How To Treat Non Melanoma Skin Cancer

Am I At Risk For Basal Or Squamous Cell Skin Cancers

According to the Skin Cancer Foundation, 90%, or 9 of 10, of basal and squamous cell skin cancers are caused by ultraviolet rays. UV rays from the sun are strongest during the middle of the day. Man-made UV rays, like those from tanning beds or sun lamps, are just as dangerous. You may be at higher risk for basal or squamous cell skin cancer if you:

• Have fairer skin that burns easily
• Are male

Personalized Expert Skin Cancer Treatment

If you or a family member have been diagnosed with skin cancer, we understand how frightening this can be. Skin cancer is the most common of all cancers and accounts for nearly half of all cancers in the United States.At Forefront Dermatology, our experienced, collaborative team of board-certified dermatologists and fellowship-trained Mohs skin cancer surgeons combine the very latest in expert clinical knowledge and technology, with a comprehensive and compassionate approach to care. This allows us to offer our patients a personalized program of patient-centered care for all of those we treat.

What Should I Expect Before During And After Excision

The best type of doctor and setting for excision will depend on tumor size, location, and type. Thin melanomas and low-risk non-melanoma skin cancers can be excised in a doctors office. A numbing medicine will be injected at the tumor. After the procedure, you will be given instructions on how to care for the incision.

Excision of thicker melanomas may be done at the same time as sentinel lymph node biopsy. This procedure is usually done at the hospital under general anesthesia. Often it is an outpatient surgery, although sometimes patients stay overnight.

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Remission And The Chance Of Recurrence

A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.

A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. While many remissions are permanent, it is important to talk with your doctor about the possibility of the cancer returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.

If skin cancer returns after the original treatment, it is called recurrent cancer. It may come back in the same place , nearby , or in another place . Certain parts of the body, such as the ears and lips, are more prone to develop recurrent skin cancers. In addition, people whose immune system is suppressed due to a medication or disease are also at higher risk for skin cancer recurrence.

When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence. After this testing is done, you and your doctor will talk about the treatment options. Often the treatment plan will include the treatments described above. Your doctor may suggest clinical trials that are studying new ways to treat this type of recurrent cancer. Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects.

What Affects The Skin Cancer Survival Rate

The most important factor that affects the skin cancer survival rate is how early on the skin cancer is detected. However, there are a few additional factors to take into consideration, including:

• The age of the patient
• The patients access to care and treatment
• Whether the patient currently has any other chronic diseases, and how well theyre being managed if there are any

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Coping With Emotional And Social Effects

You can have emotional and social effects after a cancer diagnosis. This may include dealing with difficult emotions, such as sadness, anxiety, or anger, or managing your stress level. Sometimes, people find it difficult to express how they feel to their loved ones. Some have found that talking to an oncology social worker, counselor, or member of the clergy can help them develop more effective ways of coping and talking about cancer.

You can also find coping strategies for emotional and social effects in a separate section of this website. This section includes many resources for finding support and information to meet your needs.

Points Of Contact For More Information About Non

Hospitals that are particularly experienced in treating patients with skin cancer can demonstrate this through certification. The German Cancer Society regularly checks their compliance with certain professional requirements.

You can find the addresses of the certified centers on the OncoMAP website.

You can also search for dermatology clinics in Germany on the homepage of the German Dermatological Society.

Do you have further questions about dealing with the condition in everyday life and additional support options? More information is provided on the website of the Cancer Information Service of the German Cancer Research Center .

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Certain Factors Affect Prognosis And Treatment Options

The prognosis for squamous cell carcinoma of the skin depends mostly on the following:

• Stage of the cancer.
• Whether the patient is immunosuppressed.
• Whether the patient uses tobacco.
• The patient’s general health.

Treatment options for basal cell carcinoma and squamous cell carcinoma of the skin depend on the following:

• The type of cancer.
• The stage of the cancer, for squamous cell carcinoma.
• The size of the tumor and what part of the body it affects.
• The patients general health.

What Does Aftercare Involve

The doctor will examine every part of the patients skin at the follow-up appointment. Patients who have had squamous cell carcinoma and are at a higher risk of relapse may also have an ultrasound scan to examine the lymph nodes. Other scanning methods, such as computed tomography or magnetic resonance imaging , are only used if the doctor detects any relevant signs of disease and wants to exclude the possibility that the cancer is progressing.

Those who have recovered from non-melanoma skin cancer should also examine themselves regularly to ensure that any further tumors which may occur are detected and treated at an early stage.

