Can Skin Cancer Be Deadly?
By: Tyler Quest, MD, FAAD
Yes, skin cancer can be deadly. More than two people in the U.S. die from skin cancer every hour.
Thankfully, skin cancer is largely treatable, and usually curable. The most common skin cancer, basal cell carcinoma, has a survival rate of 100% if treated before spreading to other sites (and it is extremely rare for basal cell carcinoma to metastasize, or spread to other parts of the body, with rates as low as 0.003%). Most dermatologists (and especially Mohs surgeons - who you can learn about more in our article “Treatment options for skin cancer”) treat and completely cure basal cell carcinomas five days a week. When an individual diagnosed with basal cell carcinoma consults with an appropriately trained skin cancer specialist, the cure rate of basal cell carcinoma is over 99%.1
Squamous cell carcinoma, the second most common skin cancer, is also usually treatable and curable. However, it does carry a higher risk of metastasis in comparison to basal cell carcinoma and somewhere between 1-4% of these skin cancers may spread to other parts of the body, such as the lymph nodes. As squamous cell carcinoma is not always reported to cancer registries, the exact number of people who die from squamous cell carcinoma of the skin is unknown, but estimates are at least 5,400 people die from nonmelanoma skin cancer worldwide every month (the vast majority are squamous cell carcinomas).2
Melanoma, the third most common type of skin cancer, is different. When caught early - either an in situ or a localized melanoma - melanoma is highly curable with survival rates of 99%. However, if diagnosed after spreading to other distant organs, melanoma can become quite deadly, with the survival rate decreasing to 35%.3 As dermatologists, early detection of melanoma is one of our most important and consequential roles.
Other types of skin cancers are more rare, such as merkel cell carcinoma, but can also be deadly (merkel cell when detected early has a five year survival rate of 75%).
The vast majority of skin cancers are caused by ultraviolet (UV) damage, either from the sun or from tanning beds (a known carcinogen!).
What does this information tell us? Skin cancer is extremely common, can show up in several different ways, is usually caused by sun damage or tanning beds, and is often curable - especially when detected early. It is extremely important to protect your skin from UV damage and remember the importance of seeing a dermatologist certified by the American Board of Dermatology for your skin exams (or a nurse practitioner or physician assistant under direct supervision of a dermatologist), especially if you have one or more of the following risk factors: extensive sun or tanning bed exposure, a very fair complexion, a history of skin cancer, or numerous (50 or more) nevi (moles). Certain individuals should always be sure to see a dermatologist yearly - such as those with a history of a solid organ transplant or anyone on immunosuppressing medications, or individuals with medical conditions or genetic syndromes that raise your risk of skin cancer. Remember - dermatologists spend at least four years in college, an additional four years in medical school, AND an additional four to six years training in everything about the skin. Dermatologists are the experts in skin care, so talk to your primary care provider or use the American Academy of Dermatology “Find a Dermatologist” resource https://find-a-derm.aad.org/ to locate a dermatologist near you.
As the Skin Cancer Foundation says (perfectly) “If you see something new, changing or unusual, go get checked by a dermatologist. It could save your life.”
Metastatic basal cell carcinoma: case series and review of the literature. Tang S, Thompson S, Smee R.. New South Wales, Australia. Australas J Dermaol 2017 May;58(2): e40-43
Global Burden of Disease Cancer Collaboration. Global, regional and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2017. Global Burden of Disease Cancer Collaboration. JAMA Oncol. 2019;5(12):1749-1768.
Cancer Facts and Figures 2024. American Cancer Society. https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/2024-cancer-facts-figures.html. Accessed January 17, 2024
The Skin Cancer Foundation. https://www.skincancer.org/. Accessed January 17, 2024