Many patients that are referred to Aspire Care Clinic require skin cancer assessments. When skin cancers are suspected, a visual skin check of the area of concern is completed and a small biopsy may be taken and sent to the lab to confirm the presence of a cancer.
Skin cancers are more common in older adults but can also appear in younger adults and in rare cases, even children. Individuals who are most susceptible to skin cancers are ones with fair skin, a family history of skin cancer and having an increased number of moles. Skin cancer is most commonly caused by exposure to ultraviolet radiation (sunlight and tanning beds). There are other risk factors involved including genetic conditions, a history of smoking, HPV, immunosuppression, and long standing skin diseases and scars where the skin’s integrity has been compromised.
The most common types of skin cancers are basal cell carcinoma, squamous cell carcinoma and melanoma. If the biopsy taken of the area confirms a skin cancer, your doctor will excise the remaining cancer cells. This procedure is fairly simple but will require the use of sutures to close the excision. A nurse will go over wound care with you and advise you when to have your sutures removed.
Basal Cell Carcinoma
Basal cell carcinoma, also known as BCC, is the most common form of skin cancer and is rarely life threatening. The main symptoms of BCC involve a slow growing ulcer or nodule that can be skin coloured, pink or pigmented (brown colouring). Basal cell sites can vary in size and are prone to spontaneous bleeding if irritated.
Basal cell carcinomas can be treated with a variety of methods including cryotherapy, skin shaves, excisions or a topical cytoxic cream that is applied directly to the area of concern.
Squamous Cell Carcinoma
Squamous cell carcinoma (SCC) is a common type of keratinocyte cancer. It is formed in the cells within our epidermis that make keratin. Keratin is a protein that makes up skin, hair and nails. This type of skin cancer can be more invasive which means that the cancer cells have grown to below the layer of skin called the epidermis.
Squamous cell carcinomas usually appear as enlarged scaly or crusted lumps and they usually arise from actinic keratosis. The carcinomas can grow over weeks to months and are often tender or painful. They are normally white to yellow in colour and can look like a horn or plaque like surface. These lesions will often become irritated and normally are difficult to heal on their own. Increased sun exposure is a risk factor for both actinic keratosis and squamous cell carcinomas.
Treatments for squamous cell carcinomas can include a skin shave, but more often require an excision of the carcinoma and a small amount of surrounding tissue. The sample is then sent to the lab for further investigation and to determine if there were any remaining cancer cells in the sample. After the procedure, the area is closed with sutures.
Melanoma is a more serious type of skin cancer. It is involves the uncontrolled growth of pigment cells that are also known as melanocytes. This type of cancer is also referred to as malignant melanoma. There is a greater risk of developing melanoma if you have a family history of the cancer or you have had basal cell or squamous cell carcinoma or lots of moles.
At first melanoma can look like an unusual freckle or mole, and can be a few millimeters in diameter or up to several centimetres in size. The colour of melanomas can vary and are known to be tan, dark brown, black, blue, red and sometimes even grey looking. Melanomas will change in colour and you will see different pigments within them. They tend to be asymmetrical with an irregular pattern or border and they will change in size.
Once a sample has been confirmed as melanoma, it is treated by making a wide excision of the site. The size of the excision will depend on the depth and width of the melanoma. These excisions are often quite large as to ensure the entirety of the cancer has been removed. You can expect sutures to be put into place to close your wound. Routine skin checks and follow ups will be continued with your doctor at Aspire Care Clinic after your procedure.