A National Cancer Institute-designated Comprehensive Cancer Center

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Skin Cancer

Skin Cancer

Skin cancer is the most common type of cancer in the United States today. Although the disease is largely preventable, the incidence of skin cancer is on the rise. In fact, 40 to 50 percent of light-skinned Americans who live to age 65 will have skin cancer at least once in their lives. Even patients with olive and dark complexions can get skin cancer. City of Hope specializes in research focused on improving outcomes for many different types of cancer. Everyone should learn the risks and warning signs, and take steps to protect themselves against skin cancer.
If you or a loved one has been diagnosed with skin cancer, City of Hope is here to help. Our world-renowned, multidisciplinary team of skin cancer experts provides comprehensive, personalized care tailored to each patient’s individual needs in order to deliver the best possible outcomes.  City of Hope skin cancer doctors and behind-the-scenes specialists are committed to delivering the most effective, individualized treatments based on each patient’s specific type of disease – always taking into account how the treatments will impact your quality of life. We care for the whole person, not just the disease.
Types of Skin Cancer
  • Basal Cell Carcinoma – the most common type of skin cancer, and the most treatable – especially if found early. This slow-growing cancer rarely spreads (metastasizes) to other parts of the body. It tends to appear as a skin-colored or reddish bump on the head, neck or hands that bleeds and scabs over repeatedly.
  • Squamous Cell Carcinoma – the second-most common skin cancer.  Squamous cell carcinoma grows faster than basal cell carcinoma, although it is also highly treatable when detected early. Squamous cell carcinoma is typically found on the rim of the ear, face, lips and mouth. It can also spread to other parts of the body, though this is unusual. It also tends to be skin-colored or red, and it bleeds and scabs over repeatedly.
  • Melanoma – less common than basal cell carcinoma or squamous cell skin cancers, but more dangerous.  Sometimes called “malignant melanoma” because it can spread to other organs, melanoma begins in the pigment-producing cells (called melanocytes) that give the skin its color. Melanoma may begin as a change in a mole or birthmark or arise as a new mole-like growth. Rarely, melanomas can form in parts of the body not covered by skin such as the eyes, mouth, vagina, large intestine and other internal organs.
  • Rare Skin Cancers – the least common types of skin cancers include Merkel cell carcinoma, dermatofibrosarcoma protuberans , sebaceous carcinomas, microcystic adnexal carcinoma, atypical fibroxanthoma  and eccrine carcinoma. These rare tumors arise from other parts of the skin, such as the sensory corpuscles and oil glands. Their treatment and prognosis varies widely depending on their type, location and size.
  • Actinic (solar) keratosis – a precancerous condition that can develop into squamous cell carcinoma. It appears as rough, red or brown, scaly patches on the skin. They are often more easily felt than seen. Like skin cancer, actinic keratosis usually is found on sun-exposed areas of the body, but it can be found on other parts of the body as well.

Each type of skin cancer is treated in different ways. Your City of Hope team of skin cancer experts will carefully study your individual case and work with you to determine the best treatment plan for you.
Skin cancer symptoms, which vary from person to person, may include:
  • a change on the skin, such as a new spot or one that changes in size, shape or color
  • a sore that doesn’t heal
  • a spot or sore that changes in sensation, itchiness, tenderness or pain
  • a small, smooth, shiny, pale or waxy lump
  • a firm red lump that may bleed or develops a crust
  • a flat, red spot that is rough, dry or scaly

Having one or more of these symptoms does not necessarily mean you have skin cancer. Nonetheless, early detection and treatment is critical with any illness – especially cancer – so it’s important to see a doctor right away if you notice any of the above symptoms.
If you have been diagnosed with skin cancer, we’re here to help. City of Hope is committed to making the process of becoming a patient here as easy as possible. Call 800-826-HOPE (4673) or complete the online appointment form.

Skin Cancer Risk Factors

A risk factor is anything that increases your chances of getting skin cancer.   Sun damage is the No. 1 risk factor for skin cancer.  Moreover, “artificial (ultraviolet) sunlight” used in tanning beds and booths causes the same risk for skin cancer as natural sunlight.

