Cancer May Spread From Where It Began To Other Parts Of The Body
- 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.
What Are The Melanoma Stages And What Do They Mean
Stage 0 and I are localized, meaning they have not spread.
- Stage 0: Melanoma is localized in the outermost layer of skin and has not advanced deeper. This noninvasive stage is also called melanoma in situ.
- Stage I: The cancer is smaller than 1 mm in Breslow depth, and may or may not be ulcerated. It is localized but invasive, meaning that it has penetrated beneath the top layer into the next layer of skin. Invasive tumors considered stage IA are classified as early and thin if they are not ulcerated and measure less than 0.8 mm.
Find out about treatment options for early melanomas.
Intermediate or high-risk melanomas
Localized but larger tumors may have other traits such as ulceration that put them at high risk of spreading.
- Stage II: Intermediate, high-risk melanomas are tumors deeper than 1 mm that may or may not be ulcerated. Although they are not yet known to have advanced beyond the primary tumor, the risk of spreading is high, and physicians may recommend a sentinel lymph node biopsy to verify whether melanoma cells have spread to the local lymph nodes. Thicker melanomas, greater than 4.0 mm, have a very high risk of spreading, and any ulceration can move the disease into a higher subcategory of stage II. Because of that risk, the doctor may recommend more aggressive treatment.
The Early Stages Of Skin Cancer
Some forms of cancer, especially melanoma, may appear suddenly and without warning. Most people become alarmed only when they develop a crust or sore that refuses to heal. Did you know that the early stages of cancer do not always look or feel so bad? Harmless-looking moles, skin lesions, or unusual skin growths may also be the signs of early stages.
Regular skin examination can help you spot these early clues. If you see anything suspicious or observe unusual appearances in your skin, we can help you get the right diagnosis and treatment immediately. Some forms of cancer in the skin can be life-threatening and spread without being given urgent attention.
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Ive Been Diagnosed With Melanomawhat Happens Next
Doctors use the TNM system developed by the American Joint Committee on Cancer to begin the staging process. Its a classification based on three key factors:
T stands for the extent of the original tumor, its thickness or how deep it has grown and whether it has ulcerated.
What Is Breslow depth?
Breslow depth is a measurement from the surface of the skin to the deepest component of the melanoma.
Tumor thickness: Known as Breslow thickness or Breslow depth, this is a significant factor in predicting how far a melanoma has advanced. In general, a thinner Breslow depth indicates a smaller chance that the tumor has spread and a better outlook for treatment success. The thicker the melanoma measures, the greater its chance of spreading.
Tumor ulceration: Ulceration is a breakdown of the skin on top of the melanoma. Melanomas with ulceration are more serious because they have a greater risk of spreading, so they are staged higher than tumors without ulceration.
N indicates whether or not the cancer has already spread to nearby lymph nodes. The N category also includes in-transit tumors that have spread beyond the primary tumor toward the local lymph nodes but have not yet reached the lymph nodes.
M represents spread or metastasis to distant lymph nodes or skin sites and organs such as the lungs or brain.
After TNM categories are identified, the overall stage number is assigned. A lower stage number means less progression of the disease.
How To Tell If Squamous Cell Carcinoma Has Spread
Many doctors will order a PET or CT scan once a squamous cell carcinoma diagnosis has been reached to ensure the cancer has not spread to other parts of the body and is contained within the layers of the skin. Your doctor may also test your lymph nodes near the tumor site.
Diagnostic services, staging services and a comprehensive range of treatments are all available at Moffitt Cancer Center, and referrals are not required. To learn more about squamous cell carcinoma stages and the treatment options for each, call or submit a new patient registration form online.
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Skin Color And Being Exposed To Sunlight Can Increase The Risk Of Basal Cell Carcinoma And Squamous Cell Carcinoma Of The Skin
Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer not having risk factors doesnt mean that you will not get cancer. Talk with your doctor if you think you may be at risk.
Risk factors for basal cell carcinoma and squamous cell carcinoma of the skin include the following:
- Being exposed to natural sunlight or artificial sunlight over long periods of time.
- Having a fair complexion, which includes the following:
- Fair skin that freckles and burns easily, does not tan, or tans poorly.
- Blue, green, or other light-colored eyes.
- Red or blond hair.
Although having a fair complexion is a risk factor for skin cancer, people of all skin colors can get skin cancer.
Older age is the main risk factor for most cancers. The chance of getting cancer increases as you get older.
