Skin Cancer

Skin Cancer – UC Irvine – Orange County, CA

Skin cancer is the most common form of cancer in the United States and the entire world. According to the National Cancer Institute, it is estimated that more than 2 million NEW cases of skin cancer will be diagnosed in the United States this year alone. Although less than 1,000 of these cases will result in deaths, the incidence of skin cancer is rising faster than any other type of cancer. Skin cancer most commonly occurs on the head and neck area, but it can occur anywhere on the body. Skin cancer is NOT strictly a cosmetic issue. Even benign forms of skin cancer should be considered dangerous and treated immediately.

Types of Skin Cancer:

There are different types of skin cancer, each with their own distinct set of characteristics. The type of skin cancer directly correlates to the treatment plan administered by our board certified head and neck specialists.

- Basal Cell Carcinoma

The most common type of skin cancer, basal cell carcinoma classically looks like a flesh colored (red/brown) small raised bump with “pearly” appearance. It is often described as a pimple or sore that bleeds or scales and persists. These are most commonly seen in areas of the skin that have been exposed to excess sunlight. Basal cell carcinoma can spread to the surrounding skin but are unlikely to spread to other parts of the body.

- Squamous Cell Carcinoma

Squamous cell carcinoma is also commonly seen on the areas of the body that have been exposed to excessive sun, but can also occur inside the mouth or on the genitals. Other risk factors for squamous cell carcinoma include: burns, radiation exposure, or chemical exposure. Most commonly seen on or around the nose, forehead region, lower lip, and hands, squamous cell carcinoma has a unique appearance often described as a red bump or ulcer that persists. Unlike Basal Cell Carcinoma, squamous cell carcinomas can spread to the areas lymph nodes. Early diagnosis and treatment is imperative as this form of cancer can prove to be deadly.

- Malignant Melanoma

Arguably the most commonly discussed type of skin cancer is Melanoma. This form of skin cancer arises from skin cells called melanocytes. It is a very harmful type of skin cancer that is able to spread to other areas of the body. Melanoma often appears as a mole; a dark, pigmented lesion with unique characteristics such as an irregular shape, border, and multiple colors. As with many forms of cancer, the key to ensuring a better prognosis is early diagnosis and treatment. Our highly experienced Head and Neck Cancer specialists advise patients to know where they have moles on their skin. This will help spot an irregular mole in an irregular location early on which leads to a more favorable prognosis if it is diagnosed as skin cancer and treated.

Signs and Symptoms of Skin Cancer:

Different types of skin cancer present with unique, distinct characteristics in most cases, but even the same type of skin cancer can present differently in different people. In general, you should consider any change to your skin, especially a skin growth (something growing on the skin) that persists for longer than 2 weeks, to be a warning sign of skin cancer. If you are in Orange County and you notice a skin growth on your face, head, or neck with any of the following potential signs of skin cancer, you should immediately consult one of our Board Certified Head and Neck Cancer Specialists:

• Bleeding
• Itching
• Change in shape
• Change in size

These are classic signs of skin cancer that should not be ignored. When skin cancer is diagnosed and treated early on its course, it has a high cure rate.

Skin Cancer Diagnosis at UC-Irvine:

Early diagnosis is a key factor in skin cancer prognosis. At UC-Irvine’s highly regarded Head and Neck Department, diagnosis of skin cancer often begins with a thorough medical history followed by a physical examination targeting the area of the skin where signs of cancer are presenting. Any growths, moles, or dry patches will be examined and discussed. If skin cancer is suspected following the history and physical examination, a biopsy will be taken for further lab investigation. A biopsy is a quick, safe, and easy diagnostic test where a sample of the indicated tissue is removed after the area is numbed. A biopsy is required for a more accurate diagnosis of skin cancer.

Skin Cancer Treatment at UC-Irvine:

If the biopsy results are positive and a diagnosis of skin cancer is made, a treatment plan will be devised based on the type and severity of the skin cancer, as well as the patient’s overall health. The goal when treating skin cancer is to remove all of the cancer. In patients whose cancer has NOT spread, this can often be achieved through surgical excision utilizing one, or more, of several techniques:

• Surgical Excision: As the name suggests, surgical excision involves cutting out the skin cancer as well as the normal looking margin. This is most often an outpatient procedure performed under local anesthesia.
• Mohs Surgery: Mohs surgery involves removing the visible part of the skin cancer as well as normal looking surrounding tissue layers which may also contain cancer cells. This is performed one layer at a time, with each layer being microscopically examined for the presence of cancer cells. If cancer cells are present, the surgeon removes another layer of skin. This process continues until a removed skin layer has no cancer cells present. Succesful Mohs surgery correlates with a high cure rate.
• Curettage and electrodesiccation: This technique is most commonly used for smaller basal or squamous cell cancers. The cancer is scraped with a long surgical instrument called a curette. An electric needle is then used to cauterize any remaining cancer cells. This process is performed multiple times to ensure complete removal of the cancer.  

Non-Surgical Treatment Options for Skin Cancer:

Surgical treatment for skin cancer may not always be indicated. If a patient cannot undergo surgery, the cancer cannot be completely removed through surgery, or the cancer was caught very early on, non-surgical treatment options will be explored.

• Immunotherapy: A topical cream (such as imiquimod) is applied to the affected skin under the instructions of one of our Board Certified Head and Neck Cancer Specialists to stimulate the body’s natural immune response to fight cancer cells.
• Cryosurgery: A unique treatment option where the affected skin area is frozen. Freezing the area causes the skin and cancer cells to slough off.
• Chemotherapy: Chemotherapy can be applied topically to the affected skin in the form of the medication 5-fluorouracil (5-FU). This destroys the affected skin cells causing new skin cells to regenerate after the healing process. Chemotherapy can also be given orally or intravenously (IV) in which case it will travel through the body and kill cancer cells.
• Radiation therapy: Radiation treatment is more commonly seen in older patients who have skin cancer over a large area that cannot be removed surgically. Through multiple radiation treatment sessions, cancer cells get destroyed.