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Basal Cell Cancer Squamous Cell Cancer Merkel Cell Cancer Melanoma

Firefighters experience higher rates of certain cancers than the general population likely due to exposure to hazardous materials on the job. Research indicates elevated levels of skin cancers, in particular melanoma, amongst firefighters. Knowing your risk is the first step in protecting yourself against disease. Awareness of the signs & symptoms of skin cancer is critical for early detection and the earlier a cancer is found, the better the likelihood of a positive outcome.


Basal cell carcinoma (also called basal cell cancer) is the most common skin cancer. About 8 out of 10 skin cancers are basal cell carcinomas.

  • Basal cell cancer most often appear on sun-exposed areas such as your face, scalp, ears, but can appear on the torso, arms and legs.

Basal cell cancers usually appear as a small dome-shaped bump that has a pearly white or pink color. Another common sign is a sore that bleeds and heals, and comes back again. It’s rare for a basal cell cancer to spread to other parts of the body. If a basal cell cancer is left untreated, it can grow into nearby areas and invade the bone or other tissues beneath the skin.

Squamous cell carcinoma (also called squamous cell cancer) is the second most common skin cancer. About 2 out of 10 skin cancers are squamous cell carcinomas.

  • Squamous cell cancer most often appear on sun-exposed areas such as your face, neck, arms, scalp, backs of the hands, and ears. They can also occur on the lips, inside the mouth, on the genitalia, or anywhere on the body.

Squamous cell cancers usually appear as crusted or scaly patches on the skin with a red, inflamed base, a growing tumor, or a non-healing sore. Squamous cell cancers are more likely to grow into deeper layers of skin and infrequently can involve lymph nodes.

Merkel Cell Carcinoma – Merkel cells are found in the top layer of the skin close to the nerve endings that receive the sensation of touch. Merkel cell carcinoma is a rare type of skin cancer that forms when Merkel cells grow out of control.

  • Merkel cell cancer usually appears on sun-exposed areas such as your head, and neck but may occur on arms, legs and trunk. A very small portion start in other parts of the body, such as inside the nose or esophagus.

Merkel cell carcinomas usually appear as a painless bump that can be red- purple color or skin color. They can grow quickly and can sometimes open as ulcers or sores.

Melanoma (also called malignant melanoma and cutaneous melanoma) is much less common than other skin cancers, but is more dangerous because it is much more likely to spread to other parts of the body if not caught early.

  • Melanomas most often appear on your trunk (chest and back) in men and on the legs in women. The neck and face are other common sites. However, a melanoma can develop anywhere. Melanoma tumors are usually brown or black, but can appear pink, tan, or even white.

Having darker skin lowers your risk of melanoma, but anyone can get melanoma including on the palms of the hands, soles of the feet, and under the nails. Melanomas can also form in other parts of your body such as the eyes, mouth, genitals, but these are much less common than melanoma of the skin.

Recognizing Melanoma

Recognizing a change in your skin or mole/freckle is the best way to detect melanoma early. Evaluate both new and existing moles/freckles using the following ABCDE guideline.

A stands for Asymmetry – if the mole is asymmetric- one half looking different from the other half.

B stands for Border – if the mole has an irregular or scalloped shape or has a poorly defined border.

C stands for Color– if the color is different from one area to another; has multiple colors with shades of tan, brown or black, or even white, red, or blue.

D stands for Diameter – if the mole is greater than 6 mm or the size of a pencil eraser. (they can be smaller)

E stands for Evolving – if the mole or skin lesion looks different from others or is changing in size, shape, or color.

If you have a mole with any of these characteristics, point it out to your doctor.

LEVINE CANCER INSTITUTE urges everyone to examine their skin regularly, preferably once a month. This means looking over your entire body including your back, your scalp, the soles of your feet, between your toes and the palms of your hands. If you notice a mole that is different from others, or that changes, itches or bleeds, even if it is small, you should make an appointment to see your care provider.

For more information on cancer, please visit Levine Cancer Institute at:

Article by: Dr. Richard White, Dr. Laura McGirt, Marlow Price, RN and Jennifer Vanderkamp, RN of Levine Cancer Institute Cutaneous Malignancy Program

References: American Cancer Society and National Institutes of Health

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