Hand cancers.

Of all the nasty things that happen frequently to your hands from infections, fractures, dislocations, and arthritis, one thing does not occur that frequently--cancer.

Well, not exactly.

Cancer does occur in the hands and when it does, it's usually a very bad thing. The most common cause of cancer in the hand is a metastasis from someplace else on the body, eg lung cancer. This is a sign of a terminal condition, and in most cases, there is not much that can be done because the cancer is essentially incurable. Likewise, cancers that occur on the hand primarily (not a metastasis) are bad news too because they are usually things like sarcomas, which often require limb amputation and have a very poor prognosis.

Fortunately, these conditions do not occur frequently. In fact, the vast majority of tumors and masses in the hand are benign and are not cancer. But that doesn't mean cancer doesn't occur in the hands. It does, and quite frequently.

I am sure you are confused by now, and rightly so. How can cancer be both common and uncommon? Well, it's because the majority of cancers that occur on the hand are not hand cancers per se, but skin cancers that occur on the hand.

Semantics?

No, not really, because these cancers, which include things like basal cell and squamous cell carcinoma, occur throughout the skin of the body, and are treated essentially the same, ie with surgical excision in the vast majority of cases.

Plus, these cancers are, for the most part, indolent, meaning they are extremely slow growing and not aggressive, especially if they occur in older folks and are related to sun exposure. Likewise, they rarely metastasize and are not a cause of death in most people.

So, in short, they are not cancers you should be afraid of, but likewise, you shouldn't ignore them because they can grow and cause disfigurement, and if left long enough, they can metastasize. Some people do die from basal cell carcinoma, and this is a shame because it should never happen.

So what does a skin cancer on the hand look like?

Essentially, it is a red scaly lesion that may have a crust and quite often, bleed frequently. It may heal up between the times it gets crusty and bleeds and look shiny and waxy. Most importantly, these lesions do not go away, and over time, they do get bigger.

Here is a pretty classic example of a skin cancer (in this case, basal cell carcinoma) that has occurred on the hand. I can treat a cancer like this easily and safely with a small office procedure, and there is no need for any further treatment like chemotherapy and radiation. (Luckily, the vast majority of skin cancers that occur on the hand need no further treatment other than simple excision, which, as I have said, can be done in the comfort of my office.)

Below is an example of a squamous cell carcinoma. Now, although the majority of squamous call carcinomas on the hand are no big deal, left untreated they can cause much bigger problems than a basal cell carcinoma because they are more aggressive cancers. 

Generally speaking though, in a patient who is older where the cancer is the result of sun-exposure (and not say radiation or medications such as immune suppressants), squamous cell carcinoma is treated easily with excision only. But I can't stress enough that it is important NOT to let these things go neglected. They can easily get out of hand, rather quickly in some cases, and what should be a curable cancer, can become one that can result in an untimely and unnecessary death. 

So, make sure you see your doctor, and make sure if there is any doubt, get a biopsy, which can be a virtually painless, office procedure, that will give the answers that you need so you can get a reliable and effective cure.