Skin Cancers

Overview

Your skin is your body’s largest organ and your immune system’s first line of defense against infection and injury. Its thin, outer layer is called the epidermis, with the dermis underneath it and the hypodermis (subcutaneous tissue) farther below.

The most common types of skin cancer are named for the cells in which they develop: basal cell carcinoma (BCC) and cutaneous squamous (pronounced SKWAY-mus) cell carcinoma (CSCC). These two types of carcinomas are often grouped together and referred to as non-melanoma skin cancers (NMSCs). On the other hand, Merkel cell carcinoma (MCC) is among the many rare types, subtypes and variants of cancer that affect the skin.

Basal Cell Carcinoma (BCC)

This is the most common form of skin cancer in the United States, with more than 20 subtypes and variants. It forms in basal cells, which are round cells in the lower part of the epidermis, and begins when these cells become abnormal and grow out of control. BCC usually grows slowly and very rarely spreads beyond surrounding tissues. The most common site for BCC to occur is on the face.

Common forms of treatment include surgery, radiation therapy, cryosurgery, photodynamic therapy, topical chemotherapy, topical immunotherapy, targeted therapy and a clinical trial. Types of surgery may include simple excision, Mohs micrographic surgery, curettage and electrodesiccation.

Cutaneous Squamous Cell Carcinoma (CSCC)

Cutaneous squamous cell carcinoma (CSCC) is less common than BCC. It is sometimes called squamous cell carcinoma of the skin, squamous cell carcinoma or squamous cell skin cancer to differentiate it from squamous cell carcinoma that develops in other parts of the body. CSCC is commonly found on more sun-exposed areas of the skin, such as the face, ears, neck, lips and backs of the hands. It can also develop on scarred or damaged skin.

CSCC develops in squamous cells, which form the outermost part of the epidermis. Under a microscope, these thin, flat cells resemble fish scales. CSCC is more likely to spread than BCC, but it usually remains local, meaning it is confined to tissues surrounding the original site. Regional CSCC has spread to nearby lymph nodes, and metastatic CSCC has spread to distant parts of the body.

The most common forms of treatment include surgery, radiation therapy, cryosurgery, photodynamic therapy, immunotherapy or a clinical trial. Types of surgery include simple excision, Mohs micrographic surgery and curettage and electrodesiccation.

Actinic Keratosis

Actinic keratosis (pronounced ak-TIH-nik KAYR-uh-TOH-sis) is a common skin condition that usually forms on areas exposed to the sun, such as the face, scalp, back of the hands or chest, that have had long-term exposure to ultraviolet light. It is most common in people with fair skin, and is also called senile keratosis and solar keratosis. It may be referred to as sun spots or age spots.

It may appear as a thick, scaly patch of skin that may become cancer. It is a subtype of cutaneous squamous cell carcinoma (CSCC). Actinic keratosis is considered a precancer because it rarely progresses to become CSCC. If detected early, it can be treated before it develops into skin cancer.

The most common treatments for actinic keratosis include topical chemotherapy, topical immunotherapy, a chemical peel, photodynamic therapy and surgery, such as a simple excision, curettage and desiccation, dermabrasion and laser surgery.

Merkel Cell Carcinoma (MCC)

This rare cancer forms in oval-shaped cells located in the basal layer in the lower part of the epidermis. These neuroendocrine cells are thought to be receptors that help produce the sensation of light touch. MCC begins when these cells become abnormal and grow out of control, most often in the head and neck area as well as on the trunk, arms and legs.

Because MCC is highly aggressive, it grows rapidly and is likely to spread, first to nearby lymph nodes and then to distant areas. These may include skin and lymph nodes elsewhere in the body, the brain, lungs, bones and other organs.

Common treatment options include surgery, radiation therapy, chemotherapy and immunotherapy. Types of surgery include wide local excision and lymph node dissection. Clinical trials may also be an option.

 

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