Help For Skin Cancer Patients Caregivers And Families
As the COVID-19 pandemic continues to unfold, weve heard from skin cancer patients who are concerned about the coronavirus, including the delta and omicron variants.
You are not alone. We have entered an unprecedented time for our healthcare system. COVID-19 precautions are necessary in most healthcare settings, including wearing masks and maintaining social distancing.
What You Can Do
Be patient, but also proactive. If you have a medical emergency, you should try to get in to see a dermatologist as soon as possible. If you are not yet comfortable spending time indoors, see if your doctor offers any telemedicine options for non-emergencies.
In the meantime, find ways to relieve stress: try mindfulness, deep breathing, meditation, a good book, or speak with friends and family by phone or video chat. Above all, try to eat healthy and nutritious foods, exercise and get enough sleep.
Staying informed, asking questions and heeding the advice of medical professionals and the Centers for Disease Control and Prevention is the best way to stay safe during the COVID-19 pandemic.
Teledermatology is a telemedicine subspecialty using the latest technology to allow patients better access to high-quality dermatologic care without traveling to the clinic. Heres how you may be able to use teledermatology to help when it comes to skin cancer:
COVID-19 resources: Below is a list of additional resources and information about COVID-19 for patients and caregivers.
Are You At Risk For Skin Cancer
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Certain types of skin are at greater risk for developing sun damage and skin cancer. Do you know your skin type?
The Fitzpatrick Skin Type is a skin classification system first developed in 1975 by Thomas Fitzpatrick, MD, of Harvard Medical School. There are six skin phototypes, going from light to dark. Individuals with skin types I and II face the highest risk of developing skin cancer, while types V and VI are at the lowest risk. That is because those with more pigmentation have more natural protection from the sun. However, people with darker skin can still get skin cancer. Everyone, regardless of skin type, should practice a complete sun protection strategy and have regular skin exams with a dermatologist.
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Indoor Tanning Industry Responds
“The risks of getting skin cancer from indoor tanning are clearly exaggerated,â says John Overstreet, spokesman for the Indoor Tanning Association, an industry group. Blistering sunburns raise the risk of skin cancer, he says, and those are more likely to occur outdoors.
Staff members at indoor tanning facilities suggest customers limit how long they tan to avoid burning, he says, and staff also take into account the fairness of someoneâs skin when giving that advice.
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How Are Moles Evaluated
If you find a mole or spot that has any ABCDE’s of melanoma — or one that’s tender, itching, oozing, scaly, doesn’t heal or has redness or swelling beyond the mole — see a doctor. Your doctor may want to remove a tissue sample from the mole and biopsy it. If found to be cancerous, the entire mole and a rim of normal skin around it will be removed and the wound stitched closed. Additional treatment may be needed.
If The Cancer Comes Back
If melanoma does come back at some point, your treatment options will depend on where the cancer is, what treatments youve had before, and your overall health. For more on how recurrent cancer is treated, see Treatment of Melanoma Skin Cancer by Stage. For more general information on dealing with a recurrence, see Understanding Recurrence.
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Skin Cancer Diagnosis Always Requires A Skin Biopsy
When you see a dermatologist because youve found a spot that might be skin cancer, your dermatologist will examine the spot.
If the spot looks like it could be a skin cancer, your dermatologist will remove it all or part of it. This can easily be done during your appointment. The procedure that your dermatologist uses to remove the spot is called a skin biopsy.
Having a skin biopsy is essential. Its the only way to know whether you have skin cancer. Theres no other way to know for sure.
What your dermatologist removes will be looked at under a microscope. The doctor who examines the removed skin will look for cancer cells. If cancer cells are found, your biopsy report will tell you what type of skin cancer cells were found. When cancer cells arent found, your biopsy report will explain what was seen under the microscope.
How Is Skin Cancer Of The Head And Neck Diagnosed
Diagnosis is made by clinical exam and a biopsy. Basal cell and squamous cell cancers are staged by size and extent of growth. Basal cell cancers rarely metastasize to lymph nodes, but they can grow quite large and invade local structures. Squamous cell cancers have a much higher incidence of lymph node involvement in the neck and parotid gland and can spread along nerves.
Melanoma is staged, based not on size but on how deeply it invades the skin layers. Therefore, a superficial or shave biopsy will not provide accurate staging information used to guide treatment. Melanomas can have a very unpredictable course and may spread to distant organs. Melanomas with intermediate thickness often require sentinel node biopsy, a surgical procedure performed by a head and neck surgeon, to determine if microscopic spreading to lymph nodes has occurred.
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How Can I Tell If I Have Skin Cancer
Skin cancer is actually one of the easiest cancers to find. Thats because skin cancer usually begins where you can see it.
You can get skin cancer anywhere on your skin from your scalp to the bottoms of your feet. Even if the area gets little sun, its possible for skin cancer to develop there.
