Around 2010 one of my perennial "pre-cancer" spots flared-up and turned into REAL cancer. There is no doubt in your mind when it does. It goes from being something which simply is a dry, damaged, flaking & never completely healing area to something akin to a growing volcanic mountain before an explosion. When I went to have it looked at he said "can you come in tomorrow?". I said "is there an option?" He said "If you wanna live, no." That's when they cut an ellipse around the lesion and remove it with a scalpel.