The three most common skin cancer types are basal cell carcinoma, squamous cell carcinoma, and melanoma.
If caught early, these can be curable by surgery alone. If caught too late, some skin cancers can be disfiguring or life-threatening.
Basal Cell Carcinoma (BCC) is the most common skin cancer, with over 2 million cases diagnosed in the United States every year. Although BCC often arises in patients with fair skin, it can develop in people of all skin types and colors. BCC usually arises in sun-exposed areas, but can occur anywhere on the skin, including the genital region. While it is slowly growing, if left untreated it can become deeply invasive and locally destructive.
BCC can have a variety of appearances. It may appear as a painless, raised, shiny area of skin with small blood vessels or a raised area with ulceration. It may also look like a waxy lump, a transparent bump, or a small pink growth with a rolled edge and a crusted indentation. It can also be pigmented, scar-like, or an open sore that does not heal.
While a regular physical or checkup can help you spot problems early, you can look for signs on your own as well. These include:
While BCC often appears on the areas of your skin that receive the most direct sunlight, that’s not always the case. Our team can help you identify symptoms and diagnose BCC anywhere on your body. BCC is also very treatable, which means you have plenty of treatment options to choose from. Early diagnosis and the right treatment are the best ways to ensure you don’t experience any severe problems from BCC. No matter the size of your skin cancer, we will be here to guide you and provide the best treatments available.
Squamous cell carcinoma (SCC) was long thought to be the second most common skin cancer, but it now appears to be nearly as common as BCC. SCC is more serious than BCC because, if left untreated, it can spread and become life-threatening. However, if diagnosed and treated early, SCC is easily treatable and highly curable.
SCC can also have a variety of appearances. It may look like a rough red patch, an open sore that won’t heal, a brown scaly patch, or a growth raised above the surface of the skin. SCC can appear anywhere, including in non-sun-exposed areas and even beneath the nails. No matter what, early diagnosis and treatment are essential. Treatment is most effective when the diagnosis is made early.
Small, low risk SCCs may be treated with topical creams, local destruction or excision. High risk SCCs, which have more risk factors for recurrence, are more likely to be treated with Mohs micrographic surgery to increase the probability of cure. There are new genetic tests that can be done when a SCC is diagnosed to predict its level of risk. There are also new treatments available for skin cancers that are unlikely to be successfully treated with surgery or radiation.
While a history of excessive exposure to sunlight plays a role in developing all skin cancers, there is sometimes a genetic predisposition to developing melanoma, which sometimes runs in families. Patients with a previous or family history of melanoma, or who have many moles, or atypical/dysplastic moles, are at greater risk for developing melanoma.
The first sign of melanoma is often a change in the shape, color, size, or thickness of an existing mole, but melanomas can also appear as new moles. The only way to diagnose melanoma is to perform a biopsy. Melanomas can vary greatly in how they look, but the following “ABCDE” features can be helpful in diagnosing them:
While some melanomas may have all the ABCDE features, others may only have one or two, or even lack pigment, presenting as a pink patch. In more advanced cases, the surface of the lesion may ooze or bleed, become hard or lumpy, or even itchy, tender or painful. As with non-melanoma skin cancers, when caught early, melanoma can be curable by surgery alone, but if caught too late, it can be life-threatening.
Skin cancers arise due to mutations in our DNA, whether in skin cells (in squamous cell carcinoma) or in pigment cells (in melanoma). These mutations direct damaged cells to multiply and form cancerous tumors. If caught early, skin cancers are usually treated successfully. If not, they can become disfiguring or can spread to other areas of the body, becoming life threatening.
Genomic testing is not the same as genetic testing. While genetic tests are designed to identify a single genetic mutation, such as BRCA1 or BRCA2 for breast cancer, genomic tests evaluate multiple mutations. Dr. Ratner uses genomic testing to assess the risk profile of certain squamous cell carcinomas and melanomas, helping her to predict their risk of recurrence and/or spread.
The DecisionDx-SCC test measures the biological activity of specific genes in your squamous cell carcinoma to predict the likelihood that it will metastasize within three years of testing. Test samples are taken from the original biopsy. No additional procedures are required. The test classifies the tumor as being at low, moderate or high biological risk of spread. Dr. Ratner uses these results to personalize and guide her patients’ treatment and follow-up.
DecisionDx-SCC is not appropriate for all patients with SCC. Dr. Ratner determines whether testing is appropriate based on the risk factors of each patient and their tumor. Risk factors include immunosuppression, large size, deep invasion, head and neck location, rapid growth, poorly defined borders, poor differentiation, history of previous treatment or a history of radiation. Test results are used in combination with other clinical information and laboratory data to determine optimal management. Treatment and follow up care can then be tailored, as in recommending watchful waiting by a patient’s dermatologist as opposed to multidisciplinary evaluation and management with more frequent follow-up.
Decision Dx-Melanoma testing measures the biological activity of specific genes in your melanoma to predict the likelihood of metastasis within three years of testing. Test samples are taken from the original biopsy. No additional procedures are required. The test classifies the tumor as being at low, moderate or high biological risk of spread. Dr. Ratner uses these results to personalize and guide her patients’ treatment and follow-up.
Dr. Ratner determines whether DecisionDx-Melanoma testing is required based on the clinical and histologic risk profile of her patients with melanoma. Using the genetic information within a patient’s tumor and incorporating traditional clinicopathologic features, DecisionDx-Melanoma testing helps provide personalized results regarding risk of recurrence and/or metastasis and likelihood of sentinel lymph node positivity. This test can be used to guide risk-aligned management decisions for properly selected patients, helping to improve prognostic accuracy and positively impact outcomes, which is associated with improved survival.
Whatever treatment you need, Désirée Ratner, M.D., P.C., can help. Please reach out to us today at (212) 814-5884 to discuss your skin cancer situation and treatment options. We look forward to speaking with you.
Désirée Ratner, M.D., P.C.
115 East 61st Street, 9th Floor
New York, NY 10065
Phone:
(212) 814-5884
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