Other factors that increase the risk of developing skin cancer include:
  • Age – the longer you are exposed to the sun over time, the higher your risk of developing skin cancer
  • Fair complexion, freckles, and blond or red hair
  • You sunburn easily
  • Previous skin cancer
  • Previous skin injuries, such as a major scar or burn
  • Living in a sunny climate
  • Chronic exposure to natural sunlight
  • History of three or more blistering sunburns before age 20
  • Exposure to artificial ultraviolet light (tanning bed/booth)
  • Occupational exposure (working outside; exposure to coal tar pitch, creosote, arsenic compounds or radium)
  • Having many moles
  • Unusual moles
  • Family or personal history of melanoma
  • Actinic keratosis, a precancerous condition that appears as rough, red or brown, scaly patches on the skin
Decrease Your Risk

Most skin cancers are preventable.  By incorporating the following steps into your everyday lifestyle, you can greatly decrease the chances that you or your family will develop skin cancer:
  • Avoid sun exposure during the sun’s peak hours, between 10 a.m. and 4 p.m.
  • Always apply sunscreen or makeup with a sun protection factor (SPF) of 30 or higher before going outdoors. If you’ll be in water or sweating, reapply sunscreen throughout the day
  • When working outdoors, in addition to applying sunscreen, wear long sleeves, a hat and gloves
  • Keep infants out of the sun and protect children at all times; apply SPF 30 or higher sunscreen to infants and teach older children to make applying sunscreen before going outside a regular habit
  • Skip the tanning beds/booths; there is no “safe” tan
  • Examine your skin monthly; have any suspicious moles checked by a health-care practitioner
  • If you are at risk, have your skin examined at least once each year by a dermatologist
If you have been diagnosed with skin cancer, we’re here to help. City of Hope is committed to making the process of  becoming a patient here as easy as possible. Call 800-826-HOPE (4673) or complete the online appointment form.



Skin Self Examination

The earlier skin cancer is found, the better, so we recommend that everyone do a monthly skin examination on themselves to identify potential skin cancers early. 
Check yourself from head to toe like this:

Stand in front of a full-length mirror, using a hand-held mirror along with the full mirror to examine hard-to-see places. Carefully look at all areas of your body, including the scalp, back, buttocks, shoulders, backs of the thighs and genitals. Enlist the help of a friend or family member to examine places you can’t see – like your earlobes and the backs of your ears and head.

Knowing the “ABCDEs” of skin cancer diagnosis can save your life.
Use these simple guidelines to determine if you need to see a doctor:

A is for ASYMMETRY:  One half of a mole or birthmark does not match the other.
B is for BORDER: Normal spots have smooth edges. Cancerous spots may have irregular, ragged, notched, or blurred edges.
C is for COLOR: The color is not the same all over and may include shades of brown or black or sometimes patches of red, white or blue.
D is for DIAMETER: Most melanomas are larger than 6 mm or 1/4 inch, about the size of a pencil eraser.
E is for EVOLVING: Melanomas usually change in size, shape or color.  They can also be different in appearance from your other moles.  They may be itchy and painful and may also bleed.
If you see one or more of these signs of possible skin cancer, make an appointment with a physician immediately.

Importantly, some melanomas do not fit the ABCDEs described above. Therefore, it is critical that if you detect any changes in the size, shape or color of a skin mark or the appearance of a new spot, get it checked out by a doctor immediately.

Other possible skin cancer warning signs include:
  • A sore that does not heal
  • A new growth
  • Spread of pigment from the border of a spot to surrounding skin
  • Redness or a new swelling beyond the border
  • Persistent itchiness, tenderness or pain
  • Change in the surface of a mole – scaling, oozing, bleeding or the appearance of a bump or nodule

Diagnosing Skin Cancer

The self-examination section explains the simple “ABCDEs” of identifying potential skin cancers early. If you see one or more of the warning signs described, make an appointment with a physician immediately.

It’s important to note that not all skin marks that show some of the ABCDE characteristics are cancerous, but the more ABCDE features a skin mark has, the more likely it could be skin cancer. It is always wise to be overcautious when evaluating suspected skin cancer. Though pictures are helpful to self-examine your skin, only a physician will be able to diagnose skin cancer.

We adhere to guidelines established by the National Comprehensive Cancer Network (NCCN) to detect all types of skin cancer, using such diagnostic tests and procedures as:
  • Skin examination; a doctor or nurse examines the skin for moles, birthmarks or other pigmented areas that look abnormal in color, size, shape or texture
  • Laboratory tests
  • Chest X-ray
  • Biopsy; tissue samples are examined under a microscope to determine what types of cells are present
  • Wide local excision; a surgical procedure in which some of the normal tissue surrounding the area where skin cancer was located is removed and checked for cancer cells
  • Lymph node mapping and sentinel lymph node biopsy; during surgery to remove a melanoma or related skin tumor, a radioactive substance and/or blue dye is injected and flows through lymph ducts to the sentinel node or nodes. Cancer cells are likely to spread to these nodes first. Nodes containing the radioactive substance or dye are removed and checked for cancer cells. If no cancer is detected, it may not be necessary to remove additional nodes.
  • CT or CAT (computerized axial tomography) scan; a procedure using a computer connected to an X-ray machine to obtain detailed pictures of areas inside the body. A dye may be used to help visualize organs or tissues more clearly.
  • MRI (magnetic resonance imaging); creates a series of detailed pictures of areas inside the body using the combination of a powerful magnet, radio waves and computer imaging.
  • PET (positron emission tomography) scan; used to identify malignant cells even before an actual “lump or bump” can be detected in a physical exam or on CAT or MRI scans. A small amount of radionuclide glucose (sugar) is injected into a vein. Because cancer cells divide more rapidly than normal cells, they take up more glucose than normal cells and therefore appear brighter in the scan.
City of Hope is here to help. We are committed to making the process of becoming a patient here as easy as possible. Call 800-826-HOPE (4673) or complete the online appointment form.

