Skin cancer on the face can spread at different rates depending on the type of skin cancer. The three main types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma. Basal cell carcinoma and squamous cell carcinoma are known together as nonmelanoma skin cancers, while melanoma is more serious and can spread rapidly if not treated early.
Basal Cell Carcinoma
Basal cell carcinoma (BCC) is the most common type of skin cancer, accounting for around 80% of cases. It starts in the lowest layer of the epidermis – the basal cells. BCC typically develops on sun-exposed areas like the face, head and neck. It usually grows slowly over months or years and rarely spreads to other parts of the body. However, if left untreated, BCC can penetrate deeply and damage surrounding tissue.
On the face, BCC often appears as a round, pearly bump or a flat, scaly patch. The tumor will slowly increase in size over time. It may bleed, crust over, or become an open sore. BCC grows at an average rate of 0.5mm per month. However, some aggressive cases may spread more rapidly at a rate of 2-3mm per month. High-risk basal cell carcinoma on the central face can invade tissue deeply within 5 years.
So in summary, the average rate of spread for basal cell carcinoma on the face is:
– 0.5mm per month
– 15mm per year
But aggressive BCC may spread at 2-3mm per month.
Squamous Cell Carcinoma
Squamous cell carcinoma (SCC) accounts for around 20% of skin cancer cases. It arises from the squamous cells found in the outer layer of the skin. Like BCC, SCC is usually caused by cumulative sun exposure and tends to occur on the head, face, lips, ears, neck, shoulders, hands and arms. It appears as a firm, red bump or a flat scaly patch.
SCC is more aggressive than BCC, and is more likely to spread to other areas of the body if not treated. The rate of spread depends on the location. High-risk SCC on the central face can spread at around 2mm per month. SCC on the ears and lips have higher rates of growth and spread. Overall, the average rate of spread for SCC on the face is estimated as:
– 1-2mm per month
– Up to 30mm per year
However, SCC can grow rapidly at over 2.5mm per week in some cases. One study found the average rate of spread for high-risk SCC on the head and neck was 2.1mm per month.
Melanoma
Melanoma is the most dangerous type of skin cancer. It develops from melanocytes – the pigment-producing cells of the skin. The first sign is often a new spot on the skin or an existing mole that changes in size, shape or color. Melanoma most often occurs on the trunk, legs and arms, but can also appear on the head and neck. Risk factors include sun exposure, multiple moles, fair skin and a family history of melanoma.
Melanoma grows and spreads much more rapidly than BCC or SCC if it is not caught early. The tumor thickness gives an indication of how quickly it is likely to spread. Thinner melanomas less than 1mm grow slowly over months to years. However, thicker melanomas over 4mm can metastasize in just a few months.
Studies show the average growth rate for melanoma is approximately 0.5mm per month. However, some melanomas can grow at rates of up to 5mm per month. One model estimates the spread rate as:
– 0.5mm per month for thin melanomas under 1mm
– 1.2mm per month for melanomas 1-2mm thick
– 2.5mm per month for thicker melanomas over 2mm
The location on the head and neck also impacts growth rate. Melanoma tends to grow faster when it occurs on the scalp, ears, lips and around the eyes.
So in summary, melanoma growth rates on the face can range from:
– 0.5-5mm per month
– Up to 60mm per year
But thicker melanomas over 2mm may spread at 2-3mm per month.
Typical Growth Rates Summary
| Skin Cancer Type | Average Growth Rate on Face |
|---|---|
| Basal Cell Carcinoma | 0.5mm per month |
| Squamous Cell Carcinoma | 1-2mm per month |
| Melanoma | 0.5-5mm per month |
What Impacts the Speed of Spread?
