Nonmelanoma Skin Cancer: Frequently Asked Questions

Here are some answers to frequently asked questions about nonmelanoma skin cancer.

What is nonmelanoma skin cancer?

Nonmelanoma skin cancer is the most common type of cancer in the U.S. The most common types of nonmelanoma skin cancers are basal cell skin cancer and squamous cell skin cancer. They are named for the kind of skin cell in which the cancer starts. Basal cell skin cancer is much more common than squamous cell skin cancer. Both types are most often caused by sun damage.

Melanoma is a type of skin cancer that starts in skin cells called melanocytes, the cells that give the skin its tan or brown color. Melanoma is the most dangerous type of skin cancer. It can spread quickly to anywhere in the body.

My skin is dark and I tan easily. Can I still get skin cancer?

Skin cancer is more common in people with fair skin. But anyone can get skin cancer, including people with dark skin tones.

Sunscreen SPF numbers range from 2 to 100+. What number do I need? 

Most people need a sunscreen with an SPF of at least 15. Some expert groups, such as the American Academy of Dermatology and the American Cancer Society, recommend using a broad-spectrum sunscreen with an SPF of at least 30. Check the bottle label to see that it protects against both UVA and UVB rays.

When do I need to apply sunscreen? 

Apply sunscreen every day. Ultraviolet rays can damage your skin even on cloudy days or in the winter. Apply sunscreen 15 minutes before going outdoors and every couple of hours after that. Also reapply sunscreen after swimming, sweating, or toweling off. When outdoors, get even more protection by wearing tightly woven clothing and a wide-brimmed hat.

What do I look for during a skin self-exam?

Any change in your skin may be a sign of skin cancer. Check your skin regularly and become familiar with your skin and your pattern of moles and freckles. Pay close attention to moles larger than a pencil eraser. Note any pigmented areas that have changed color or size, as well as any growths that bleed, heal, and then bleed again. The more consistently you check your skin, the better you'll get at spotting any changes. If you find anything unusual, see your doctor right away. The earlier skin cancer is found, the better the chance for cure.

How do I do a skin self-exam?

Follow these steps:

• Look at the front and back of your body in the mirror. Then raise your arms and look at your left and right sides.

• Bend your elbows and look at your palms, forearms, including the undersides, and your upper arms.

• Examine the back and front of your legs. Also look between your buttocks and around your genital area. You may need to use a hand mirror to do this.

• Sit and closely examine your feet, including the soles and the spaces between your toes.

• Look at your face, neck, and scalp. You may want to use a comb or a blow dryer so that you can see better or have someone help look at the back of your head and neck area.

Can a doctor tell if I have skin cancer by looking at it? 

A doctor trained in skin cancer detection can usually tell if a growth is possibly cancerous. Even so, a biopsy is the only way to know for sure if a lesion is cancer. A biopsy involves removing some or all of the changed skin so it can be checked for cancer cells.

What is Mohs surgery? 

Mohs surgery is a special surgery technique used to treat skin cancer. Your doctor uses a local anesthetic to numb the area. Then, he or she removes the cancer one layer of skin at a time. Each layer is checked under a microscope for cancer cells, and your surgeon removes layers until no more cancer is seen. Surgeons usually do this surgery for facial lesions in difficult areas, if the tumor is very large, or when cancer has come back. This technique gives the highest cure rate of all methods. Because the surgeon removes only the minimum amount of tissue, he or she can often obtain optimal cosmetic results. Surgeons usually do plastic reconstruction at the same time as Mohs surgery, though small wounds may be allowed to heal naturally after surgery. Only a dermatologist who has had special training should do this type of surgery.

What is curettage and electrodesiccation? 

Curettage is a common treatment for nonmelanoma skin cancer. During this form of surgery, your doctor gives you a local anesthetic to numb the area. Then he or she scrapes the cancer with a tool shaped like a spoon with a sharp edge. This tool is called a curette. After curettage, the doctor also does electrodesiccation. The area where the cancer was removed is treated with electricity from a machine. This helps stop the bleeding and kills any cancer cells that may be left around the wound. People treated with curettage and electrodesiccation may have a scar that is white and flat.

What is an excisional biopsy? 

For this type of biopsy, your doctor tries to remove the whole growth, along with some surrounding healthy tissue. An excisional biopsy is sometimes enough to cure skin cancer.

Should everyone get a second opinion for a diagnosis of nonmelanoma?

Many people with cancer get a second opinion from another doctor. There are many reasons to get a second opinion. You may want to seek a second opinion if you're not comfortable with the treatment decision, if the type of cancer is rare, if there are different ways to treat the cancer, or if you aren't able to see a cancer expert.

How can I get a second opinion?

These are some of the ways to get a second opinion:

• Ask your primary care doctor. Your doctor may be able to recommend a specialist, such as a dermatologist, Mohs surgeon, medical oncologist, oncologic surgeon, or radiation oncologist. Sometimes these doctors work together at cancer centers or programs.

• Check with the American Academy of Dermatology and the American College of Mohs Surgery. Both are excellent sources of information about nonmelanoma skin cancer and can provide names of doctors for second opinions.

• Call the National Cancer Institute's Cancer Information Service. The number is 800-4-CANCER (800-422-6237). They have information about treatment facilities, including cancer centers and other programs supported by the National Cancer Institute.

• Seek other options. You can get names of doctors from your local medical society, a nearby hospital, a medical school, or local cancer advocacy groups, as well as from other people who have had that type of cancer.