Skin Cancer

If you’ve been recently diagnosed with skin cancer, you and your family might be overwhelmed with questions and concerns. Your first decision is where to get treatment.

You want a place where you can get the most advanced treatment options available. A place where you are supported by a team of compassionate experts. A place where you are treated as a whole person.

MultiCare Regional Cancer Center is that place. We have the region’s best health care providers in the field of oncology. Our world-class treatment facility offers cutting-edge technology in a welcoming and positive healing environment.

Learn about our cancer care team or more about skin caner in the tabs below.

Skin Cancer Facts

Skin cancer is the abnormal growth of cells in the skin. It is the most common type of cancer. It is almost always cured when it is found early and treated. So it is important to see your doctor if you have changes in your skin.

Skin cancer is named by the cell type from which it comes. Melanoma, for instance, originates from melanocyte cells, which make melanin in skin. This is the most serious type of skin cancer.

More common skin cancers are nonmelanomas, which are highly curable and slow-growing. The two main types are basal cell carcinoma and squamous cell carcinoma.

There are other types of skin cancer that are not melanoma. But these are much less common. They include Merkel cell carcinoma and several kinds of sarcomas.

Symptoms

Any change in the shape, size or color of a mole or birthmark can be a sign of skin cancer.

Skin cancers may grow in a mole or birthmark that you already have but may also grow in unmarked skin. They can be found anywhere on your body. Most of the time, they are on the upper back in men and women and on the legs of women.

Unlike a normal mole or mark, a melanoma or nonmelanoma can:

• Change color, size or the shape of its border
• Be lumpy or rounded
• Become crusty, ooze or bleed
• Have uneven borders or shape
• Be any size but are usually 6 mm or larger

Prevention

Causes and Risk Factors

Both melanoma and nonmelanoma skin cancer is usually caused by too much exposure to the sun or tanning beds and sunlamps. This kind of exposure causes normal skin cells to become abnormal. These abnormal cells quickly grow out of control and attack the tissues around them.

Risk factors include:

• Having fair skin
• Being male and over 40
• Having a history of skin cancer
• Being exposed often to strong X-rays, to certain chemicals (such as arsenic, coal tar and creosote) or to radioactive substances (such as radium)

Other things in your family background can increase your chances of getting the disease. For example, you may have abnormal, or atypical, moles. Atypical moles may fade into the skin and have a flat part that is level with the skin. They may be smooth or slightly scaly, or they may look rough and "pebbly."

Prevention

The best ways to prevent all kinds of skin cancer include: 

• Try to stay out of the sun during the middle of the day (from 10 a.m. to 4 p.m.)
• Wear protective clothes when you are outside, such as a hat that shades your face, a long-sleeved shirt, and long pants
• Use sunscreen everyday with an SPF of least 15 that protects against both types of UV radiation in the sun's rays—UVA and UVB
• Use a higher SPF when you are at higher elevations
• Avoid sunbathing and tanning salons

Early Detection and Screening

Check your skin every month for odd marks, moles or sores that will not heal. Pay extra attention to areas that get a lot of sun, such as your hands, arms and back. Ask your doctor to check your skin during regular physical exams or at least once a year.

Diagnosis

Tests and Exams

Your doctor will check your skin to look for abnormal moles or growths. If your doctor thinks you have skin cancer, he or she will use a biopsy to find out if you have skin cancer. This means taking a sample of the growth and sending it to a lab to see if it contains cancer cells.

Other techniques may include total-body photography to monitor for changes in any mole and to watch for new moles appearing in normal skin. A series of photos of the suspicious lesions may be taken. Then the photos can be used as a baseline to compare with follow-up photos.

For certain types of skin cancer, a complete medical history and a physical exam are needed to find out whether the cancer has spread (metastasized) to other parts of the body. Imaging tests, including positron emission tomography (PET scan), computed tomography (CT scan) or magnetic resonance imaging (MRI), may be used to identify metastases in other parts of the body, such as the lymph nodes, lungs, brain, liver or other organs.

Staging

Melanoma has a complex system of staging that includes:

• The clinical staging system, which uses information gained from the removal of the melanoma and from blood tests and X-rays for any spread of the cancer
• The pathologic staging system, which uses information gained from the removal of the melanoma and from pathological exam after lymph nodes are removed (lymphadenectomy)

Treatments

Surgery

The most common treatment for any type of skin cancer is surgery. The most common way is to numb your skin so that it does not hurt, then cut out the cancer. You will be awake while this is done. That may be all the treatment that you may need for early-stage melanomas that have not spread to other parts of your body and nonmelanomas.

In more advanced stages, melanoma may spread, or metastasize, to other organs and bones, requiring additional treatment such as radiation, chemotherapy or immunotherapy.

Types of surgery for melanoma include:

• Local Excision. This surgery takes out the melanoma and a little of the tissue around it.
• Wide Local Excision. This surgery removes more of the tissue around the melanoma. Lymph nodes may also be removed during this surgery.
• Lymph Node Dissection (lymphadenectomy). This is surgery to remove lymph nodes to see if they have cancer cells. Or this may be done to remove lymph nodes that are cancerous.
• Sentinel Lymph Node Biopsy. This surgery removes the first lymph node that the cancer may have spread to from the tumor. If this lymph node does not have any cancer cells, then you may not need to have more lymph nodes removed.

After your treatment, you will need regular checkups because having skin cancer once means you are more likely to get it again.