There are several factors that influence how quickly skin cancer may spread on the face:
Type of Skin Cancer
– Melanoma spreads faster than basal cell or squamous cell carcinomas
– SCC is more aggressive than BCC
Tumor Thickness
– Thicker tumors tend to spread more rapidly
– Melanomas over 4mm can metastasize within months
Location on Face
– Central face, ears, lips, around eyes and nose have increased risk
– More blood vessels in these areas can aid spread
High Risk Features
– Ulceration, bleeding, rapid growth, recurrence after treatment
– Indicates cancer is more likely to spread
Delay in Treatment
– The longer cancer is left untreated, the more it will spread
– Early diagnosis and treatment is key
Weakened Immune System
– Conditions like HIV/AIDS impede the body’s ability to fight cancer
– Cancer can grow and spread faster
When Does Skin Cancer on the Face Metastasize?
Metastasis refers to skin cancer spreading from the face to other areas of the body. This occurs through the lymph nodes and bloodstream.
Basal Cell Carcinoma
Basal cell carcinoma very rarely metastasizes. Only 0.0028-0.55% of cases spread to other parts of the body. When it does happen, it is usually after many years of growth or in cases where BCC goes repeatedly untreated. BCC may metastasize to the lymph nodes, lungs, liver and bones.
Squamous Cell Carcinoma
Around 2-10% of squamous cell carcinomas metastasize. The risk is higher for tumors over 2cm in diameter or 4mm in thickness. SCC usually spreads first to nearby lymph nodes in the neck, followed by distant sites like the lungs, liver, brain or bones.
Melanoma
Melanoma has the highest risk of spreading to other organs. The 5-year survival rates are:
– Stage 0 – 99%
– Stage 1A – 97%
– Stage 1B – 92%
– Stage 2A – 81%
– Stage 2B – 70%
– Stage 3A – 78%
– Stage 3B – 59%
– Stage 3C – 40%
– Stage 4 – 15-20%
Melanoma on the head or neck has a high risk of spreading to the brain. Metastasis most often occurs through the lymph vessels to nearby lymph nodes. It can then spread to distant sites like the lungs, liver, bones and brain.
Treatment Options Based on Stage
Treatment options depend on the type of skin cancer, location on the face, size and how far it has spread.
Stage 0
Stage 0 skin cancers are only located in the top layer of skin and have not grown deeper. BCC and SCC may be treated with topical creams, cryosurgery (freezing), laser therapy or surgical excision to remove the tumor.
Stage 1
Stage 1 indicates a small localized skin cancer. BCC and SCC are treated with surgical excision, curettage and electrodesiccation, cryosurgery, laser surgery, or radiation therapy. Mohs surgery may be used for high-risk areas on the face.
Small stage 1 melanomas are treated with surgical excision with safety margins. Sentinel lymph node biopsy may done to check for spread to lymph nodes.
Stage 2
Larger stage 2 skin cancers that have grown deeper are excised with wider margins. Radiation therapy or Mohs surgery may also be used. If lymph nodes are affected, a lymph node dissection will be required.
Stage 3
More extensive surgery is needed for larger stage 3 tumors. Lymph node removal, immunotherapy, radiation and chemotherapy may also be utilized.
Stage 4
Stage 4 means the cancer has metastasized to other organs. Treatment focuses on stopping spread and preserving quality of life. Options include surgery, immunotherapy, targeted therapy, chemotherapy, and radiation therapy.
Prevention
To help prevent skin cancer spreading on your face:
– Apply broad-spectrum SPF 30+ sunscreen daily
– Seek shade and wear protective clothing
– Avoid tanning beds
– Examine skin monthly and note changes in moles
– Get a professional skin exam annually
– Treat precancerous lesions like actinic keratoses
– Follow treatment plan for any skin cancers diagnosed
Conclusion
The rate that skin cancer spreads on the face depends on the type, location, thickness and stage of the tumor. Basal cell carcinoma is slowest growing at about 0.5mm per month. Squamous cell carcinoma spreads faster at 1-2mm per month. Melanoma is the most rapid at 0.5-5mm monthly. Thicker tumors over 2mm have quicker growth rates. Central face, ears, lips and around the eyes are high-risk locations. Regular skin examinations, early diagnosis and prompt treatment are vital to stop skin cancer spreading beyond the face. With appropriate management, the majority of skin cancers on the face can be treated successfully.
