Diagnosis

At Wilmot Cancer Institute, we provide the full spectrum of cancer care, from initial diagnosis and treatment to recovery and rehabilitation. Doctors from various disciplines — dermatology, pathology, surgical oncology, plastic surgery, medical oncology, radiation oncology and more — come together to plan each patient’s care. They develop individualized treatment plans that aim not only to address the cancer but also minimize the side effects of treatment.

Symptoms

Different types of skin cancers have difference symptoms. They tend to occur on areas that are exposed to the sun, such as the face, head, neck, ears and back of the hands.

Basal cell carcinomas

These cancers tend to appear on skin that is often exposed to the sun such as the face, head and neck, but they can occur anywhere on the body. They can appear as:

• Flat, firm, pale or yellow areas, similar to a scar
• Small bumps that may be pink or red, translucent, shiny or pearly and that may have blue, brown or black areas
• Pink growths that have raised edges and a lower center and which may have abnormal blood vessels that spread out from the center
• Open sores that may ooze or have crusted areas and that don't heal or heal and return

Squamous cell carcinomas

These also tend to appear on sun-exposed skin, but they can also appear on other parts of the body.  They can appear as:

• Rough or scaly red patches that may crust or bleed
• Raised growths or lumps that sometimes have a lower center
• Open sores that may ooze or have crusted areas and that don't heal or heal and return
• Wart-like growths

Melanomas

These skin cancers can occur anywhere on the skin. Signs of melanoma include changes in the way a mole or pigmented area appears. Look for:

• Asymmetry in the shape or size of the mole
• Irregular edges
• Changes in color or bleeding
• Changes in size
• Any other changes in the way a mole looks

Diagnosis

Getting an accurate diagnosis is essential to getting the best treatment. Diagnosing skin cancer can include:

Medical history and physical examination: This first step includes a complete medical history and assessment of risk factors and symptoms. The doctor will also examine the skin for any abnormalities.

Biopsy: A biopsy involves removing cells or tissue for further examination by a specialized pathologist. When having a biopsy, you will be given an injection of a medication that will help to numb the area. The sample of cells is then removed and sent to our dermatopathologist to be examined under a microscope. Your dermatologist will be able to discuss the results of your biopsy within a few days. Here are some types of biopsies that may be performed:

• Shave biopsy involves shaving a few layers of cells from the skin after it has been numbed.
• Punch biopsy uses a tiny tool to take a cylindrical sample of cells, providing cells from deeper layers of the skin.
• Incisional biopsy involves cutting out part of the suspected tumor using a surgical knife.
• Excisional biopsy removes all of the suspected tumor. This type of biopsy is most often performed in cases of suspected melanoma.
• Fine needle aspiration uses a very thin needle to remove a small sampling of cells.

Dermatopathology: At Wilmot, a pathologist who specializes in identifying skin cancers will examine the tissue from a biopsy under a microscope to determine whether cancer is present.