Melanoma isn't only skin cancer that carries the risk of death

May 15, 2013 | by Nicole White

Melanoma is the skin cancer that’s most associated with being lethal, but a study in JAMA Dermatology suggests a much more common skin cancer also carries a risk of metastasis and death.

A new JAMA study finds that the second most common form of skin cancer -- cutaneous squamous cell carcinoma -- carries a small risk of metastasis and death. A new JAMA study finds that the second most-common form of skin cancer -  cutaneous squamous cell carcinoma -  carries a small risk of metastasis and death.

The 10-year retrospective study, led by researchers at Brigham and Women’s Hospital, examined outcomes for cutaneous squamous cell carcinoma, or CSCC, diagnosed between Jan. 1, 2001, and Dec. 31, 2009 – the largest study of CSCC outcomes since 1968.

Squamous cell carcinomas are the second most-common skin cancer, according to the Skin Cancer Foundation. Although most cases of this type of cancer are easily cured with surgery or ablation, the study found that the cancer carries a low but significant risk of metastasis and death.

Squamous cell carcinomas form in the skin’s upper layers, known as the epidermis. They’re often found on the ear, face, lips and mouth, and they tend to be skin-colored or red. Such cancers also are likely to repeatedly bleed and form scabs. Because they’re  easily treated when detected early, squamous cell carcinomas  don’t instill the fear that melanoma does.

“There’s a perception that melanoma is the only potentially deadly skin cancer, but this study serves as an important reminder that other skin cancers carry a risk of death,” said Vijay Trisal, M.D., an assistant professor of surgical oncology at City of Hope and a consultant for Showtime’s “The Big C.” “With summer weather already upon us, it is vital that we all take measures to protect ourselves against skin cancer.”

That means shirts, hats and sunscreen – which should be reapplied regularly, especially after swimming or sweating.

Using a Brigham and Women’s Hospital database, researchers analyzed the medical records of 985 patients diagnosed with CSCC. They found specifically that CSCC patients had a 3.7 percent risk of metastasis and a 2.1 percent risk of disease-specific death.

As Trisal pointed out, certain factors are associated with poor outcomes: tumors that are more than 2 centimeters, that have invaded fat, occur on the ear or temple, or are present in immunocompromised patients.

“These should be taken more seriously than the ‘garden variety’ skin cancers,” he said.

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