Skin cancer is the most common form of cancer. Approximately 20% of Americans will develop at least one skin cancer at some point in their lives. Dr. Buster has treated skin cancer in patients from teens to nearly 100 years old. It can develop at any age, but is exceedingly rare in children. There are three main types of skin cancer: basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma.

Basal cell carcinoma

This is the most common form of skin cancer—about 80% of non-melanoma type skin cancers. Basal cell carcinoma is typically easy to treat and slow growing, but if neglected or a more aggressive form can be extremely destructive—leading to loss of vital structures (e.g., eye, nose) and can require extensive reconstructive surgery and/or prostheses. Biopsy is key as it allows confirmation of the diagnosis and also the subtype. This information is used by Dr. Buster to select the ideal treatment option(s) to discuss with you. For more information on basal cell carcinoma including treatment information, please go to the Skin Cancer Foundation website.

Squamous cell carcinoma

This is the second most common form of non-melanoma skin cancer, comprising about 20%. Though is typically low-grade, it can be aggressive and life threatening and approximately 5,000 Americans lose their lives each year to squamous cell carcinoma of the skin. Like basal cell carcinoma, diagnosis of squamous cell carcinoma is confirmed with biopsy. Location, depth, and involvement of structures beyond skin (e.g., lymph nodes) determine how this type of skin cancer is treated. Typically squamous cell carcinoma can be treated with simple surgical procedures and even topical medications can be used if the squamous cell carcinoma is only in the top layer of the skin (aka squamous cell carcinoma in situ). Squamous cell carcinomas can are larger or at higher risk for recurrence and/or spread can often still be treated surgically (e.g., *Mohs surgery *hyperlink this or excision with a larger amount of surrounding normal tissue removed). Radiation is another, less commonly used treatment option typically reserved for patients over age 60 who cannot tolerate or do not want to have surgery. For more information on squamous cell carcinoma including treatment information, please go to the Skin Cancer Foundation website.

Melanoma

Though melanoma is less common than BCC and SCC, it accounts for most skin cancer deaths. The good news is that when caught early it can be cured in the overwhelming majority of cases. Risk of melanoma in children is approximately 1 in a million, but rates begin to rise in teens and young adults. Though it is most common in older adults, it is one of the most common causes of cancer in teens and young adults and is increasing in frequency. Risk factors for melanoma include:

• Having a lot of moles—especially if multiple abnormal moles. Most melanoma comes up on its own separate from moles, but 1/3 of the time it is associated with a pre-existing mole. Thus the more moles one has, the greater the chance that one of the many could develop abnormal cells.
• Having family members who have had melanoma—especially first-degree relatives (e.g., siblings, parents).
• Fair skin, light/red hair and freckles. Melanoma can develop in ANY skin tone including very dark skin. However, it is much more common in people with fair skin.

• Excess ultraviolet (UV) radiation exposure. This is the one risk factor over which you have the most control. Sunburn is a sign that the skin has gotten more UV than it can handle. Not everyone has skin that will tan, but for those who do, it is a sign that their skin is trying to protect itself. DNA damage occurs with both sunburn and suntan. Tanning beds have been classified by the World Health Organization as carcinogenic. Tanning under the age of 30 increases the risk of melanoma by approximately 70%.

For more information on melanoma including treatment information, please go to the National Cancer Comprehensive Network site for patients.

Skin cancer tips and signs

A non-healing sore may be a skin cancer. It may be painless. If you have a sore that does not heal within 1 month despite taking care of it and avoiding picking, please schedule a visit with Dr. Buster to evaluate it. Rapidly growing lesions should be evaluated without delay as some forms of skin cancer can develop and grow over days to weeks.

Know your ABCDEs of melanoma:

• Asymmetry
• Border irregularity
• Color variegation (multiple colors)
• Diameter >6mm (size of a pencil eraser)
• Evolving/changing
• I also advise patients to look for ugly duckling spots/moles. This means a skin lesion that doesn’t look like anything else on you.