You can also get skin cancer in places that may surprise you. Skin cancer can begin under a toenail or fingernail, on your genitals, inside your mouth, or on a lip.
Treatment Options For Skin Cancer
The goal of any skin cancer treatment is to remove the cancer before it has a chance to spread. If the skin cancer has spread to nearby tissues or organs, treating the cancer becomes more difficult. If it hasnt spread, though, treating skin cancer is often very successful.
Treatment options include:
- Surgery. Surgically removing the cancerous spot is a common option. In some cases, the spot can be removed easily in a doctors office. More advanced cases may require in-depth surgery.
- Cryosurgery. This type of surgery freezes the affected skin, killing the cancerous cells. Over time, the dead skin cells fall off.
- Immunotherapy. Immunotherapy uses a persons immune system to target and destroy cancer. In the case of skin cancer, a medicated cream is applied to the cancerous area. The immune system then works to destroy the cancer.
- Chemotherapy. If skin cancer has progressed beyond the skin, chemotherapy can help target and kill any cancer cells surgery cant remove. Chemotherapy comes in several forms, including oral medication, injected shots, and IV infusions. It can even be applied to the skin.
- Radiation therapy. Radiation seeks out and destroys cancer cells. Radiation is used to treat a larger area, or an area thats too difficult to treat with surgery.
- In this type of therapy, a chemical is applied to the skin cancer. After staying on the skin for many hours, the skin is exposed to a special light, destroying the cancer cells.
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Can You Die From Skin Cancer If Youre Diagnosed With Squamous Cell Carcinoma
Squamous Cell Carcinoma usually involves the head or neck and is more likely to spread to other parts of the body than basal cell carcinoma, although this happens infrequently. Patients with specific disease risk factors are more likely to experience metastasis and die from the disease, according to the University of New Mexico Comprehensive Cancer Center.
The choice of treatment depends on the tumors size, location, depth of penetration, and the patients age and health. Of the eight treatment options, five involve surgery. The cure rate is 95 percent if the patient is treated early.
To prevent SCC, avoid sun exposure and protect your skin by wearing clothes that cover the arms, legs, face, neck, and ears. Wear SPF 30 to 50 sunscreen on all exposed skin, and stay away from tanning beds. A study of more than 9,000 patients found that people who use tanning beds have a 67 percent increased risk of non-melanoma cancer, including both SCC and BCC.
Basal Cell And Squamous Cell Survival Rates
Because basal cell and squamous cell carcinomas are lower-risk skin cancers, theres little information on survival rates based on stage.
Both types of cancer have a very high cure rate. According to the Canadian Cancer Society, the five-year survival rate for basal cell carcinoma is 100 percent. The five-year survival rate for squamous cell carcinoma is 95 percent.
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When To See A Dermatologist Regularly For Skin Checks
Go to a dermatologist for a baseline skin check, which is a visual inspection of your skin by a medical professional, if you:
- Have any risk factors for skin cancer outlined above
- Have a history of blistering sunburns
- Are fair-skinned and have lots of moles
At that point, your dermatologist may determine you are low risk and do not need regular visits, or he or she may say you should come back sooner because you have a lot of skin damage, Dr. Jolly says.
Some populations require regular skin checks because their health history puts them at higher risk of skin cancer, including people who have received organ transplants.
What happens is somebody receives a solid organ transplant, and then they have to now be on medicines that suppress their immune system so that they dont reject their organ, but the risk of skin cancer after organ transplant and being on those medicines can be 200-fold higher than prior to transplant. A properly functioning immune system is necessary to help your body combat factors that put you at risk for skin cancer, Dr. Jolly says.
A dermatologist should see organ transplant patients at least once before their transplant and again periodically after their transplant. A significant number of those patients will stay with a dermatologist for regular surveillance, Dr. Jolly says.
Talk to your doctor if you are concerned about skin cancer. If you need a doctor, find one near you.
Complementary And Alternative Treatments
It’s common for people with cancer to seek out complementary or alternative treatments. When used alongside your conventional cancer treatment, some of these therapies can make you feel better and improve your quality of life. Others may not be so helpful and in some cases may be harmful.
It is important to tell all your healthcare professionals about any complementary medicines you are taking. Never stop taking your conventional treatment without consulting your doctor first.
All treatments can have side effects. These days, new treatments are available that can help to make many side effects much less severe than they were in the past.
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Stages Of Skin Cancer
If you receive a skin cancer diagnosis, the next step is to identify its stage.
Staging is how doctors determine whether the cancer has spread to other parts of your body. Staging is common with melanoma and Merkel cell carcinoma, because these cancers are more likely to spread.
Typically, basal cell and squamous cell carcinomas dont involve staging. These skin cancers are easily treated and dont usually spread. However, your doctor may recommend staging for larger lesions.
