Detection and diagnosis of skin cancer

The cure rate for skin cancer could be 100 percent if all skin cancers were brought to a doctor's attention before they had a chance to spread. Therefore, people should check themselves regularly for new growths or other changes in the skin. Any new, colored growths or any changes in growths that are already present should be reported to the doctor without delay. Doctors should also look at the skin during routine physical exams. People who have already had skin cancer should be sure to have regular exams so that the doctor can check the skin--both the treated areas and other places where cancer may develop.

Diagnosis

Basal cell carcinoma and squamous cell carcinoma are generally diagnosed and treated in the same way. When an area of skin does not look normal, the doctor may remove all or part of the growth. This is called a biopsy. To check for cancer cells, the tissue is examined under a microscope by a pathologist or a dermatologist. A biopsy is the only sure way to tell if the problem is cancer.

Doctors generally divide skin cancer into two stages:

• Local (affecting only the skin)
• Metastatic (spreading beyond the skin)

Because skin cancer rarely spreads, a biopsy often is the only test needed to determine the stage. In cases where the growth is very large or has been present for a long time, the doctor will carefully check the lymph nodes in the area. In addition, the patient may need to have additional tests, such as special x-rays, to find out whether the cancer has spread to other parts of the body. Knowing the stage of a skin cancer helps the doctor plan the best treatment.

Questions to ask the doctor

Skin cancer has a better prognosis, or outcome, than most other types of cancer. Although skin cancer is the most common type of cancer in this country, it accounts for much less than 1 percent of all cancer deaths. It is cured in 85 to 95 percent of all cases. Still, any diagnosis of cancer can be frightening, and it's natural to have concerns about medical tests, treatments, and doctors' bills. Patients have many important questions to ask about cancer, and their doctor is the best person to provide answers. The following are some other questions that patients might want to ask their doctor:

• What types of treatment are available?
• Are there any risks or side effects of treatment?
• Will there be a scar?
• Will I have to change my normal activities?
• How can I protect myself from getting skin cancer again?
• How often will I need a checkup?

Some patients become concerned that treatment may change their appearance, especially if the skin cancer is on their face. Patients should discuss this important concern with their doctor. And they may want to have a second opinion before treatment.