Skin Cancer: Key Q&A

Reviewed By:
Martin E. Liebling, M.D., FACP

What is the difference between melanoma and non-melanoma skin cancer?
There are several important differences between these two types of skin cancer. Non-melanoma skin cancer is far more common and less dangerous than melanoma skin cancer. Non-melanoma skin cancers develop in more than a million people each year, and the number of cases is rising. Most non-melanoma skin cancers can be treated with simple removal. When detected early, these cancers have a high cure rate.

Melanoma accounts for only 4 percent of all of the diagnosed skin cancers. However, it is the deadlier of the two cancers and accounts for more than 75 percent of skin-cancer-related deaths each year. It can spread to other areas of the body if left untreated. But, as with non-melanoma skin cancer, it is highly curable when treated in the early stages.

How will I know if I need medical attention for a skin growth?
With some education and training, you can learn to detect suspicious areas on your skin. The most important warning sign is a growth that changes in size, shape, texture or color. Some of the more common signs of melanoma are a mole that has an irregular border, becomes darker or discolored, or increases in size. In some cases, the growth may become scaly or itch. If you notice these changes, you should immediately have the area evaluated by a dermatologist (a doctor who specializes in skin conditions). It is important to remember that many skin changes do not indicate cancer. A qualified doctor can determine if your growth is cancer or a less-serious skin condition.

How will a doctor determine whether I have skin cancer?
To diagnose cancer, your doctor will perform a biopsy. An incisional or excisional biopsy is usually recommended to remove suspected melanomas. An incisional biopsy removes a portion of the tumor, whereas an excisional biopsy removes the entire tumor. A pathologist will examine the tissue under a microscope to determine whether cancer is present. A biopsy is the only definitive way to diagnose cancer. It can determine the type of cancer as well as the stage (how far the cancer has spread). Based on the biopsy, your doctor will be able to plan necessary treatment for your cancer.

How will my treatment be determined?
A number of factors will help your doctors determine the best treatment for your skin cancer. If it is non-melanoma, treatment typically involves removal of the growth through simple excision, freezing or burning of the tissue. For melanoma, the treatment may be more involved. The growth will be removed to help keep the cancer from spreading. If the cancer has already spread, you may need additional treatment, involving chemotherapy, radiation therapy or biological therapy. Your treatment will depend on the type and size of cancer, as well as other factors.

Am I at greater risk for skin cancer in the future?
It is even more important for you to protect yourself from the sun once you have been diagnosed with skin cancer. The areas that have been treated may be more sensitive to the sun, and you may be more susceptible to further skin damage. Everyone should take preventive measures against skin cancer. The Occupational Safety and Health Administration (OSHA) recommends wearing protective clothing in the sun, using sunscreen regularly and avoiding exposure during peak midday hours. In addition, some medications can increase your sensitivity to sunlight. If you are taking such a medication, you are at greater risk for sunburn and other skin damage. You should consult with a doctor about your medications and sun sensitivity.

Are indoor tanning beds safer than tanning in the sun?
Exposure to all forms of UV rays increases your risk of skin cancer. UV light occurs naturally in sunlight and is associated with suntans and sunburns. In tanning booths and beds, artificial UV lights are used. These lights have effects on the skin that are similar to natural sunlight, and they are not considered to be a safer method of tanning. The research on whether indoor tanning is related to melanoma is inconsistent. However, most health-care professionals believe that any unprotected exposure to UV rays increases your risk of skin cancer.

How often should I be screened by a doctor for skin cancer?
Routine examinations by a doctor qualified to diagnose skin cancer are important for those with a low or normal risk, and even more so for those with an increased risk of developing melanoma. If you are between age 20 and 39, you should schedule a full-body screening by a dermatologist every three years. If you are 40 or older, you should be examined annually. For individuals who have been diagnosed with skin cancer, it is best to follow your doctor's recommendations for follow-up care. In addition, you should conduct monthly self-examinations between your scheduled doctor's exams. If you notice any skin abnormalities, particularly those that are associated with skin cancer, you should be seen immediately by your dermatologist.