Skin Cancer

Your skin is your body’s largest organ. It has many functions. The most important one is keeping germs and harmful substances out of your body. Your skin has three layers: 

  • Epidermis, the outside layer, that acts as a barrier
  • Dermis, that contains hair follicles, sweat glands and connective tissue
  • Hypodermis, the deepest layer, made of fat and connective tissue

Skin cancer begins in the epidermis, which is made up of three kinds of cells:

  • Squamous cells: Thin, flat cells that form the top layer
  • Basal cells: Round cells under the squamous cells
  • Melanocytes: Cells that make pigment that gives the skin its color. When skin is exposed to the sun, these cells make more pigment, darkening the skin.

Skin cancer is the most common kind of cancer. It affects millions of Americans each year. The most common kinds of skin cancer are basal cell carcinoma (BCC), and cutaneous squamous cell carcinoma (cSCC). Both kinds are usually slow growing and easily treated with surgery.

Basal cell carcinoma is the most common kind of skin cancer. It rarely spreads to nearby lymph nodes or other organs. Squamous cell carcinoma is not quite as common, but is more likely to spread.
 
Another kind of skin cancer is melanoma. It affects melanocytes. It’s more serious but is not as common as BCC or cSCC. It is much more likely to spread. In fact, its rate of spread to lymph nodes is up to 40 percent. About 75 percent of skin cancer deaths are from melanoma.

The most common cause of skin cancer is ultraviolet (UV) radiation. The most common source of UV radiation is sun exposure. That’s why it’s a good idea to wear sunscreen and protect your skin from the sun.

Some diseases can increase your risk for skin cancer. For instance, human papilloma virus (HPV), which causes warts, can lead to cSCC. Burns and other wounds can lead to cSCC as well. If you’ve had an organ transplant, you may be at increased risk. That’s because your immune system must be suppressed to keep it from rejecting the organ.

Treatment

The main treatment for skin cancer is usually surgery. When surgeons remove the tumor, they may also remove nearby lymph nodes (called the “sentinel” lymph nodes) to see whether the cancer has spread to them. If these lymph nodes contain cancer cells, other lymph nodes may need to be removed.

If the skin cancer is near the throat, your throat may need reconstruction. You may also need a skin graft using tissue from elsewhere in your body.

Your doctors may recommend radiation treatment or chemotherapy along with surgery. In some cases, radiation is used instead of surgery. Radiation as the main treatment can only be done once.

Side Effects of Treatment 

Your doctor will talk to you about possible side effects.

Side effects of surgery can include:

  • Risk of anesthesia
  • Infection
  • Bleeding
  • Pain
  • Scars and other cosmetic damage

Side effects of radiation depend on where the cancer is, and can include:

  • Skin redness, blistering or peeling
  • Changes in skin color
  • Hair loss in the area being treated
  • Damage to glands and teeth if the cancer is nearby

Side Effects of Chemotherapy

The most common drugs used to treat skin cancer are called cisplatin and cetuximab. Sometimes other drugs are used, which may have different side effects. If side effects are severe, talk to your doctor right away.

The most common side effects for cetuximab include:

  • Diarrhea
  • Headache
  • Weight loss
  • Constipation
  • Nail changes
  • Stomach upset
  • Nausea, vomiting
  • Changes in skin like acne, cracks, skin dryness

The most common side effects of cisplatin are:

  • Nausea and vomiting 
  • Diarrhea 
  • Temporary hair loss
  • Loss in ability to taste food
  • Hiccups
  • Dry mouth
  • Dark urine 
  • Decreased sweating 
  • Dry skin
  • Dehydration

Your Future

If you follow the recommended treatment for early-stage skin cancer, you will most likely fully recover. Your chance for long-term survival is excellent. 

Higher stage cSCC and melanoma skin cancer patients have lower survival rates. BCC that has spread can decrease your quality of life, but most people who are treated have a normal life span.

Keep in mind that life span and quality of life after skin cancer depends on your age, health and other factors. Your doctor will talk to you about what to expect and how to care for yourself after treatment.
 