Staging is based on the size of the growth and whether it has high-risk features. High-risk features include:
- larger than 2 millimeters thick
- spreads into the lower levels of the skin
- spreads into the space around a nerve
- appears on the lips or ears
- appears abnormal under a microscope
Heres a general breakdown of skin cancer stages:
- Stage 0. The cancer hasnt spread to surrounding areas of the skin.
- Stage 1. The cancer is 2 centimeters across or less, with no high-risk features.
- Stage 2. The cancer is more than 2 cm across and has a least two high-risk features.
- Stage 3. The cancer has spread to the bones in the face or nearby lymph nodes.
- Stage 4. The cancer has spread to the lymph nodes or internal organs.
Skin Cancer: Young Adults Get It Too
Editor’s note: Updated June 3, 2015, to add new research presented at the American Society for Clinical Oncology meeting and CDC report on melanoma.
At 27, just months after Danielle got married, she gave in to her husband Derekâs pleas to get a troublesome mole on her stomach checked out. The mole had been there for years, and her family was also concerned about it. “It would peel off and flake off and bleed,” she says.
Her doctor diagnosed her with the most deadly of skin cancers: melanoma. Even worse, it had spread to her lymph nodes. “Our first year of marriage was spent in hospitals, doctors’ offices, The Cancer Center, at chemo treatments, and having numerous surgeries,” she says.
Sheâs now in remission, but she has to go back to her oncologist every 3 months and to her doctor for skin checks every 6 months.
“You always think it can’t happen to you, but it does,” says Danielle, now 29. “I wish someone had told me when I was younger that tanning is not cute.”
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Determine Your Skin Cancer Risk
The guidelines above apply to everyone, but certain individuals are at a higher risk for developing skin cancer and should be especially cautious with sun exposure.
If any of the descriptions below apply to you, see a dermatologist for a full-body examination once a year. Skin cancer risk is cumulative. The more risk factors you have and the more sun damage over a lifetime the higher your risk.
Skin cancer risk factors include:
- Personal history of skin cancer or precancerous skin lesions
- Tendency to freckle or burn easily
- Lots of sun exposure throughout your life
- Many sunburns as a child or adolescent
- Family history of skin cancer or conditions that are more likely to develop into skin cancer, such as dysplastic nevus syndrome or numerous atypical moles
- Chronic, non-healing wounds or burn injuries
- Radiation therapy
- Exposure to toxic materials, such as arsenic
- Exposure to certain subtypes of human papilloma virus . HPV 6,11,16 and 18 have been linked to the development of squamous cell carcinoma, especially in patients with compromised immune systems.
- Organ transplant patients on immunosuppressant drugs have an increased risk of skin cancer
Can I Lower My Risk Of Cancer Coming Back Or Getting New Skin Cancers
If you have skin cancer, you probably want to know if there are things you can do that might lower your risk of the cancer coming back, or of getting a new skin cancer.
People who have had skin cancer are at higher risk for developing another skin cancer. Because of this, its important to limit your exposure to UV rays Rays?) and to examine your skin every month for signs of possible new skin cancers. Seeing your doctor regularly for skin exams is also important. Skin cancers that are found early are typically much easier to treat than those found at a later stage.
Smoking has been linked to an increased risk of squamous cell skin cancer, as well as to many other types of cancer. If you smoke and are thinking about quitting, call the American Cancer Society for information and support at 1-800-227-2345.
Adopting other healthy behaviors such as eating well, being active, and staying at a healthy weight might help as well, but no one knows for sure. However, we do know that these types of changes can have positive effects on your health, including lowering your risk for many other types of cancer, as well as other diseases.
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How Common Is Skin Cancer
You may think places with sunnier, hotter weather have more cases of skin cancer. This isnt necessarily the case. In fact, the Centers for Disease Control and Prevention notes California and Florida had fewer cases per 100,000 people than states with cooler climates, like Wyoming, Montana, and Idaho, in 2015.
The states with the fewest cases of skin cancer are:
States with the most cases of skin cancer include:
Can I Lower My Risk Of The Melanoma Progressing Or Coming Back
If you have melanoma, you probably want to know if there are things you can do that might lower your risk of the cancer coming back, or of getting a new skin cancer.
At this time, not enough is known about melanoma to say for sure if there are things you can do that will be helpful. We do know that people who have had melanoma are at higher risk for developing another melanoma or other type of skin cancer. Because of this, its very important to limit your exposure to UV rays and to continue to examine your skin every month for signs of melanoma coming back or possible new skin cancers. Skin cancers that are found early are typically much easier to treat than those found at a later stage.
Adopting healthy behaviors such as not smoking, eating well, being active, and staying at a healthy weight might help as well, but no one knows for sure. However, we do know that these types of changes can have positive effects on your health that can extend beyond your risk of melanoma or other cancers.
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