If you or a loved one is dealing with a diagnosis of non-melanoma skin cancer, our multidisciplinary clinic- The Melanoma and Skin Center of Excellence has a comprehensive care team with some of the nation’s experts in melanoma at West Cancer Center & Research Institute to help you. We also want to provide you with resources and information to help you manage your melanoma diagnosis in conjunction with our care team.
What is Non-Melanoma
These are all types of skin cancer (see below) that are not melanoma, the more serious form of skin cancer.
Types of Non-Melanoma Skin Cancer
These are rare forms of cancer that can occur anywhere on your body, but are usually on the skin of your head and neck, and form in the lining of the lymph or blood vessels.
BASAL CELL CARCINOMA
Long-term exposure to sunlight is considered to be the cause of most basal cell carcinomas that begin in the basal cells, a type of skin cell that replaces old ones that have died off with new ones.
CUTANEOUS B-CELL LYMPHOMA
This rare form of skin cancer begins in the B-cells, a type of white blood cell whose role is to fight disease.
CUTANEOUS T-CELL LYMPHOMA
These rare forms of cancer are a type of non-Hodgkin lymphoma that begins in the white blood cells and attack the skin.
DERMATOFIBROSARCOMA PROTUBERANS (DFSP)
This rare, slow growing skin cancer begins in connective tissue cells in the middle layer of your skin and rarely spreads beyond the skin.
MERKEL CELL CARCINOMA
These bluish-red or flesh colored cancers are another rare form that usually develop in older people with a weak immune system and/or long term exposure to sunlight. They are usually on the face, head, and neck and can grow fast and spread to other parts of the body.
The eyelid is usually the area these cancers appear and begin in the oil glands but can spread to other parts of the body and may be difficult to treat, even after surgical removal.
SQUAMOUS CELL CARCINOMA
While usually not life-threatening, this is the most common form of skin cancer that results from long-term exposure to UV radiation from the sun or tanning beds. These cancers form on the squamous cells located in the outer or middle layer of skin and if untreated can spread and cause serious complications.
Stages of Non-Melanoma Skin Cancer
Basal Cell and Squamous Cell Carcinoma
Basal cell and squamous cell carcinoma usually do not spread to other parts of the body.
Merkel Cell Cancer
Doctors use the TNM system to describe the stage of Merkel cell cancer. Doctors use the results from diagnostic tests and scans to answer these questions:
- Tumor (T): How large is the primary tumor? Where is it located?
- Node (N): Has the tumor spread to the lymph nodes? If so, where and how many?
- Metastasis (M): Has the cancer metastasized to other parts of the body? If so, where and how much?
The results are combined to determine the stage of Merkel cell cancer for each person.
This is called carcinoma in situ. Cancer cells are found only in the top layers of the skin. The cancer does not involve the lymph nodes, and it has not spread.
The primary tumor is 2 centimeters (cm) or smaller at its widest part. The cancer has not spread to the lymph nodes or to other parts of the body.
The tumor is larger than 2 cm and has not spread to the lymph nodes or other parts of the body.
The tumor has grown into nearby tissues, such as muscles, cartilage, or bone. It has not spread to the lymph nodes or elsewhere in the body.
The cancer has spread to the lymph nodes. The tumor can by any size and may have spread to nearby bone, muscle, connective tissue, or cartilage.
The tumor is any size or may have grown into nearby tissues. Biopsy or surgery has found that the cancer has spread to nearby lymph nodes. The cancer has not spread to other parts of the body. Or, there is no sign of a tumor, but cancer was found in a nearby lymph node during an exam or with imaging scans. Its presence was confirmed using a microscope.
The tumor is any size or may have grown into nearby tissues. The cancer has spread through the lymphatic system, either to a regional lymph node located near where the cancer started or to a skin site on the way to a lymph node, called “in-transit metastasis.” In-transit metastasis may have reached these other lymph nodes. The lymphatic system is part of the immune system and drains fluid from body tissues through a series of tubes or vessels.
The tumor has spread to distant parts of the body, such as the liver, lung, bone, or brain.
Symptoms of Non-Melanoma Skin Cancer
If you are experiencing any of these symptoms, we urge you to speak to your provider as soon as possible for further examination.
- A crusty sole that bleeds easily
- A growth or area that is itchy
- Raised and scaly red patches
- A wart like growth
- A sore that doesn’t heal or keeps coming back
- Pale yellow or white flat areas that resemble a scar
- A pinkish growth that indents in the center with raised edges
- A growth with small blood vessels on the surface
How to Diagnose Non-Melanoma Skin Cancer
If your provider would like to further investigate the possibility of skin cancer, one or more of the following diagnostic procedures may be performed:
Removal and analysis of the entire mole or growth with a border of healthy looking skin
Removal and analysis of the most irregular part of the mole or growth.
A circular tool is used to remove a round piece of skin around the mole or growth.
SKIN CANCER SCREENINGS
Periodic skin exams by a physician, plus self-exams can help detect melanoma early.
Usually used for small lesions in a cosmetically sensitive area with a razor blade
Types of Non-Melanoma Cancer Treatments
Your non melanoma cancer treatment plan will vary depending on multiple factors including, but not limited to, your stage of diagnosis, as well as the location of your cancer. Your dedicated team of cancer experts will discuss your treatment options and plan with you, allowing you and your loved ones to consider all possible treatment options for your diagnosis.
Liquid nitrogen is used to freeze and destroy the abnormal cells.
ELECTRODESICCATION AND CURETTAGE (ED&C)
ED&C uses a curette to remove the abnormal cells by scraping down to normal tissue and cauterizing the area. This technique is usually utilized on areas where scarring would be less noticeable.
The tumor is cut out together with some healthy tissue, know as a margin.
This treatment is accepted as the single most effective technique for removing Basal and Squamous Cell Carcinoma. Thin layers of skin containing the cancerous cells are removed, tested under a microscope and repeated until the tissue sample contains no cancer cells.
PHOTODYNAMIC THERAPY (PTD)
Special drugs, called photosensitizing agents, are activated by certain kinds of light to destroy cancer cells
A topic cream of 5-fluorouracil (5-FU) and imiquimod can be prescribed to topically destroy abnormal tissue.
SYSTEMATIC THERAPY OR CHEMOTHERAPY
Anti-cancer drugs are injected or given orally to attack cancer cells that may have spread to lymph nodes and other organs