Care Team

You may see one or more of the following specialists for your cancer treatment.
Bryan Anderson, MD Bryan Anderson, MD Dermatologist View Researcher Profile
Elizabeth Billingsley, MD Elizabeth Billingsley, MD Dermatologist View Researcher Profile
Joseph Drabick, MD, FACP Joseph Drabick, MD, FACP Hematologist/Oncologist View Researcher Profile
Diane Hershock, MD, PhD Diane Hershock, MD, PhD Medical Oncologist View Researcher Profile
Heath Mackley, MD, FACRO Heath Mackley, MD, FACRO Radiation Oncologist View Researcher Profile
James Marks, MD James Marks, MD Dermatologist View Researcher Profile
Rogerio Neves, MD, PhD Rogerio Neves, MD, PhD Surgeon View Researcher Profile
Colette R. Pameijer, MD Colette R. Pameijer, MD Surgeon View Researcher Profile
Marc Rovito, MD Marc Rovito, MD Hematologist/Oncologist View Researcher Profile
Christie Travelute, MD Christie Travelute, MD Dermatologist View Researcher Profile
Henry Wagner Jr., MD Henry Wagner Jr., MD Radiologist View Researcher Profile
Amanda Cooper, MD Amanda Cooper, MD View Researcher Profile

Locations

Penn State Cancer Institute

Penn State Cancer Institute

400 University Dr
Hershey, PA 17033

Phone: 717-531-6585

Clinical Trials

A Multicenter, Randomized, Double-blind, Vehicle-controlled, Phase 3 Efficacy and Safety Study of Patidegib Topical Gel, 2%, for the Reduction of Disease Burden of Persistently Developing Basal Cell Carcinomas (BCCs) in Subjects with Basal Cell Nevus Syndrome

Groups, Classes and Support

Support groups offer an opportunity to connect with other patients, caregivers and families. Learn more about support groups offered at Penn State Cancer Institute.

Other Resources

To find out more about non-melanoma skin cancer (including cSCC and BCC), visit:

To find out more about melanoma, visit The American Head and Neck Society.

Prevention and Screening

The best way to prevent skin cancer is to protect your skin from the sun. Use sunscreen with a sun protection factor (SPF) of at least 15 when you go outside, even if it’s cloudy. Seek shelter in the shade, and don’t use tanning beds or sunlamps. Even if you tan easily, you’re still increasing your risk. If you have fair skin, your risk is even higher.

It can be hard to detect skin cancer. Look for: 

  • Thick, raised or rough skin that seems to spread
  • Dark brown or black lesions, or different colors within a lesion
  • Irregular or indistinct borders
  • Moles that change size or shape

Have your doctor check any lesions, moles or changes on your skin. It’s a good idea to have your skin checked by a doctor every year.

Symptoms and Diagnosis

Skin cancer is usually a result of too much sun exposure. Skin cancer is the most common form of cancer. Many types of skin cancer are both preventable and treatable. 

Symptoms

If you or your primary care doctor thinks you might have skin cancer, you should see a dermatologist, a doctor who specializes in the skin. The dermatologist will talk to you about your family and health history, and will check your skin for signs of cancer. He or she might check any lesions with a microscope while they’re still on your body. This test is called a dermoscopy.

If the dermatologist thinks you have skin cancer, he or she will take a skin sample for biopsy. The sample will go to a lab to be checked for cancer and to see how deep it is.

For skin cancers that have spread to lymph nodes, you’ll need imaging to see how far it has spread. The type of imaging will depend on the stage of cancer and where it is. Some common types include:

  • Computed tomography (CT scan or CAT scan), using special X-rays to create detailed, three-dimensional (3-D) images
  • Magnetic resonance imaging (MRI), using magnetic fields and radio waves to create detailed images
  • MRI of the brain, for more advanced skin cancer, to check for spread to the brain
  • Positron emission tomography (PET) scan, which is often along with a CT scan, using a special camera and medicine called a tracer

These tests and imaging methods are used to diagnose skin cancer and to stage it. Staging means finding out how much cancer is in your body and how far it has spread. It’s a way of describing how severe the cancer is, so doctors can decide how to treat it. The stages range from 0 to 4. Stage 0 means cancer cells are only in the top layer of the epidermis. Stage 4 means the cancer has spread to distant organs, such as the brain, lungs or liver. 

