Question: Dr. Akal, are there different kinds of skin cancer and are they a concern for all ages and races?

Answer: A million people in the United States are diagnosed with skin cancer every year. It affects people of all ages and races. The most common forms of skin cancers are basal cell carcinoma and squamous cell carcinoma—which are known as non-melanoma skin cancers.  Melanoma, the most serious form of skin cancer is not as common as the other two major types of skin cancer and fortunately there are ways to detect most skin cancers early, when they are curable. Malignant melanomas can be deadly and the number of new cases is still rising.

Periodic skin examinations are the key to diagnosing skin cancer at its earliest stage. Basal cell carcinoma and squamous cell carcinoma may appear as lumps/scaling or color changes in the skin, which, once noticed by the patient or primary care doctor should be further evaluated. Best practice guidelines suggest a biopsy of the suspicious lesion should be performed prior to treatment but in some instances treatment can be considered if the physician is confident in the diagnosis.

Risk factors for skin cancer include previous melanoma or non-melanoma skin cancers, skin that burns readily and fails to tan, blue eyes, red hair and multiple freckles or moles. 

Depending on the type of skin cancer – there are several treatment options which can be done in the primary care physician’s office. Basal cell skin cancers can be treated with topical medications, cryotherapy or freezing with liquid nitrogen or excision. There are different types of  basal cell cancer, superficial, nodular, infiltrative or nodulo-infiltrative—treatment options vary based on the type. Squamous cell cancer is a more aggressive type that can spread to lymph nodes and usually requires excision of the lesion to ensure that the edges of the skin excised is cancer free. A technique called MOHS surgery is utilized in certain types of skin cancers especially those on the face.

Malignant melanoma requires wide excision of the lesion and consultation with a malignant melanoma dermatologist/oncologist. At Red Hook Family Practice we are can facilitate and expedite this option as we have strong connections with skin specialists in the US mainland.

We urge you to do the right thing—protect yourself with sunblock, UV clothing, broad brimmed hats and avoid sunburns. If you see any suspicious lesions have them evaluated.