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Skin cancer is the most common of all cancers. It is a disease in which malignant cells are found in the outer layers of your skin. Several types of cancer can start in the skin. The most common are basal cell cancer and squamous cell cancer. These types are called nonmelanoma skin cancer. Skin cancer is a disease in which malignant cells are found in one of the layers of the skin. Skin, the body's largest organ, protects the body against heat, light, infection and injury. It consists of two main layers: the epidermis (top layer) and the dermis (inner layer). The dermis contains blood vessels, hair follicles, sweat glands, and oil glands. The epidermis consists of mostly flat, scale-like cells known as squamous cells. Beneath the squamous cells are round basal cells. Melanocytes are in the epidermis. They contain malanin, the pigment of the skin. When you expose your skin to the sun (or ultraviolet light in a tanning bed), the melanocytes produce more pigment, causing your skin to darken. Benign tumors are not cancerous. In the skin, examples of benign tumors are moles and non-cancerous warts. Most people have between 10 to 40 moles. Malignant tumors are cancerous. Cancer cells can spread to nearby healthy cells and destroy them. The cancerous cells can also invade other parts of the body. Basal
Cell Carcinoma Squamous
Cell Carcinoma Malignant
Melanoma Actinic
keratosis Risk Factors Exposure to ultraviolet radiation (UV light), such as sunlight and tanning booths, can damage the cells in your skin and that damage can lead to basal cell or squamous cell carcinomas. Although UV light is the main risk factor, other factors include heredity and environment. People from families with a history of skin cancer are at higher risk. Scientists have identified a gene that is thought to help cause basal cell carcinoma. The gene, known as PTC or "patched", normally controls the growth and development of cells. When it is defective or damaged - for example, by sunlight - cancer of the basal cell can occur. Environmental factors, such as depletion of the ozone layer, high elevation, or latitude (proximity to the equator) can contribute to higher risk of skin cancer. Exposures to radiation or substances such as creosote are also risk factors. Although anyone can get skin cancer, the risk is greater for people who have fair skin that freckle easily. Prevention tips:
People should check themselves regularly for new growths or changes in the skin. It is almost totally curable when caught in the early stages. Performing a self-examination requires a full length mirror, a hand mirror, and a well-lighted room. Examine your body front and back in the mirror, bend your elbows and look at your arms and the palms of your hands. Next, look at your legs and feet, spaces between your toes and bottom of soles. Check your back and buttocks with a hand mirror. Finally examine your neck and scalp with the hand mirror. Any suspicious spots should be reported to your physician. Performing a skin self-examination requires a full-length mirror, a hand-held mirror and a well-lighted room. Examine your body, front and back, in the mirror. Bend your elbows and look at your arms and the palms of your hands. Next, look at your legs and feet, spaces between toes, and bottom of soles. Check your back and buttocks with a hand mirror. Finally, examine your neck and scalp with the hand mirror. Any suspicious spots should be reported to your physician. What to look for:
When an area of skin does not look normal, the doctor will remove some of the cells so they can be examined under a microsscope for the presence of cancer. This is called a biopsy. To do this, the doctor may remove all or part of the growth. How Can I Detect Skin Cancer? People should check themselves regularly for new growths or changes in the skin. It is almost totally curable when caught in the early stages. Performing a self-examination requires a full length mirror, a hand mirror, and a well-lighted room. Examine your body front and back in the mirror, bend your elbows and look at your arms and the palms of your hands. Next, look at your legs and feet, spaces between your toes and bottom of soles. Check your back and buttocks with a hand mirror. Finally examine your neck and scalp with the hand mirror. Any suspicious spots should be reported to your physician. Performing a skin self-examination requires a full-length mirror, a hand-held mirror and a well-lighted room. Examine your body, front and back, in the mirror. Bend your elbows and look at your arms and the palms of your hands. Next, look at your legs and feet, spaces between toes, and bottom of soles. Check your back and buttocks with a hand mirror. Finally, examine your neck and scalp with the hand mirror. Any suspicious spots should be reported to your physician. What to look for:
How Is Cancer Diagnosed? When an area of skin does not look normal, the doctor will remove some of the cells so they can be examined under a microsscope for the presence of cancer. This is called a biopsy. To do this, the doctor may remove all or part of the growth.
