Skin Cancer (Non-Melanoma)

There are several types of skin cancer. Skin cancer that forms in melanocytes (skin cells that make pigment) is called melanoma. Skin cancer that forms in the lower part of the epidermis (the outer layer of the skin) is called basal cell carcinoma. Skin cancer that forms in squamous cells (flat cells that form the surface of the skin) is called squamous cell carcinoma. Skin cancer that forms in neuroendocrine cells (cells that release hormones in response to signals from the nervous system) is called neuroendocrine carcinoma of the skin. Most skin cancers form in older people on parts of the body exposed to the sun or in people who have weakened immune systems.

 

Basal cell carcinoma

 

Basal cell carcinoma is the most common type of skin cancer. It usually occurs on areas of the skin that have been in the sun, most often the nose. Often this cancer appears as a small raised bump that has a smooth, pearly appearance. Another type looks like a scar and is flat and firm to the touch. Basal cell carcinoma may spread to tissues around the cancer, but it usually does not spread to other parts of the body.

 

Squamous cell carcinoma

 

Squamous cell carcinoma occurs on areas of the skin that have been in the sun, such as the ears, lower lip, and the back of the hands. Squamous cell carcinoma may also appear on areas of the skin that have been burned or exposed to chemicals or radiation. Often this cancer appears as a firm red bump. Sometimes the tumor may feel scaly or bleed or develop a crust. Squamous cell tumors may spread to nearby lymph nodes.

 

Stages of Non-melanoma Skin Cancer:

 

Stage 0 (Carcinoma in Situ): In stage 0, abnormal cells are found in the squamous cell or basal cell layer of the epidermis (topmost layer of the skin). These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.

Stage I: In stage I, cancer has formed. The tumor is 2 centimeters or smaller at its widest point and may have one high-risk feature.

Stage II: In stage II, the tumor is either:

  • larger than 2 centimeters at its widest point; or
  • any size and has two or more high-risk features.

Stage III: In stage III:

or

  • The tumor has spread to the jaw, eye socket, or side of the skull. Cancer has not spread to lymph nodes.
  • Cancer has spread to one lymph node on the same side of the body as the tumor. The lymph node is not larger than 3 centimeters and one of the following is true:
    • the tumor is 2 centimeters or smaller at its widest point and may have one high-risk feature; or
    • the tumor is larger than 2 centimeters at its widest point; or
    • the tumor is any size and has two or more high-risk features; or
    • the tumor has spread to the jaw, eye socket, or side of the skull.

Stage IV: In stage IV, one of the following is true:

  • The tumor is any size and may have spread to the jaw, eye socket, or side of the skull. Cancer has spread to one lymph node on the same side of the body as the tumor and the affected node is larger than 3 centimeters but not larger than 6 centimeters, or cancer has spread to more than one lymph node on one or both sides of the body and the affected nodes are not larger than 6 centimeters; or
  • The tumor is any size and may have spread to the jaw, eye socket, skull, spine, or ribs. Cancer has spread to one lymph node that is larger than 6 centimeters; or
  • The tumor is any size and has spread to the base of the skull, spine, or ribs. Cancer may have spread to the lymph nodes; or
  • Cancer has spread to distant parts of the body.

 

Treatment of Non-melanoma Skin Cancer:

 

Four types of standard treatment are used:

  • Surgery
  • Radiation therapy
  • Chemotherapy
  • Photodynamic therapy
  • New.

New types of treatment are being tested in clinical trials

  • Biologic therapy

Patients may want to think about taking part in a clinical trial. Patients can enter clinical trials before, during, or after starting their cancer treatment.

Search for clinical trials in Georgia.

Adapted from the National Cancer Institute's PDQ Database: http://www.cancer.gov/cancertopics/types/skin/. (Accessed July 2016)