Skin Cancer

Your skin is your body’s largest organ. It has many functions. The most important one is keeping germs and harmful substances out of your body. Your skin has three layers: 

  • Epidermis, the outside layer, that acts as a barrier
  • Dermis, that contains hair follicles, sweat glands and connective tissue
  • Hypodermis, the deepest layer, made of fat and connective tissue

Skin cancer begins in the epidermis, which is made up of three kinds of cells:

  • Squamous cells: Thin, flat cells that form the top layer
  • Basal cells: Round cells under the squamous cells
  • Melanocytes: Cells that make pigment that gives the skin its color. When skin is exposed to the sun, these cells make more pigment, darkening the skin.

Skin cancer is the most common kind of cancer. It affects millions of Americans each year. The most common kinds of skin cancer are basal cell carcinoma (BCC), and cutaneous squamous cell carcinoma (cSCC). Both kinds are usually slow growing and easily treated with surgery.

Basal cell carcinoma is the most common kind of skin cancer. It rarely spreads to nearby lymph nodes or other organs. Squamous cell carcinoma is not quite as common, but is more likely to spread.
 
Another kind of skin cancer is melanoma. It affects melanocytes. It’s more serious but is not as common as BCC or cSCC. It is much more likely to spread. In fact, its rate of spread to lymph nodes is up to 40 percent. About 75 percent of skin cancer deaths are from melanoma.

The most common cause of skin cancer is ultraviolet (UV) radiation. The most common source of UV radiation is sun exposure. That’s why it’s a good idea to wear sunscreen and protect your skin from the sun.

Some diseases can increase your risk for skin cancer. For instance, human papilloma virus (HPV), which causes warts, can lead to cSCC. Burns and other wounds can lead to cSCC as well. If you’ve had an organ transplant, you may be at increased risk. That’s because your immune system must be suppressed to keep it from rejecting the organ.

The main treatment for skin cancer is usually surgery. When surgeons remove the tumor, they may also remove nearby lymph nodes (called the “sentinel” lymph nodes) to see whether the cancer has spread to them. If these lymph nodes contain cancer cells, other lymph nodes may need to be removed.

If the skin cancer is near the throat, your throat may need reconstruction. You may also need a skin graft using tissue from elsewhere in your body.

Your doctors may recommend radiation treatment or chemotherapy along with surgery. In some cases, radiation is used instead of surgery. Radiation as the main treatment can only be done once.

Side Effects of Treatment 

Your doctor will talk to you about possible side effects.

Side effects of surgery can include:

  • Risk of anesthesia
  • Infection
  • Bleeding
  • Pain
  • Scars and other cosmetic damage

Side effects of radiation depend on where the cancer is, and can include:

  • Skin redness, blistering or peeling
  • Changes in skin color
  • Hair loss in the area being treated
  • Damage to glands and teeth if the cancer is nearby

Side Effects of Chemotherapy

The most common drugs used to treat skin cancer are called cisplatin and cetuximab. Sometimes other drugs are used, which may have different side effects. If side effects are severe, talk to your doctor right away.

The most common side effects for cetuximab include:

  • Diarrhea
  • Headache
  • Weight loss
  • Constipation
  • Nail changes
  • Stomach upset
  • Nausea, vomiting
  • Changes in skin like acne, cracks, skin dryness

The most common side effects of cisplatin are:

  • Nausea and vomiting 
  • Diarrhea 
  • Temporary hair loss
  • Loss in ability to taste food
  • Hiccups
  • Dry mouth
  • Dark urine 
  • Decreased sweating 
  • Dry skin
  • Dehydration

Your Future

If you follow the recommended treatment for early-stage skin cancer, you will most likely fully recover. Your chance for long-term survival is excellent. 

Higher stage cSCC and melanoma skin cancer patients have lower survival rates. BCC that has spread can decrease your quality of life, but most people who are treated have a normal life span.

Keep in mind that life span and quality of life after skin cancer depends on your age, health and other factors. Your doctor will talk to you about what to expect and how to care for yourself after treatment.
 

