What's Vital When It Comes To Identifying Skin Cancer

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There was a spot on my right nostril that didn’t go away. It felt different than a pimple or a blemish. I inherited my pale skin from my mother, who had numerous skin cancer surgeries as a result of her long days in the sun as a competitive golfer. I also had numerous painful sunburns as a child, which is a risk factor and why I schedule annual full-body skin checks by a dermatologist who specializes in detecting skin cancer. Still, I made an early appointment to point out the hard bump on my nostril.

The doctor took a biopsy. It came back positive for basal cell carcinoma (BCC), which is “the most common form of skin cancer,” says Dr. Maral Kibarian Skelsey, a clinical professor of dermatology at Georgetown University and a spokesperson for the Skin Cancer Foundation.

Approximately 3.6 million cases of BCC are diagnosed in the U.S. yearly.

What is Basal Cell Carcinoma?

“BCCs form within the skin’s basal cells, which line the deepest part of the epidermis, the outermost layer of the skin,” Dr. Skelsey explains.

They grow slowly but have been rising steadily in the U.S. Most are the result of DNA damage from the sun’s ultraviolet radiation or from indoor tanning.

What Does BCC Look Like?

Not all skin cancers have the same appearance. What’s most important is that “you examine your skin for anything new, changing or unusual,” explains Dr. Skelsey.

Her advice is to look for these identifying traits:

· An open sore that doesn’t heal or returns.

· Bleeding, oozing or crusting.

· A reddish patch or irritated area.

· A shiny bump or nodule that is pearly, clear, pink, red or white, although they can also be tan, black or brown, especially in people of color.

BCCs can be mistaken for normal moles, but not all moles are BCCs. “If you see anything new, changing or unusual on your skin, make an appointment with a dermatologist right away,” says Dr. Skelsey. The Skin Cancer Foundation recommends examining your own skin once a month and scheduling annual skin exams with a board-certified dermatologist. Once you have a history of BCCs, a dermatologist might suggest biannual checkups.

How Do You Treat BCCs?

First, your dermatologist will examine your skin with a magnifying glass to identify anything suspicious. If a biopsy is needed, the doctor will remove a small sample to diagnose a lesion or mole. The biopsy is performed quickly under local anesthesia.

Results usually come back in less than a week; if they’re positive, the doctor will outline your treatment options.

“Mohs micrographic surgery is the most effective technique for treatment of BCCs with a cure rate of 99%,” says Dr. Skelsey. Mohs is usually recommended for large or rapidly growing spots, as well as for cosmetic regions on the face, ears or fingers. A surgeon removes a small slice of skin with a scalpel, which undergoes lab analysis. If it’s free of cancer cells, the procedure ends. Otherwise, the surgeon removes additional layers of skin until the analysis is clear of cancer cells. The surgeon then does a final wound repair.

Other forms of treatment are excisional surgery, curettage and electrodesiccation, radiation therapy and topical therapy. “It’s important to talk to your dermatologist to determine what course of action is right for you,” says Dr. Skelsey.

I had Mohs surgery for the nodule on my nostril, which was on a noticeable location. After the biopsy, a surgeon took a skin graft from my ear to make my Mohs surgery invisible. Now, no one can see it, not even me.

My next two BCCs, both identified through self-examination, were recognized very early and were more superficial than my first one. After the biopsy, my dermatologist conducted curettage and electrodesiccation (also known as electrosurgery). The Skin Cancer Foundation describes it as “scraping or shaving off the BCC using a sharp instrument with a ring-shaped tip, then using heat or a chemical agent to destroy remaining cancer cells.” This procedure has a 95% cure rate. If BCCs return, Mohs surgery is often advised.

The electrosurgery procedures were successful, requiring one office visit and a week of daily home care, applying Vaseline and a bandage to promote healing and prevent infection. My Mohs surgery left no visible scars, but it was a longer procedure with more follow-up visits.

Regular Self-Checks Are Vital

“When detected early, most BCCs are treatable,” says Dr. Skelsey. Melanoma, however, is less common than BCC and more dangerous as it can metastasize (spread).

My BCC was my third in two years. I noticed all of them before I saw my dermatologist. Like breast self-exams, it’s essential for everyone to check their skin on a regular basis at home, with the assistance of a partner who can examine your back.

Although monthly self-exams are advisable, I check more often. I’m not a doctor, but I know my skin and can notice something new or if something has changed and appears suspicious. My Mohs surgeon’s parting advice was to wear sunscreen every day. I leave a bottle near my front door so I never forget.

 
Have any of you ever had skin cancer? How did you identify it? Let us know in the comments below.