Treatment Options

Each type of skin cancer – just like each patient – is unique. Thus, we tailor your skin cancer treatment specifically to your cancer type.  City of Hope takes a multidisciplinary approach to the treatment of skin cancer to deliver the highest standard of personalized care and achieve the best possible outcomes for our patients. We adhere to guidelines established by the National Comprehensive Cancer Network (NCCN) for treating all types of skin cancer.

Treatment for skin cancer and the precancerous skin lesions known as actinic keratoses varies depending on their size, type, depth and location. Small skin cancers limited to the skin’s surface may not require treatment beyond an initial skin biopsy   that removes the entire growth.

Other treatment options include:
  • Cryotherapy (Freezing) – actinic keratoses and some small, early skin cancers can be removed by freezing them with liquid nitrogen (cryosurgery); the dead tissue sloughs off when it thaws
  • Excisional surgery – appropriate for any type of skin cancer, this procedure involves cutting out (excising) the cancerous tissue and a surrounding margin of healthy skin; Mohs micrographic surgery is a specialized type of excision that allows evaluation of the margins during the procedure
  • Electrodesiccation and currettage – typically a fast and simple process, this procedure often is used to remove small basal cell skin cancers; the doctor numbs the area to be treated, removes the cancer with a sharp tool called a curette and then sends an electric current to the site to kill any remaining cancer cells
  • Radiation therapy – radiation may be used when surgery isn't an option; this procedure uses high-energy rays to kill cancer cells; the goal of radiation treatment is to destroy cancer cells without harming nearby healthy tissue
  • Chemotherapy – uses anticancer drugs to kill skin cancer; for cancers limited to the top layer of skin, creams or lotions containing anti-cancer agents may be applied directly to the skin; systemic chemotherapy can be used to treat skin cancers that have spread to other parts of the body
  • Photodynamic therapy (PDT) – destroys skin cancer cells with a combination of laser light and drugs that makes cancer cells sensitive to light; PDT makes skin sensitive to light, so patients need to avoid direct sunlight for at least six weeks after treatment
  • Biological therapy – stimulates the immune system in order to kill cancer cells; biological therapy medications used to treat certain skin cancer include interferon and interleukin-2
  • Immunotherapy – a melanoma treatment that employs the body’s own defense system to fight cancer cells; City of Hope is the leader in the use of immunotherapy
City of Hope is committed to making the process of becoming a patient here as easy as possible. Call 800-826-HOPE (4673) or complete the online appointment form.


Committed to providing the highest standard of care for the whole person, not just the disease, City of Hope offers a wide array of support and educational services through the Sheri & Les Biller Patient and Family Resource Center .
Patients and loved ones have access to a coordinated team of social workers, psychiatrists, psychologists, patient navigators, pain management specialists and spiritual care providers at the center.  In addition, they can participate in a wide array of programs including educational classes designed to better prepare them and their caregivers for treatment, healing arts workshops, peer support groups and much more.

Additional resources for skin cancer patients include:
Patients may be invited to participate in City of Hope clinical trials when an investigational drug or therapy is appropriate for them.
Part of the National Institutes of  Health, the National Cancer Institute, established under the National Cancer Act of 1937, is the federal government's principal agency for cancer research and training.
800-4-CANCER (226237)
The NCCN, an alliance of 19 of the world's leading cancer centers, including City of Hope, is an authoritative source of information to help patients and health professionals make informed decisions about cancer care.
866-788-NCCN (6226) or send an email
The American Cancer Society has many national and local programs, as well as a 24-hour support line, to help cancer patients and survivors with challenges such as travel, lodging and emotional issues.
800-ACS-2345 (227-2345)
866-228-4327 for TYY

American Academy of Dermatology (AAD)
The AAD represents virtually all practicing dermatologists in the United States and promotes excellence in education and research, clinical practice and surgical standards, and patient care and public interest.
866-503-SKIN (7546)

Melanoma International Foundation
The Melanoma International Foundation provides information for melanoma patients and their families on patient support, early detection, education and advocacy.

Society for Melanoma Research (SMR)
The SMR is a diverse organization of scientific and medical investigators devoted to alleviating the suffering of people with melanoma.
Email: info@SocietyMelanomaResearch.org

SkinCarePhysicians.com was developed by the American Academy of Dermatology specifically for patients and health professionals to use as a resource for up-to-date information on the treatment and management of skin diseases.

