Benign Growth vs. Skin Cancer: It’s Best to Get Checked If There’s Any Doubt

Skin cancer is when malignant (cancerous) cells form within the tissues of the skin. It’s also the most common type of cancer, which can be found anywhere in the body. But it’s more commonly found on parts of the body which are most exposed to the sun’s ultraviolet rays.

How can you tell if a spot or growth on the skin is cancer or something much less serious? But people cannot tell the difference, which is why it’s so important to see your physician or skin specialist to be absolutely sure.

Many harmless skin conditions, especially as we age, can appear suspicious – and should be examined by a healthcare professional, explains Michael Raisch, M.D., Mohs micrographic surgeon and dermatologist at Baptist Health Miami Cancer Institute. One such condition, seborrheic keratosis, is a common skin growth. It may seem suspect because it can look like a wart, pre-cancerous skin growth (actinic keratosis), or skin cancer. Despite their appearance, seborrheic keratoses are harmless.

Michael Raisch, M.D., Mohs micrographic surgeon and dermatologist at Baptist Health Miami Cancer Institute.

 

“There are a lot of benign -- meaning non-cancerous -- growths on our skin that happen as we age and sometimes can mimic a skin cancer,” said Dr. Raisch. “When we have a skin cancer screening, I would say 50 percent of the people who come in say: ‘What's this? It looks weird.’ And it's something benign. The important thing is that they're looking. I am very happy when those people come in because it means they're alert.”

Skin cancer specialists at Miami Cancer Institute’s Multidisciplinary Skin Cancer Clinic provide the most comprehensive approach to screening, diagnosing and treating skin cancer. The clinic’s team utilizes the latest skin cancer monitoring and detection tools, such as the Vectra 3D Whole Body Photo-Imaging and Reflectance Confocal Microscopy (RCM), a non-invasive imaging technique that uses a low-power laser, without radiation.

“People have an intuition of what is normal for their skin,” said Dr. Raisch. “Oftentimes with a basal cell skin cancer, which is the most common type of skin cancer, the ones that present later are ones where someone has thought: ‘I thought that was just a pimple. It was always in the same place. It would get a little sore there. It would heal up and then it would come back.’ That is probably the most consistent story for a basal cell. So, if you have a sore or growth that's not healing -- that's really something that's important to notice.”

While people with light skin, hair and eyes have a higher risk for sun-related skin cancers, there are also risk factors for Hispanics and African-Americans.

Types of Skin Cancer

Basal cell carcinoma (a nonmelanoma skin cancer) is the most common type in the U.S., with more than 3 million people diagnosed with the disease annually. 

“Basal cell skin cancer is the one that looks like a non-healing sore,” said Dr. Raisch. “Sometimes it's just a shiny pink area on the skin. It might have a little bit of scabbing on it or crusting just because those are generally somewhat fragile in terms of their structure.”

The next most common is a squamous cell carcinoma, which are found in the tissue that forms the skin’s surface, called the epidermis, and the cells are thin, flat and scaly. “These I often describe as a red warty appearing growth, something that looks like a wart. But you can tell your body doesn't like it because it's very red and inflamed. And those often do have kind of a thick layer of scabby crust on the top.”

And then there’s melanoma skin cancer, the most dangerous form of skin cancer because it can metastasize (spread) to other parts of the body. Melanoma is the most frequently diagnosed cancer in adults ages 20 to 30, and the leading cause of cancer death in young women ages 25 to 30.

“Melanoma is the highest cause of skin cancer mortality in the United States,” said Dr. Raisch. “Thankfully, it's much rarer than non-melanoma skin cancer. But because it does have a much greater potential to cause metastasis, meaning spread to other areas of the body and causing death, it's a very important one for people to be aware about.”

Melanoma often begins with a mole or a patch of skin, usually on sun-exposed skin like the head (especially the face/nose), neck, arms, legs and midsection.

Vital Importance of Sun Protection

Most skin cancers are directly attributable to ultraviolet light exposure from the sun, referred to as UVA or UVB. It’s essential to wear protective head or body gear or clothing, and apply sunscreen with a SPF (sun protection factor) of at least 30.

“The best thing you can do to prevent skin cancer is to limit your ultraviolet light exposure,” said Dr. Raisch. “One of the best things about living in South Florida is you have the ability to go out and be active and enjoy all of the good weather that we have. And I actually want people to be out there enjoying life. I just want them to take reasonable steps to prevent skin cancer. Putting on protective clothing, applying sunscreen and doing your activities when there's less ultraviolet light exposure are all things that you can do to really help.”

A good example for runners to follow is to avoid the hottest and most humid part of the day. “The other side benefit of doing that early morning run is there's really almost no UVB, which is the type of ultraviolet light that is most directly attributable to causing a skin cancer. UVA is similar to visible light in its spectrum, so it's pretty constant throughout the day. But UVB has a peak in the middle of the day, and then drops off dramatically as the sun gets lower in the sky.”

For more on skin cancer from Dr. Raisch, listen to a recent segment of the Baptist HealthTalk podcast.