The Five Stages Of Skin Cancer
Cancer in the skin thats at high risk for spreading shares features with basal cell carcinoma and squamous cell carcinoma. Some of these features are:
- Not less than 2 mm in thickness
- Has spread into the inner layers of the skin
- Has invaded skin nerves
In the earliest stage, cancer is only present in the upper layer of the skin. You may notice the appearance of blood vessels or a dent in the center of the skin growth. There are no traces of malignant cells beyond this layer.
At stage 1, cancer has not spread to muscles, bone, and other organs. It measures roughly 4/5 of an inch. Theres a possibility that it may have spread into the inner layer of the skin.
In this stage, cancer has become larger than 4/5 of an inch. Cancer still has not spread to muscles, bone, and other organs.
At stage 3, the cancer is still larger than 4/5 of an inch. Facial bones or a nearby lymph node may have been affected, but other organs remain safe. It may also spread to areas below the skin, such as into muscle, bone, and cartilage but not far from the original site.
Cancer can now be of any size and has likely spread into lymph nodes, bones, cartilage, muscle, or other organs. Distant organs such as the brain or lungs may also be affected. In rare cases, this stage might cause death when allowed to grow and become more invasive.
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Recurrence In Other Parts Of The Body
Melanoma can also come back in distant parts of the body. Almost any organ can be affected. Most often, the melanoma will come back in the lungs, bones, liver, or brain. Treatment for these recurrences is generally the same as for stage IV melanoma . Melanomas that recur on an arm or leg may be treated with isolated limb perfusion/infusion chemotherapy.
Melanoma that comes back in the brain can be hard to treat. Single tumors can sometimes be removed by surgery. Radiation therapy to the brain may help as well. Systemic treatments might also be tried.
As with other stages of melanoma, people with recurrent melanoma may want to think about taking part in a clinical trial.
The treatment information given here is not official policy of the American Cancer Society and is not intended as medical advice to replace the expertise and judgment of your cancer care team. It is intended to help you and your family make informed decisions, together with your doctor. Your doctor may have reasons for suggesting a treatment plan different from these general treatment options. Don’t hesitate to ask him or her questions about your treatment options.
Squamous Cell Carcinoma Treatment
Squamous cell carcinomas detected at an early stage and removed promptly are almost always curable and cause minimal damage. However, left untreated, they may grow to the point of being very difficult to treat.
A small percentage may even metastasize to distant tissues and organs. Your doctor can help you determine if a particular SCC is at increased risk for metastasis and may need treatment beyond simple excision.
Fortunately, there are several effective ways to treat squamous cell carcinoma. The choice of treatment is based on the type, size, location, and depth of penetration of the tumor, as well as the patients age and general health. Squamous cell carcinoma treatment can almost always be performed on an outpatient basis.
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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.
Squamous Cell Carcinoma In Situ
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Squamous cell carcinoma in situ, also known as Bowens disease, is a precancerous condition that appears as a red or brownish patch or plaque on the skin that grows slowly over time. The patches are often found on the legs and lower parts of the body, as well as the head and neck. In rare cases, it has been found on the hands and feet, in the genital area, and in the area around the anus.
Bowens disease is uncommon: only 15 out of every 100,000 people will develop this condition every year. The condition typically affects the Caucasian population, but women are more likely to develop Bowens disease than men. The majority of cases are in adults over 60. As with other skin cancers, Bowens disease can develop after long-term exposure to the sun. It can also develop following radiotherapy treatment. Other causes include immune suppression, skin injury, inflammatory skin conditions, and a human papillomavirus infection.
Bowens disease is generally treatable and doesnt develop into squamous cell carcinoma. Up to 16% of cases develop into cancer.
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Early Signs Of Skin Cancer To Look Out For
Detecting skin cancer early is the best way to ensure it is treated successfully. But how can skin cancer be detected early? The good thing about skin cancer is that it leaves easily identifiable marks on our bodies long before it becomes a serious problem. During skin cancer screenings your dermatologist will look for these telltale signs. Well help you identify them so that you can be on the lookout when youre at home and, therefore, spot skin cancer early.
There are three common types of skin cancer basal cell carcinoma , squamous cell carcinoma , and melanoma. BCC and SCC are far more common than melanoma and are both non-life threatening. Melanoma, on the other hand, is the more aggressive of the three and typically causes serious complications, including death.