There are treatments for all patients with skin cancer. Treatment methods depend on the type and stage of the disease as well as the patient's age and overall health. The doctor is the best person to answer questions about treatment options. Most basal cell and squamous cell carcinomas are treated with surgery. Sometimes doctors suggest radiation or chemotherapy, or a combination of these methods. A number of different types of surgery can be used, including:
If a large cancer is removed, reconstruction surgery with a skin flap or graft may also be needed. To make a skin graft, the doctor takes a piece of skin from another part of the body to replace the skin that was removed. Radiation
therapy Chemotherapy Treatments There are treatments for all patients with skin cancer. Treatment methods depend on the type and stage of the disease as well as the patient's age and overall health. The doctor is the best person to answer questions about treatment options. Most basal cell and squamous cell carcinomas are treated with surgery. Sometimes doctors suggest radiation or chemotherapy, or a combination of these methods. A number of different types of surgery can be used, including:
If a large cancer is removed, reconstruction surgery with a skin flap or graft may also be needed. To make a skin graft, the doctor takes a piece of skin from another part of the body to replace the skin that was removed. Radiation
therapy Chemotherapy
ANSWER: The most common warning sign of skin cancer is a change on the skin, especially a new growth or a sore that doesn't heal. Skin cancers do not all look the same.
Both Basal and squamous cell cancers are found mainly on areas of the skin that are exposed to the sun - the head, face, neck, hands, and arms. However, skin cancer can occur anywhere.
3. What causes skin cancer? ANSWER: Several risk factors increase the chance of getting skin cancer. Ultraviolet (UV) radiation from the sun is the main cause of skin cancer. There are two types of ultraviolet radiation - UVA and UVB. UVB rays are more likely to cause sunburn, but UVA rays pass further into the skin. Scientists have long thought that UVB radiation can cause skin cancer. They now think UVA radiation also may add to skin damage that can lead to cancer. For this reason, skin specialists recommend that people use sunscreens that block both kinds of UV radiation. Artificial sources of UV radiation, such as sunlamps and tanning booths, can also cause skin cancer. Although anyone can get skin cancer, the risk is greatest for people who have fair skin that freckles easily - often those with red or blond hair and blue or light colored eyes. The risk of developing skin cancer is also affected by where are person lives. People who live in areas that get high levels of UV radiation from the sun are more likely to get skin cancer. In addition, skin cancer is related to lifetime exposure to UV radiation. Most skin cancers appear after age 50, but the sun's damaging effects begin at an early age. Therefore, protection should start in childhood to prevent skin cancer later in life.
4. How can I prevent skin cancer? ANSWER: Whenever possible, people should avoid exposure to the midday sun (from 10am to 2pm standard time, or from 11am to 3pm daylight saving time). Keep in mind that protective clothing, such as sun hats and long sleeves, can block out the sun's harmful rays. Also, lotions that contain sunscreens can protect the skin. Sunscreens are rated in strength according to a sun protection factor (SPF), which ranges from 2 to 30 or higher. Those rated 15 to 30 block most of the sun's harmful rays.
5. How can I detect skin cancer? ANSWER: Check yourself regularly for new growths or changes in the skin. It is almost totally curable when caught in the early stages. Performing a self-examination requires a full length mirror, a hand mirror and a well - lighted room.
Any suspicious spots should be reported to your doctor. The doctor should also look at the skin during routine physical exams.
6. How is skin cancer diagnosed? ANSWER: When an area of skin does not look normal, the doctor will perform a biopsy (removal of all or part of growth). The tissue is examined under the microscope to determine if it is cancerous. Doctors generally divide skin cancer into two stages: local (affecting only the skin) or metastatic (spreading beyond the skin). Because skin cancer rarely spreads, a biopsy often is the only test needed to determine the stage. In cases where the growth is very large or has been present for a long time, the doctor will carefully check the lymph nodes in the area. In addition, you may have to have additional tests, such as special x-rays, to find out whether the cancer has spread to other parts of the body. Knowing the stage of a skin cancer helps the doctor plan the best treatment. 7. What will my doctor do if I have skin cancer? ANSWER: In treating skin cancer, the doctor's main goal is to remove or destroy the cancer completely with as small a scar as possible. To plan the best treatment, the doctor considers the location and size of the cancer, the risk of scarring, and the person's age, general health, and medical history. It is sometimes helpful to have the advice of more than one doctor before starting treatment. It may take a week or two to arrange for a second opinion, but this short delay will not reduce the chance that treatment will be successful.