You may see one or more of the following specialists for your cancer treatment.
Bryan Anderson, MD Bryan Anderson, MD Dermatologist View Researcher Profile
Elizabeth Billingsley, MD Elizabeth Billingsley, MD Dermatologist View Researcher Profile
Joseph Drabick, MD, FACP Joseph Drabick, MD, FACP Hematologist/Oncologist View Researcher Profile
Diane Hershock, MD, PhD Diane Hershock, MD, PhD Medical Oncologist View Researcher Profile
Heath Mackley, MD, FACRO Heath Mackley, MD, FACRO Radiation Oncologist View Researcher Profile
James Marks, MD James Marks, MD Dermatologist View Researcher Profile
Rogerio Neves, MD, PhD Rogerio Neves, MD, PhD Surgeon View Researcher Profile
Colette R. Pameijer, MD Colette R. Pameijer, MD Surgeon View Researcher Profile
Marc Rovito, MD Marc Rovito, MD Hematologist/Oncologist View Researcher Profile
Christie Travelute, MD Christie Travelute, MD Dermatologist View Researcher Profile
Henry Wagner Jr., MD Henry Wagner Jr., MD Radiologist View Researcher Profile
Amanda Cooper, MD Amanda Cooper, MD View Researcher Profile
Penn State Cancer Institute

Penn State Cancer Institute

400 University Dr
Hershey, PA 17033

Phone: 717-531-6585
A Multicenter, Randomized, Double-blind, Vehicle-controlled, Phase 3 Efficacy and Safety Study of Patidegib Topical Gel, 2%, for the Reduction of Disease Burden of Persistently Developing Basal Cell Carcinomas (BCCs) in Subjects with Basal Cell Nevus Syndrome

Support groups offer an opportunity to connect with other patients, caregivers and families. Learn more about support groups offered at Penn State Cancer Institute.

Other Resources

To find out more about non-melanoma skin cancer (including cSCC and BCC), visit:

To find out more about melanoma, visit The American Head and Neck Society.

The best way to prevent skin cancer is to protect your skin from the sun. Use sunscreen with a sun protection factor (SPF) of at least 15 when you go outside, even if it’s cloudy. Seek shelter in the shade, and don’t use tanning beds or sunlamps. Even if you tan easily, you’re still increasing your risk. If you have fair skin, your risk is even higher.

It can be hard to detect skin cancer. Look for: 

  • Thick, raised or rough skin that seems to spread
  • Dark brown or black lesions, or different colors within a lesion
  • Irregular or indistinct borders
  • Moles that change size or shape

Have your doctor check any lesions, moles or changes on your skin. It’s a good idea to have your skin checked by a doctor every year.

Skin cancer is usually a result of too much sun exposure. Skin cancer is the most common form of cancer. Many types of skin cancer are both preventable and treatable. 

Symptoms

If you or your primary care doctor thinks you might have skin cancer, you should see a dermatologist, a doctor who specializes in the skin. The dermatologist will talk to you about your family and health history, and will check your skin for signs of cancer. He or she might check any lesions with a microscope while they’re still on your body. This test is called a dermoscopy.

If the dermatologist thinks you have skin cancer, he or she will take a skin sample for biopsy. The sample will go to a lab to be checked for cancer and to see how deep it is.

For skin cancers that have spread to lymph nodes, you’ll need imaging to see how far it has spread. The type of imaging will depend on the stage of cancer and where it is. Some common types include:

  • Computed tomography (CT scan or CAT scan), using special X-rays to create detailed, three-dimensional (3-D) images
  • Magnetic resonance imaging (MRI), using magnetic fields and radio waves to create detailed images
  • MRI of the brain, for more advanced skin cancer, to check for spread to the brain
  • Positron emission tomography (PET) scan, which is often along with a CT scan, using a special camera and medicine called a tracer

These tests and imaging methods are used to diagnose skin cancer and to stage it. Staging means finding out how much cancer is in your body and how far it has spread. It’s a way of describing how severe the cancer is, so doctors can decide how to treat it. The stages range from 0 to 4. Stage 0 means cancer cells are only in the top layer of the epidermis. Stage 4 means the cancer has spread to distant organs, such as the brain, lungs or liver.