Basal Cell Carcinoma Stages
There are certain features that are considered to make the cancer at higher risk for spreading or recurrence, and these may also be used to stage basal cell carcinomas. These include:
- Greater than 2 mm in thickness
- Invasion into the lower dermis or subcutis layers of the skin
- Invasion into the tiny nerves in the skin
- Location on the ear or on a hair-bearing lip
After the TNM components and risk factors have been established, the cancer is given a stage. For basal cell carcinoma staging, the factors are grouped and labeled 0 to 4. The characteristics and stages of basal cell carcinoma are:
Stage 0: Also called carcinoma in situ, cancer discovered in this stage is only present in the epidermis and has not spread deeper to the dermis.
Stage 1 basal cell carcinoma: The cancer is less than 2 centimeters, about 4/5 of an inch across, has not spread to nearby lymph nodes or organs, and has one or fewer high-risk features.
Stage 2 basal cell carcinoma: The cancer is larger than 2 centimeters across, and has not spread to nearby organs or lymph nodes, or a tumor of any size with 2 or more high-risk features.
Stage 3 basal cell carcinoma: The cancer has spread into facial bones or 1 nearby lymph node, but not to other organs.
Stage 4 basal cell carcinoma: The cancer can be any size and has spread to 1 or more lymph nodes which are larger than 3 cm and may have spread to bones or other organs in the body.
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What Are The Risk Factors For Skin Cancer
The most common risk factors for skin cancer are as follows.
- Ultraviolet light exposure, either from the sun or from tanning beds. Fair-skinned individuals, with hazel or blue eyes, and people with blond or red hair are particularly vulnerable. The problem is worse in areas of high elevation or near the equator where sunlight exposure is more intense.
- A chronically suppressed immune system from underlying diseases such as HIV/AIDS infection or cancer, or from some medications such as prednisone or chemotherapy
- Exposure to ionizing radiation or chemicals known to predispose to cancer such as arsenic
- Certain types of sexually acquired wart virus infections
- People who have a history of one skin cancer have a 20% chance of developing second skin cancer in the next two years.
- Elderly patients have more skin cancers.
Most basal cell carcinomas have few if any symptoms. Squamous cell carcinomas may be painful. Both forms of skin cancer may appear as a sore that bleeds, oozes, crusts, or otherwise will not heal. They begin as a slowly growing bump on the skin that may bleed after minor trauma. Both kinds of skin cancers may have raised edges and central ulceration.
Signs and symptoms of basal cell carcinomas include:
Signs and symptoms of squamous cell carcinomas include:
- Persistent, scaly red patches with irregular borders that may bleed easily
- Open sore that does not go away for weeks
- A raised growth with a rough surface that is indented in the middle
- A wart-like growth
Thinking About Taking Part In A Clinical Trial
Clinical trials are carefully controlled research studies that are done to get a closer look at promising new treatments or procedures. Clinical trials are one way to get state-of-the art cancer treatment. In some cases they may be the only way to get access to newer treatments. They are also the best way for doctors to learn better methods to treat cancer. Still, they’re not right for everyone.
If you would like to learn more about clinical trials that might be right for you, start by asking your doctor if your clinic or hospital conducts clinical trials.
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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.
How Is Skin Cancer Treated
Treatment depends upon the stage of cancer. Stages of skin cancer range from stage 0 to stage IV. The higher the number, the more cancer has spread.
Sometimes a biopsy alone can remove all the cancer tissue if the cancer is small and limited to your skins surface only. Other common skin cancer treatments, used alone or in combination, include:
Cryotherapy uses liquid nitrogen to freeze skin cancer. The dead cells slough off after treatment. Precancerous skin lesions, called actinic keratosis, and other small, early cancers limited to the skins top layer can be treated with this method.
This surgery involves removing the tumor and some surrounding healthy skin to be sure all cancer has been removed.
With this procedure, the visible, raised area of the tumor is removed first. Then your surgeon uses a scalpel to remove a thin layer of skin cancer cells. The layer is examined under a microscope immediately after removal. Additional layers of tissue continue to be removed, one layer at a time, until no more cancer cells are seen under the microscope.
Mohs surgery removes only diseased tissue, saving as much surrounding normal tissue as possible. Its most often used to treat basal cell and squamous cell cancers and near sensitive or cosmetically important areas, such as eyelids, ears, lips, forehead, scalp, fingers or genital area.
Curettage and electrodesiccation
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