Frequently Asked Questions About nonMelanoma Skin Cancer

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

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

A: Skin cancer is more common in people with fair skin, but it can occur in all people, including those with dark skin tones.

Q: Sunscreen numbers range from 2 to 60. What number do I need? 

A: Most people need a sunscreen with an SPF (sun protection factor) of at least 30. Check the bottle label to see that it protects against both UVA and UVB rays.

Q: When do I need to apply sunscreen? 

A: You should apply sunscreen everyday. Ultraviolet rays can damage the skin even on cloudy days or in the winter. Sunscreens should be applied 30 minutes before going outside and every couple of hours thereafter. Also reapply sunscreen after swimming, sweating, or toweling off. When outside, get even more protection by wearing a wide-brimmed hat.

Q: What do I look for during a skin self-examination?

A: 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.

Q: How do I do a skin self-examination?

A: 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.

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

A: 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.

Q: What is Mohs surgery? 

A: Mohs technique is a special kind of surgery used to treat skin cancer. For it, the 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 layers are removed until no more cancer is seen. This surgery is usually done 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 only the minimum amount of tissue is removed, optimal cosmetic result can often be obtained. While small wounds may be allowed to heal naturally after surgery, plastic reconstruction is typically done at the same time as the Mohs surgery. Only a dermatologist who has had special training should do this type of surgery.

Q: What is curettage and electrodesiccation? 

A: Curettage is a common treatment for nonmelanoma skin cancer. During this form of surgery, the doctor gives the patient 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. The chance of cure with this treatment averages about 90% for nonmelanoma skin cancers.

Q: What is an excisional biopsy? 

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

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

A: Many people with cancer get a second opinion from another doctor. There are many reasons to get a second opinion. These include if the person is not comfortable with the treatment decision, if the type of cancer is rare, if there are different ways to treat the cancer, or if the person is not able to see a cancer expert.

Q: How can someone get a second opinion?

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

• The person’s primary doctor may be able to recommend a specialist such as a Mohs surgeon, medical oncologist, oncologic surgeon, or radiation oncologist. Sometimes these doctors work together at cancer centers or programs.

• The American Academy of Dermatology and the American College of Mohs Micrographic Surgery and Cutaneous oncology are excellent sources of information about nonmelanoma skin cancer and can provide names of doctors for second opinions.

• The Cancer Information Service (1-800-4-CANCER) informs callers about treatment facilities, including cancer centers and other programs supported by the National Cancer Institute.

• Patients can get names of doctors from their 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.

• The Official ABMS Directory of Board Certified Medical Specialists is a reference book from the American Board of Medical Specialists that lists doctors by state. It gives their specialty, background, and training. It is available at most public libraries. You can also view it online at www.abms.org.