8. How will my skin cancer be treated? ANSWER: Treatment for skin cancer usually involves some type of surgery. In some cases, doctors suggest radiation therapy or chemotherapy. Sometimes a combination of these methods is used. Surgery: Skin cancers can be cut from the skin. Sometimes they are completely removed at the time of biopsy and no further treatment in needed. Curettage and Electrodesiccation: The cancer is scooped out with a curettage (an instrument with a sharp, spoon-shaped end). The area is also treated with electrodesiccation. An electric current from a special machine is used to control bleeding and kill any cancer cells remaining around the edge of the wound. Most patients develop a flat, white scar. Moh's Surgery: Moh's technique is a special type of surgery used for skin cancer. Its purpose is to remove all of the cancerous tissue and as little of the healthy tissue as possible. It is especially helpful when the doctor is not sure of the shape and depth of the tumor. In addition, this method is used to remove large tumors, those in hard-to-treat places, and cancers that have recurred. After being given a local anesthetic, the cancer is shaved off one thin layer at a time. Each layer is checked under a microscope until the entire tumor is removed. The degree of scarring depends on the location and size of the treated area. Only doctors who are specially trained in this type of surgery should use this method. Cryosurgery: Extreme cold may be used to treat pre-cancerous skin conditions, such as actinic keratosis, as well as certain small skin cancers. In cryosurgery, liquid nitrogen is applied to the growth to freeze and kill the abnormal cells. After the area thaws, the dead tissue falls off. More than one freezing may be needed to remove the growth completely. Cryosurgery usually does not hurt, but patients may have pain and swelling after the area thaws. A white scar may form in the treated area. Laser Therapy: Laser therapy uses a narrow beam of light to remove or destroy cancer cells. This approach is sometimes used for cancers that involve only the outer layer of skin. Grafting: Sometimes, especially when a large cancer is removed, a skin graft is needed to close the wound and reduce the amount of scarring. For this procedure, the doctor takes a piece of healthy skin from another part of the body to replace the skin that was removed. Radiation: Skin cancers responds well to radiation therapy (also called radiotherapy), which uses high-energy rays to damage cancer cells and stop them from growing. Doctors often use this treatment for cancers that occur in areas that are hard to treat with surgery. For example, radiation therapy might be used for cancers of the eyelid, the tip of the nose, or the ear. Several treatments may be needed to destroy all of the cancer cells. Radiation therapy may cause a rash or make the skin in the area dry or red. Changes in skin color and/or texture may develop after the treatment is over and may become more noticeable many years later. Topical Chemotherapy: This is the use of anticancer drugs in cream or lotion applied to the skin. Actinic keratosis can be treated effectively with the anticancer drug fluorouracil (also called 5-FU). This treatment is also useful for cancers limited to the top layer of skin. The 5-FU is applied daily for several weeks. Intense inflammation is common during treatment, but scars usually do not occur. Clinical Trials: In clinical trials (research studies with patients), doctors are studying new treatments for skin cancer.
9. What should I do after I have had my skin cancer treated? ANSWER: Even though most skin cancers are cured, people who have been treated for skin cancer have a higher-than-average risk of developing a new cancer of the skin. That is why it is so important you to continue to examine yourself regularly, to visit your doctor for regular checkups, and to follow your doctor's instructions on how to reduce your risk of developing skin cancer again.
10. Questions to Ask Your Doctor:
Skin cancer has a better prognosis, or outcome, than most other types of cancer; it is curable in over 95% of cases. Some patients become concerned that treatment may change their appearance, especially if the skin cancer is on their face. You should discuss this important concern with their doctor. You may want to have a second opinion before treatment.
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