If you have been diagnosed with skin cancer, we’re here to help. City of Hope is committed to making the process of becoming a patient here as easy as possible. Call 800-826-HOPE (4673) or complete the online appointment form.

Clinical Trials and Research

As one of the world’s premier cancer research centers, we frequently offer our patients the opportunity to participate in skin cancer clinical trials (research studies). Sometimes they are a patient’s best option for treatment. Other times, they help researchers learn how to treat cancer and improve the future of cancer treatment.

To learn more about skin cancer clinical trials at City of Hope, click here to visit our clinical trials page, or or speak to your doctor.

Our Approach

A diagnosis of skin cancer – as with any cancer – can bring about a range of emotions, but it also drives a need for information and a desire to find the best possible treatment facility.  City of Hope is recognized worldwide for its compassionate patient care, innovative science and translational research, which rapidly turns laboratory breakthroughs into promising new therapies. We’re a forward-thinking cancer center model devoted to rapidly transforming scientific discoveries into better treatments and improved prevention strategies.  More importantly, we’ve been delivering hope to cancer patients for 100 years.

What sets City of Hope apart from other cancer treatment centers?

From diagnosis through treatment and follow up, City of Hope delivers comprehensive skin cancer care for every stage of the disease.  We combine advanced diagnostics, aggressive new treatments and the expertise of a closely coordinated group of specialists to provide the latest in care for patients with different types of skin cancer, including melanoma. Our world-class, multidisciplinary team of cancer experts includes dermatologists, medical oncologists, general oncologic surgeons, plastic and reconstructive surgeons, pathologists and highly skilled technicians.  These caring professionals are dedicated to delivering the highest-quality, personalized treatment and care with the fewest possible negative side effects, with a goal of achieving the best possible outcomes.

Moreover, as a leading cancer center, City of Hope not only adheres to guidelines established by the National Comprehensive Cancer Network (NCCN), but our physicians participate in defining these guidelines for the rest of the country.  Our methods for diagnosing and treating all types of skin cancer incorporate new and established technologies that are personalized for the individual patient.

While our primary goal is to cure or control the disease, another top priority is relieving pain, suffering and discomfort – conditions directly affecting quality of life – for patients undergoing cancer treatments. This involves helping patients manage physical symptoms as well as addressing non-physical concerns like depression, anxiety, loss of appetite, nutrition and establishing or maintaining healthy lifestyle habits.

We offer a broad range of support and educational services through the Sheri & Les Biller Patient and Family Resource Center .  Patients and loved ones have access to a coordinated team of social workers, psychiatrists, psychologists, patient navigators, pain management specialists and spiritual care providers at the center.  In addition, they can participate in a wide array of programs including educational classes designed to better prepare them and their caregivers for treatment, healing arts workshops, peer support groups and much more.
Recent Headlines from our Breakthroughs Blog:
Indoor tanning: For some women it may be addictive

If you have been diagnosed with skin cancer, we’re here to help. City of Hope is committed to making the process of becoming a patient here as easy as possible. Call 800-826-HOPE (4673) or complete the online appointment form.

Skin Cancer Team

Our team consists of experienced anesthesiologists certified by the American Board of Anesthesiology. All of our anesthesiologists are doctors of medicine who have completed four years of medical school and an additional four years of residency training in anesthesiology.  We have vast experience and exposure to oncologic anesthesia, which ensures that you are provided with the best anesthetic care possible.

Support This Program

It takes the help of a lot of caring people to make hope a reality for our patients.  City of Hope was founded by individuals’ philanthropic efforts 100 years ago. Their efforts – and those of our supporters today -- have built the foundation for the care we provide and the research we conduct. It enables City of Hope to strive for new breakthroughs and better therapies – helping more people enjoy longer, better lives.

For more information on supporting this specific program, please contact our  Donor Relations Department at 800-667-5310 or developmentrelations@coh.org. Or, to make a gift that supports all the research at City of Hope,  donate online now . We thank you for your support.
Ask the Experts - Skin Cancer
Skin Cancer Care
Treatments and Clinics
A national leader in cancer treatment and prevention, City of Hope is steadfast in its drive to offer more positive outcomes to patients everywhere. Our research innovations become advances in patient care without delay, because people fighting cancer need better options – now.

To make an appointment for yourself, a family member or a friend, please complete and submit our Become a Patient Request Form, or call City of Hope at
800-826-HOPE (4673).
The Sheri & Les Biller Patient and Family Resource Center embodies the heart and soul of City of Hope’s mission to care for the whole person.
Clinical Trials
Our aggressive pursuit to discover better ways to help patients now – not years from now – places us among the leaders worldwide in the administration of clinical trials.
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