What are the types of non-melanoma skin cancer and how are they diagnosed? Expert Dr. Barbara Ma walks through key testing that aids in defining the specific diagnosis and stage of cancer, which can have an impact on treatment decisions.
Dr. Barbara Ma, is Cutaneous Oncologist and an Assistant Professor of Medicine at Weill Cornell Medicine and an Assistant Attending Physician at New York Presbyterian Hospital. Learn more about Dr. Ma.
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Transcript
Jamie Forward:
So, Dr. Ma, can we start with something really basic? What are the types of non-melanoma skin cancer?
Dr. Barbara Ma:
Sure, so, there are different types of non-melanoma skin cancers. The most common are basal cell and squamous cell.
And they’re really linked to damage from sun exposure. But they’re very common and also highly treatable, especially when caught early.
Jamie Forward:
So, when someone is diagnosed with non-melanoma skin cancer, what sort of questions should they be asking following their diagnosis?
Dr. Barbara Ma:
Sure. So, I think the most common question that people will ask is, “How did I get this in the first place?” And again, one of the biggest risk factors is really linked to UV light damage from the sun exposure. So, if there’s any childhood history of sunburns, or if you are fair-skinned, light-colored eyes – those are really common things that make you tend to burn easily. So, you are more likely to get non-melanoma skin cancers as a result of those.
So, usually, the other question that comes up is, “What can I do to prevent them from coming back?” And really, the core of it is going togonna be sunscreen and making sure that you reduce your exposure as much as you can. And it would be best to avoid tanning bed use, really, to minimize your risk.
Jamie Forward:
Sure. And what sort of tests should be done? So, Dr. Ma, what are the typical tests that are done following an initial diagnosis of non-melanoma skin cancer?
Dr. Barbara Ma:
Sure. So, a lot of times, when we’re talking about even initial diagnosis, this is usually with the dermatologist, who does a biopsy of the suspicious skin lesion. And usually it’s the pathology report that tells you that, “Oh, this is a basal cell skin cancer or a squamous skin cancer.”
And really, the difference is just which layer of the skin that it derived from. And some of the things that we also try to ask is, “Okay, so, what is the extent?” Meaning, is this something that’s spread? So, one of the things that we will usually check, actually, is the lymph node, to see if there’s any lymph nodes that are big.
And if so, we do an exam, and if they need the medical oncologist to get involved, it’s merely because if we’re suspecting that the basal or the squamous skin cancer has spread to another part of the body. Now, again, highly treatable, especially when caught early. And the treatment, especially in the early stage, from the dermatologist, is making sure that they cut out the lesion and make sure that they have negative margins. And that is the case the majority of the times. Usually, me as the medical oncologist, we mainly get involved if it’s a more advanced stage.
But that’s really not the majority of the cases for the non-melanoma skin cancers, because it’s caught early. But yeah. But if the medical oncologist, as in us, gets involved because it’s something that’s spread to lymph node or another part of the body, then usually we will use something called immunotherapy, which is an IV medication that activates the immune system to really effectively kill the skin cancer cells.