Would you like to know more about testing methods like ultrasound or computed tomography? You will find detailed descriptions of these and other methods on the website of the Cancer Information Service of the German Cancer Research Center .

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How To Prevent Non

Your genes play very little of a role in dictating whether or not you will develop non-melanoma skin cancer aside from the fact that people with fair skin are at a greater risk for the disease. Lifestyle is far and away the greater cause of skin cancer, with extended and frequent exposure to UV light the leading cause of skin cancer.

To reduce your chance of getting skin cancer, you must reduce your exposure to ultraviolet light. This means wearing sunblock and covering clothing when in the sun, completely avoiding tanning beds and other artificial UV lights, and even applying UV-blocking window tint to your vehicle and home or workplace. Just a few bad sunburns can increase the chance of skin cancer, as can prolonged UV exposure even without a burn.

What Are The Symptoms Of Nonmelanoma Skin Cancer

Nonmelanoma skin cancer often develops in areas exposed to the sun, such as the head, face, neck, arms, and hands. But it can start anywhere on the body. It may appear as a new growth. Or it may occur as a change in the size or in the color of a growth you already have. These changes can happen slowly or quickly.

Here are some possible signs of nonmelanoma skin cancer:

• A small, raised bump that is shiny or pearly
• A small, flat spot that is scaly, irregularly shaped, and pale, pink, or red
• Sores that don’t heal
• A growth with raised edges, a lower area in the center, and brown, blue, or black areas
• A wart-like growth that might bleed or crust over
• Scaly patches or bumps that are often red or purple and itch

Many of these may be caused by other health problems. But it is important to see a healthcare provider if you have these symptoms. Only a healthcare provider can tell if you have cancer.

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E Physical Emotional And Social Effects Of Cancer

Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.

Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type, and stage of cancer, may receive this type of care.

And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, the better quality of life, and report they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.

Before treatment begins, talk with your doctor about the goals of each treatment in the treatment plan. You should also talk about the possible side effects of the specific treatment plan and palliative care options.

During treatment, your health care team may ask you to answer questions about your symptoms and side effects and to describe each problem.

Who Treats Melanoma Skin Cancer

Depending on your options, you may have different types of doctors on your treatment team. These doctors may include:

• A dermatologist: a doctor who treats diseases of the skin
• A surgical oncologist : a doctor who uses surgery to treat cancer
• A medical oncologist: a doctor who treats cancer with medicines such as chemotherapy, immunotherapy, or targeted therapy
• A radiation oncologist: a doctor who treats cancer with radiation therapy

Many other specialists may be involved in your care as well, including physician assistants , nurse practitioners , nurses, psychologists, social workers, rehabilitation specialists, and other health professionals.

• Health Professionals Associated with Cancer Care

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Choosing To Stop Treatment Or Choosing No Treatment At All

For some people, when treatments have been tried and are no longer controlling the cancer, it could be time to weigh the benefits and risks of continuing to try new treatments. Whether or not you continue treatment, there are still things you can do to help maintain or improve your quality of life.

Some people, especially if the cancer is advanced, might not want to be treated at all. There are many reasons you might decide not to get cancer treatment, but its important to talk to your doctors and you make that decision. Remember that even if you choose not to treat the cancer, you can still get supportive care to help with pain or other symptoms.

Exploring The Link Between Viral

Current knowledge of the correlation between viral-immunologic profile of HIV positive patients and NMSCs is evolving. A peculiar correlation between decreased immune-surveillance and carcinogenic virus co-infections might favor oncogenesis, increasing the risk of developing tumors in these subjects .

Figure 3 The exploration of a bond between NMSCs and immuno-viral profile of PLWH.

CD4 cell count is one of the main investigations in the clinical evaluation and management of HIV-infected patients and the skin is richly endowed with these cells. Immunocompetent and PLWH seemed to share the same genetic and environmental factors that lead to the formation of NMSC. Immunosuppression can increase risk to develop NMSCs, mostly SCC . An increased rate of neoplasms could be likely to explained by the progressive decline and dysfunction of T cells associated with HIV infection.

HIV infection causes reduced activation of both CD4 and CD8 cells and an increased synthesis of TH2 cytokine subsets. This event leads to cell-mediated immunity deficiency and accumulation of genetic mutations. HIV produces specific proteins, such as nef and tat, that alter MHC signaling and chemokine production .

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There Are Three Ways That Cancer Spreads In The Body

Cancer can spread through tissue, the lymph system, and the blood:

• Tissue. The cancer spreads from where it began by growing into nearby areas.
• Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
• Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.

Cancer May Spread From Where It Began To Other Parts Of The Body

When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began and travel through the lymph system or blood.

• Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor in another part of the body.
• Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor in another part of the body.

The metastatic tumor is the same type of cancer as the primary tumor. For example, if skin cancer spreads to the lung, the cancer cells in the lung are actually skin cancer cells. The disease is metastatic skin cancer, not lung cancer.

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What Is The Skin

Skin is a thin layer of tissue that is a barrier between the outside world and our internal organs. It is the largest organ in the body. It is made up of three layers:

• The epidermis is the outermost layer of our skin. It provides a barrier from UV radiation, chemicals, bacteria, and viruses.
• The dermis is the layer underneath the epidermis. It contains connective tissues, hair follicles, and sweat glands.
• The hypodermis is the layer below the dermis and is made up of fat and connective tissue.

Over the years, the skin is exposed to numerous potential carcinogens, or cancer-causing agents, most importantly the sun and its damaging ultraviolet rays.

Radiation Therapy For Skin Cancer

External beam radiation therapy

At GenesisCare our non-melanoma skin cancer treatments include external beam radiation therapy , where radiation is delivered from outside the body, and internal radiation therapy , where the radiation dose is given via a source implanted within the body.

Intensity-modulated radiation therapy

IMRT is an advanced external beam radiation therapy technique where the beams of radiation are precisely shaped to exactly match your tumor and damage to adjacent healthy tissues is limited.

Volumetric modulated arc therapy

VMAT is an advanced form of IMRT that directs beams of radiation in an arc across the treatment area. VMAT very accurately target areas of cancer and can be used to give a homogenous dose to large treatment areas while sparing deep tissue from toxicity.

High-dose rate brachytherapy

HDR brachytherapy is an internal radiation therapy that delivers radioactive pellets to the tumor site through small plastic tubes called catheters or an implant. This is usually done in one session and is removed after 20 minutes.

Chapter 4

At GenesisCare, we offer various drug therapies and a wide range of the latest anti-cancer drugs for skin cancer treatment, including chemotherapy, targeted therapy and immunotherapy.

Chemotherapy for NMSCs

Red light treatment for NMSCs

Targeted therapy for NMSCs

Immunotherapy for NMSCs

Chapter 5

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Coping With Nonmelanoma Skin Cancer

Many people feel worried, depressed, and stressed when dealing with cancer. Getting treatment for cancer can be tough on the mind and body. Keep talking with your healthcare team about any problems or concerns you have. Work together to ease the effect of cancer and its symptoms on your daily life.

Here are some tips:

• Join a cancer support group.

Cancer treatment is also hard on the body. To help yourself stay healthier, try to:

• Eat a healthy diet, with a focus on high-protein foods.
• Drink plenty of water, fruit juices, and other liquids.
• Keep physically active.
• Rest as much as needed.
• Talk with your healthcare team about ways to manage treatment side effects.
• Take your medicines as directed by your team.

Recurrence In Nearby Lymph Nodes

If nearby lymph nodes werenât all removed during the initial treatment, the melanoma might come back in these lymph nodes. Lymph node recurrence is treated by lymph node dissection if it can be done, sometimes followed by adjuvant treatments such as radiation therapy and/or immunotherapy or targeted therapy . If surgery is not an option, radiation therapy or systemic treatment can be used.

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Risk Factors And Pathogenesis

Among immunocompetent light-skin color people, the development of NMSCs is favored mainly by chronic sun exposure and increasing age. There are important phenotypic characteristics, such as fair skin type, light-colored eyes, red hair, northern European origin and childhood freckling that influence vulnerability to solar radiation. The frequency and intensity of sun exposure are also important.

Other environmental risk factors that contribute an increased risk for NMSCs include older age, family history of skin cancer, immunodeficiency , previous radiotherapy, long-term immunosuppressive treatment, genetic syndromes and chronic, mostly occupational, exposure to arsenic .Moreover, several observational studies have documented a correlation between use of photosensitizing molecules and increased risk for BCC .

Treating Stage 0 Melanoma

Stage 0 melanoma has not grown deeper than the top layer of the skin . It is usually treated by surgery to remove the melanoma and a small margin of normal skin around it. The removed sample is then sent to a lab to be looked at with a microscope. If cancer cells are seen at the edges of the sample, a second, wider excision of the area may be done.

Some doctors may consider the use of imiquimod cream or radiation therapy instead of surgery, although not all doctors agree with this.

For melanomas in sensitive areas on the face, some doctors may use Mohs surgery or even imiquimod cream if surgery might be disfiguring, although not all doctors agree with these uses.

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