One of the questions you may have if you have been newly diagnosed with any type of skin cancer, is will the cancer spread? Metastasis is the term used to describe the process by which cancer can spread from the site of the original cancer tumor to other places in the body. Cancer cells which break away from a primary tumor can enter the bloodstream or your lymphatic system (a part of your immune system) to travel to distant places in your body. The danger is that these traveling cancer cells can cause secondary tumors to develop in vital body organs such as the lungs, bones, liver, and brain. The good news is that skin cancer which is caught early will seldom get a chance to metastasize, especially if treatment is successful in getting rid of the entire tumor. The risk of metastasis varies depending upon many factors including which type of skin cancer you have and at which stage it was diagnosed. In this post we are going to talk about what science and research show about your risk of skin cancer metastasis.
What is the risk of metastasis for these types of skin cancer?
Basal Cell Carcinoma
If you have been diagnosed with basal cell carcinoma you should know that this type of skin cancer is less likely to metastasize than either squamous cell carcinoma or melanoma. The National Institutes of Health report that basal cell skin cancer almost never spreads. This is not to say that you can leave your skin cancer alone and untreated. Untreated basal cell carcinomas can grow into surrounding skin, tissues, and even bone causing structural damage especially to the face. There are case studies reported in the literature of metastatic basal cell carcinoma (MBCC) but even here the researchers point out how rare these cases are as in fewer than 300 cases of MBCC reported in the literature and an rate of metastasis ranging from 0.0028 percent to 0.5 percent. Mohs surgery is often a successful treatment option for patients with this type of skin cancer.
Squamous Cell Carcinoma
The risk of metastasis for patients diagnosed with squamous cell carcinoma is higher than for patients who have basal cell carcinoma. If left untreated, this type of skin cancer can be lethal. The Skin Cancer Foundation reports that squamous cell carcinoma causes approximately 2,500 deaths each year in the United States. Although most squamous cell carcinomas are relatively slow-growing and localized to the skin, there is a risk for it to spread to other body sites including internal organs. The Skin Cancer Foundation estimates that between 2-10 percent of squamous cell carcinomas will spread to distant organs. The site of the tumor is important in making predictions if the skin cancer will spread. Squamous cell carcinomas on the lip, ears, palms of the hands, soles of the feet, or inside the mouth or nostrils have a high potential for metastasis.
Melanoma skin cancer has the highest risk of spreading and is considered the most deadly of skin cancers. The American Cancer Society estimates that melanoma skin cancer accounts for as many as 8,700 deaths for 2010 in the U.S. alone. The risk of metastasis for melanoma is much higher than for both basal cell and squamous cell carcinomas combined. Dr. Darrell Rigel, professor of dermatology at NYU Medical Center, was quoted during a PBS interview as warning that: “A melanoma the size of a dime on your skin has a 50% chance of already having spread.” This is why prevention, detection, and early treatment are critical when we talk about melanoma skin cancer.
If your doctor or dermatologist has any concerns that your skin cancer has spread or has a chance of spreading they may run some diagnostic tests. Your doctor may wish to determine the thickness and depth of your tumor. Early melanomas, for example, which are thin and less than 1 millimeter in thickness have an extremely high success rate of being treated and cured. The American Academy of Dermatology reports that surgical removal of these superficial melanomas which are confined to the top layers of skin offers a cure for 95% of patients. Your doctor may also use imaging tests for advanced stages of melanoma including X-rays, CT scans, or MRI’s. You can read more about these imaging tests from the Melanoma Research Foundation. Recently there has been research to show that a blood test may be used in the future to predict metastasis in melanoma patients.
Is there danger in postponing treatment for my skin cancer?
The question some people ask is how quickly a particular skin cancer can take to spread. In other words, is it dangerous to leave a skin cancer untreated? Due to the fact that nobody can tell you for certain how fast or aggressive your skin cancer may be, you are always taking a chance if you do not get treatment. We want to stress to you that the cure rates are extremely high for most types of skin cancer if you treat them early. Why wait and take that chance of having it progress to the point where your skin cancer will be harder to treat?
Even basal cell carcinoma, which is least likely to spread, can cause irreparable damage. One sad story came from one of our members who wrote that her sister with developmental disabilities had to have an eye removed due to an aggressive basal cell carcinoma. The extent of damage was so great that this member worried that her sister would die. We think of this type of skin cancer as being the least invasive or lethal, but as literature from the Merck Manuals Online Medical Library confirms: “When basal cell carcinomas grow near the eye, mouth, bone, or brain, the consequences of invasion can be serious and can lead to death.” The point of telling you this is not to scare you but to point out that all types of skin cancer carry some risk for spreading and causing destruction.
The bottom line is to get treatment for your skin cancer no matter what type of skin cancer you have. Don’t put it off or wait. You never want to be in the position of saying, “I wish I had gotten my skin cancer treated earlier.” Get it treated now.
For more information about the types of skin cancer, skin cancer prevention and treatment, please refer to our Skin Cancer Resources Guide.