Skin Cancer - Squamous Cell & Basal Cell (Non-Melanoma): The Facts

What is it?

Skin Cancer is a disease that begins in any of the layers of the skin. There are three types of Skin Cancer: basal cell carcinoma, squamous cell carcinoma, and melanoma. This handout will deal with the non-melanomas, which are basal cell carcinoma and squamous cell carcinoma. The skin protects the rest of the body from the outside elements, stores water and fat, and produces Vitamin D. The skin has three layers: the outer layer-the epidermis, the middle layer-the dermis, and an underlying layer of fatty connective tissue.

Basal Cell Carcinoma

Basal Cell Carcinoma makes up 75% of all skin cancers. It begins in cells of the lower epidermis known as basal cells. It is a slow growing cancer that rarely spreads to other areas of the body. After treatment, basal cell carcinoma can recur in the same place on the skin.

Squamous Cell Carcinoma

Squamous Cell Carcinomas commonly appear on sun-exposed areas of the body, such as the face, ear, neck, lip, and back of the hands. They begin in upper layers of the epidermis which are composed of Squamous Cells. Squamous Cell Carcinomas tend to be more aggressive than basal cell carcinomas. They are more likely to spread to underlying tissue.

There are several other types of Non-Melanoma Skin Cancer that together account for less than 1% of all Skin Cancers. These include Kaposi's Sarcoma, Cutaneous Lymphoma, skin adnexal tumors, various types of sarcomas, and Merkel Cell Carcinoma. These diseases will not be discussed here. For more information on these types of Cancer, contact the Rhode Island Cancer Council.

Who gets it?

Skin Cancers in general are currently the most common cancer in the United States. As a whole, they account for more than 40% of all cancers. This year, about 1.3 million cases of Non-Melanoma Skin Cancer will be diagnosed. Men develop Non-Melanoma Skin Cancer twice as often as women. About 1,900 people each year are expected to die this year from Non-Melanoma Skin Cancer.

There are several risk factors that have been associated with an increased chance of developing Non-Melanomas. These include:

• Sun Exposure - 90% of People who live in areas where sunlight is intense, such as the tropics, who have fair skin that burns easily or who have had severe, blistering sunburn in their lives, have a much higher risk for developing Skin Cancers. As residents of the "Ocean State," Rhode Island residents often put themselves at risk to the damaging effects of intense sunlight.
  
  
• Tanning booths and UV lamps - These devices make use of ultraviolet (UV) light to tan the skin which places people at very high risk for Skin Cancer. The FDA now classifies these devices as carcinogens, or cancer causing agents.
  
  
• Fair Complexion - People with fair skin and hair and blue or green eyes are at the highest risk. People with dark complexions have a decreased risk of skin cancer, but are not completely safe.
  

How is it Detected?

Symptoms:

Non-Melanoma Skin Cancers can normally be found early. The most common warning sign is a change on the skin, especially a new growth or sore that doesn't heal. Any abnormal area of the skin that does not go away should be reported to your doctor immediately.

Many things that are not cancer can also cause abnormal growths or sores. It is still important to have these areas examined by a doctor so that the actual cause can be determined.

Diagnostic Tests:

• Skin Biopsy - The only way to truly identify a Non-Melanoma is for a doctor to take a biopsy. A biopsy is a small tissue sample that is taken and sent to a lab to be examined under a microscope. The entire lesion or mole is usually removed and sent to the lab if it is suspected of being cancerous. This is done in the doctor's office with a local anesthetic and is normally painless.
  
  
• Fine Needle Aspiration - This is done when a doctor suspects the cancer may have spread to the lymph nodes. A needle is used to draw fluid and cells from nearby lymph nodes.
  
  
• Surgical Lymph Node Biopsy - If after the initial skin biopsy a doctor suspects that the cancer may have spread, then a surgeon may remove some of the surrounding lymph nodes and send them to a lab. This is done to determine if the cancer has spread to the lymphatic system.
  

Is it Curable?

If found and treated early, almost all non-melanoma skin cancers are curable. Unfortunately, some are not detected or treated until they have developed into more serious stages. Very few people die of basal cell carcinomas, but squamous cell carcinoma of the skin is much more deadly and must be treated with considerable skill and care. Regular skin cancer screenings by you and by a doctor can assure that any skin cancers will be found and treated early enough to completely cure them. This type of cancer is curable, but only if it is detected and treated early. Therefore, it is very important to have complete skin exams and to report any suspicious moles to your doctor immediately.

It's easier to prevent cancer than to cure it....

Certain lifestyle habits can greatly reduce your risk of developing Non-Melanoma Skin Cancer. Ninety percent of skin cancers are a result of sun or UV light exposure.

• Avoid excess sun exposure - 90% of skin cancers are a result of sun or UV light exposure. Particularly avoid the sun during its strongest times, 10 a.m.-3 p.m. Be especially careful if you are fair skinned or burn easily. Sun exposure is dangerous year round, not just in the summer!
  
  
• Cover up - Wear a hat and long sleeves if possible when you are going to be exposed to the sun and sunglasses when you are in the sun.
  
  
• Take special care of children - Most Skin Cancers are the results of severe sunburns during childhood.
  
  
• Use sunscreen or sunblock - Use at least SPF 15 anytime you are in the sun. Preferably, sunscreen should be waterproof and applied 15-30 minutes before sun exposure. It should be reapplied every 90 minutes, or more often if you are in the water.
  
  
• Have a complete skin exam every year - Local hospitals and health departments usually offer annual free clinics.
  
  
• Don't smoke.
  

If you found this information helpful, please consider making a donation to the Rhode Island Cancer Council so we may continue adding content to our website and providing valuable services to Rhode Island residents. Please click the Donate icon to the left to make a donation via credit card or your PayPal account.

See also: