Conditions treated by our UCI Health skin cancer experts include:
Basal cell carcinoma (BCC) is the most common type of skin cancer, making up about 75 percent of all U.S. skin cancer cases. Basal cell tumors tend to occur as people age, usually on parts of the body exposed to the sun—especially the face, neck, chest, arms and back.
Basal cell tumors almost never spread to the lymph nodes or to distant parts of the body and are rarely life-threatening. However, they can be locally destructive, especially when they involve structures on the face and neck. Although it is unusual for a basal cell carcinoma to metastasize (spread), if left untreated, these tumors can grow very large and invade bone and other tissues beneath the skin.
Squamous cell carcinoma (SCC) is the second most common form of skin cancer. It can be more aggressive than basal cell carcinoma, especially when tumors are larger than 2 centimeters or in critical areas such as the ear or lip. Squamous cell tumors also grow more quickly, are more likely to invade structures beneath the skin and may spread to distant areas of the body.
Still, only about 5 percent of squamous cell carcinomas do metastasize, most often to local lymph nodes. The risk of metastasis is higher for larger, untreated tumors and for individuals such as transplant patients whose immune systems are suppressed. However, most squamous cell carcinomas of the skin remain localized.
Melanoma (MM) is the most dangerous form of skin cancer. Each year, more than 68,000 Americans are diagnosed with the disease. If treated early, melanoma is usually curable. But melanoma cells can spread aggressively to other parts of the body and invade lymph nodes.
Melanoma generally appears as a brown or black patch that may also contain shades of red or purple. It may arise on its own or develop in a pre-existing mole or other pigmented tissue. It occurs most frequently on the torso in men and on the legs in women.
- Cutaneous T-cell lymphoma
Cutaneous T-cell lymphoma (CTCL) is caused when certain lymphocytes (white blood cells) become malignant and multiply within the skin. This cancer is slow growing, usually developing over many years. In its earliest stage, CTCL can resemble eczema or psoriasis. The skin may have red, scaly patches that are sometimes raised. Itching is a common symptom. There also may be more lumps on the skin and some patients develop swollen lymph nodes.
Merkel cell carcinoma is a rare form of cancer that develops on or just below the surface of the skin, often in parts of the body that are exposed to the sun. It most frequently occurs in older people and those with weakened immune systems.
Fortunately, most skin cancers are curable when treated early and appropriately. Our board-certified dermatologists are leaders in diagnosing and treating skin cancers. We also have fellowship-trained specialists who use the latest skin-preserving surgical techniques, including Mohs micrographic surgery, to remove only the cancerous cells with minimal damage to surrounding skin.
UCI Health skin cancer specialists use the most advanced methods and technologies to diagnose, stage and treat all types of skin cancers.
Our UCI Health specialists are experts at examining patches, marks or lesions on the body for evidence of skin cancers.
Diagnosis
Your physician usually begins a skin check with a visual examination, followed by tests of any suspect areas. These may include:
A diagnosis of skin cancer typically involves a biopsy, usually done on an outpatient basis. All or part of a suspicious growth is removed and examined under a microscope to determine whether cancer cells are present and, if so, what kind. The highly regarded UCI Health Dermatopathology Laboratory provides fast, accurate determinations. While a biopsy is the definitive method for making a diagnosis, new non-invasive techniques are emerging for preoperative diagnostic assistance.
Dermatologists use a dermatoscope, a handheld magnification device with a bright light, to view suspect areas in minute detail and gain a better understanding of the likely diagnosis. This technique, imported from Europe, has improve the science of diagnosis, particularly of pigmented lesions.
A SIAscope™, short for spectrophotometric intracutaneous analysis, is a far more advanced imaging system to asses pigmented lesions. This imaging device allows physicians to take high-resolution images of the skin that are analyzed for indicators of various skin diseases.
The test is painless and non-invasive, and it also helps physicians diagnose and monitor skin cancers without the need for a biopsy. By recording the pathological pattern of each mole or skin lesion, and flagging pattern changes on subsequent scans, doctors are able to precisely monitor multiple lesions simultaneously over extended periods of time.
- Laser-based skin microscopy
Laser-scanning multi-photon microscopy (MPM) is a research tool that takes very high resolution microscopic images in real time and can confirm conditions such as melanoma without a biopsy. The device is still in research mode, but it shows great promise for becoming the next non-invasive method for diagnosing pigmented lesions and melanoma.
Staging
We use the most advanced imaging technologies available in the region to determine the spread of skin cancer in the body, especially for aggressive cases of melanoma. Our experts are skilled at performing image-guided biopsies to determine the extent of lymph node involvement as well as sentinel lymph node dissections when indicated. Learn more about sentinel lymph node mapping ›
Personal care plan
We work with each patient to develop an individual treatment plan. In deciding on a recommended course of therapy, our skin cancer specialists consider these factors:
- Type of skin cancer
- Location and size of the cancer
- Pattern of cancer cell growth
|
- Health of the patient
- Age of patient
- Patient comfort and convenience
|
For more information or to schedule an appointment, please call us at 949-824-0606 or 714-456-8000.
If you have a skin cancer, your doctor or her nurse contacts you directly to discuss the diagnosis and the best options for treatment. This is best done in person in a clinical setting, but we understand that many people travel great distances, making a telephone conversation the next best choice.
Most skin cancers do not require a major work up. However, if you have developed a melanoma or a similarly complex tumor, your physician may recommend another series of tests to establish the exact localization of your tumor. These may include blood tests, X-rays, magnetic resonance imaging (MRI) and positron emission tomography (PET) scans.
When necessary, your dermatologist works with a team of experts, including dermatologic surgeons and oncologists, offering you access to a wide range of the most advanced treatments and therapies.
Some of the most common treatment methods for basal cell and squamous cell carcinomas include:
- Mohs micrographic surgery
This outpatient procedure provides the highest cure rate for skin cancer at close to 98 percent. It is useful for cancers in critical locations, such as the face, and especially for those that are aggressive, large or recurrent. The surgery, performed in a clinic setting under local anesthesia, involves removing the tumor with narrow margins and subjecting the tissue to immediate freezing for microscopic examination.
Your surgeon maps and color codes the specimen, so that if any residual tumor margin is seen under the microscope, a second and subsequent layers can be removed and tested so that only the cancer tissue is removed. In this sense, Mohs surgery is a tissue sparing technique.
Learn more about the Mohs procedure ›
For most skin cancers in less critical areas such as the limbs or trunk, simple excision under local anesthesia with immediate closure can provide an excellent cure. These outpatient procedures usually take about an hour. If the area excised is large, a skin graft or flap may be needed. Standard excision works well to remove most basal cell and squamous cell carcinomas. Mohs surgery may be preferred for skin cancers on the face or other places where preservation of healthy skin is important.
The excised tissue is sent off for pathology examination. By the time you return to have sutures removed, your physician should be able to share the final pathology report.
- Electrodessication and curettage
This more common method of excision involves removing the skin tumor with a curette — a sharp, spoon-shaped tool — after which a needle-shaped electrode is used to treat the area with an electric current to stop the bleeding and destroy any remaining cancer cells around the edges of the wound. This method is ideal for treating small skin cancers such as basal and squamous cell carcinomas on the body and scalp.
Cryosurgery involves destroying a precancerous or cancerous lesion by freezing it with liquid nitrogen. Liquid nitrogen is sprayed or swabbed on the lesion and the immediate surrounding area, sometimes after a local anesthetic is applied. Cryosurgery is used more often for precancerous growths such as actinic keratoses, but it can be used for superficial basal cell or squamous cell lesions.
Treatments include bleomycin, 5-FU, targeted molecular therapy, anti-angiogenesis therapy and immunotherapy with interferon, interleukin-2 and the newly approved melanoma drug, Yervoy™. For extensive and aggressive basal cell carcinoma, Erivedge™ (vismodegib), the first Food and Drug Administration-approved hedgehog pathway inhibitor, can be useful.
High-energy rays are sometimes used for areas that are difficult to treat surgically, such as the eyelid, tip of the nose and the ear, and also to help provide a greater margin of tumor clearance. Our radiation oncologists are experts in several modalities of radiation energy for tumor treatment. UCI Health also offers stereotactic radiosurgery for melanoma that has spread to the brain.
A narrow beam of intense light is used to make cuts in tissue or to vaporize a surface lesion such as a tumor. Laser surgery usually causes little damage to surrounding tissue and minimal bleeding, swelling and scarring.
When a tumor is in a cosmetically sensitive area or requires extensive surgery to remove, the skin cancer team has access to UCI Health plastic surgeons, who are experts in reconstructive surgery.
For more information or to schedule a consultation, please call 949-824-0606.
