The signs of skin cancer are not always readily apparent, in fact, many tumors have no noticeable symptoms at all. Due to the lack of obvious symptoms, each of us should check moles and other lesions periodically for signs of skin cancer. Some signs of cancer, including ulcers, large moles and bleeding from skin growths, are easy enough to detect. Less obvious indications, such as a gradual increase in mole size, are easier to overlook, and their early detection often hinges on a person’s ability to pay attention to his or her body.
Basal Cell Carcinoma
Basal cell carcinoma (BCC) is the most common type of skin cancer. Although BCC does not often metastasize, tumors can be aggressive, destroying surrounding tissues. A basal cell carcinoma can cause disfigurement, especially if it is located on the face.
BCC are most common on areas that receive frequent sun exposure: most often the head or the neck. Occasionally tumors may develop on the forearms and the back of the hands, but these are not common locations. A third of all basal cell carcinomas, however, appear on body parts that are usually protected from sunlight.
Each of the three varieties of BCC has a distinctive form. Nodulo-ulcerative BCC tumors are pearl-colored, and tiny blood vessels can be seen in the growth (a condition called telangiectasia). Superficial BCC forms red scaly plaques that gradually increase in size. Finally morpheaform BCC appears as white or yellowish plaques that lie flat on the skin. All forms of basal cell carcinoma may bleed, although bleeding is not a common sign.
Squamous Cell Carcinoma and Actinic Keratosis
Squamous cell carcinoma (SCC) usually develops where the body is exposed to sunlight: the face, ears, scalp, as well as the forearms and the backs of the hands. A squamous cell carcinoma may appear as a scaly patch. The scales of the SCC harden gradually, and the base of the affected skin is often red and inflamed. If the tumor has ulcerated, the area may have a thick crust with a firm, raised border.
Squamous cell carcinoma often develops from a type of skin lesion called actinic keratosis. Like SCC, actinic keratosis occurs due to sun exposure and UV damage. The lesion is flat, and its borders can be either regular or irregular. Actinic keratosis lesions are scaly, and have also been called “sandpapery.” The area of skin around the lesion may be wrinkled, rough or mottled, showing signs of sun damage.
Squamous cell carcinoma is usually localized: fewer than five percent of cases affect other areas of the body. SCC is diagnosed with a biopsy, and often cured by simply removing the tumor surgically, a process called excision.
Malignant melanoma is less common than basal or squamous cell carcinoma and is responsible for most skin cancer deaths. Malignant melanoma tends to develop on the lower legs of women, and the trunks of men (the trunk is the areas between the shoulders and the hips). However, the disease may also appear in areas of the body protected from the sun.
Many cases of malignant melanoma occur when a previously benign mole becomes cancerous. Changes to watch for in moles include the following:
raised moles that were previously flat
changes in the border or size
changes in color
Malignant melanoma responds well to prompt treatment in the disease’s early stages.
Paget’s Disease of the Nipple
Paget’s disease of the nipple is a rare cancer that appears in one to four percent of all breast cancers. The disease can also occur in males, but this is very rare. Areas of the nipple and the areola (the darker circle of skin surrounding the nipple) appear red and crusted: Paget’s disease looks very much like dermatitis. The affected area may burn and itch. In some cases, the nipple may have a bloody discharge. The nipple may also appear to be “flattened” against the breast.
In thirty percent of cases no evidence of the disease is visible.
Diagnosis of Paget’s disease is either by biopsy or analysis of nipple discharge. When dermatitis-like symptoms appear on a single breast, Paget’s disease should be considered as a possible cause.