaries of terms and acronyms.