Skin Cancer from Detection to Treatment


What is Skin Cancer?

Skin cancer is the abnormal growth of skin cells, usually caused by DNA damage from ultraviolet radiation from the sun or tanning beds.

The main types are:

Basal Cell Carcinoma
most common, slow-growing

Squamous Cell Carcinoma
can spread if untreated

Melanoma
most dangerous and can spread rapidly

Rare types:
Merkel cell carcinoma, dermatofibrosarcoma protuberans, others


1. Initial Detection / Scanning

Self-checks
Patients or their family notice unusual moles, spots, or skin changes

ABCDE rule:
Asymmetry, Border irregularity, Color variation, Diameter >6mm, Evolving.

Clinical skin exam:
A dermatologist visually examines the skin under normal light and sometimes with dermoscopy (a handheld magnifier with polarized light).

Full-body photography:
For high-risk patients, doctors may take images to monitor changes over time.


2. Diagnostic Testing

Skin biopsy

Shave biopsy
removing top layers for superficial lesions.

Punch biopsy
using a circular blade to take a full-thickness skin sample.

Excisional biopsy
removing the entire lesion if possible.

The sample is sent to a pathologist for microscopic examination.

Special tests may follow:

Immunohistochemistry
to classify cancer type.

Genetic/molecular testing
for advanced melanoma (e.g., BRAF mutation).


3. Staging

Determines how advanced the cancer is.
Imaging scans may be used:
Ultrasound
checks nearby lymph nodes.

CT / MRI
for suspected spread to organs.

PET-CT
detects active cancer in the whole body.

Sentinel lymph node biopsy
checks first lymph node(s) draining the cancer site to see if cancer has spread.

Cancer is staged from Stage 0 (in situ) to Stage IV (metastatic).


4. Treatment Options

Surgical Treatments

Excisional surgery
removes cancer with a margin of healthy skin.

Mohs surgery
removes thin layers one at a time, checked under a microscope until all cancer is gone (used for facial/critical areas).

Curettage and electrodessication
scraping off superficial cancers and sealing with electric current.

Non-Surgical Treatments

1 Topical medications
for very early cancers:

Imiquimod cream
stimulates immune system.

5-fluorouracil cream
destroys cancer cells.

2 Cryotherapy
liquid nitrogen freezes abnormal cells.

3 Photodynamic therapy
light-sensitive drug activated by laser to kill cells.

Advanced/Spread Disease

Radiation therapy
for inoperable lesions or metastasis.

Targeted therapy
drugs against specific mutations.

Immunotherapy
checkpoint inhibitors boost immune system to fight melanoma.

Chemotherapy
less common now, but sometimes used in advanced cases.


5. Follow-Up and Monitoring

Regular dermatology check-ups.
Imaging scans if cancer was advanced.
Patient education: self-exams, sun protection, and reporting new lesions.