Surgery For Skin Cancer
Small skin cancer lesions may be removed through a variety of techniques, including simple excision , electrodesiccation and curettage , and cryosurgery .
Larger tumors, lesions in high-risk locations, recurrent tumors, and lesions in cosmetically sensitive areas are removed by a technique called Mohs micrographic surgery. For this technique, the surgeon carefully removes tissue, layer by layer, until cancer-free tissue is reached.
Malignant melanoma is treated more aggressively than just surgical removal. To ensure the complete removal of this dangerous malignancy, 1-2 cm of normal-appearing skin surrounding the tumor is also removed. Depending on the thickness of the melanoma, neighboring lymph nodes may also be removed and tested for cancer. The sentinel lymph node biopsy method uses a mildly radioactive substance to identify which lymph nodes are most likely to be affected.
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Keeping Cancer In Check
Chronic exposure to the sun or intermittent sunburns can lead to skin cancer. Skin cancer risk doubles with five or more sunburns in a lifetime, but just one bad sunburn can double the risk of melanoma. While skin cancer is uncommon in African Americans, Latinos and Asians, it can also be more deadly because they are often diagnosed later in the course of the disease.
Its important to examine your skin regularly. You should report any changes in an existing mole or any new moles to your physician. People with fair complexions have the highest risk of developing skin cancer, but everyone should avoid the sun and practice safety measures to protect their skin.
The American Cancer Society recommends the Slip, Slop, Slap and Wrap policy. When you go out in the sun, slip on a shirt, slop on sunscreen, slap on a hat and wrap on sunglasses to protect your eyes and the sensitive skin around them.
Exposure to the UV rays of tanning lamps is not safe. Tanning lamps give out UV rays, which can cause long-term skin damage and can contribute to skin cancer. Tanning bed use has been linked with an increased risk of melanoma, especially for people under 30. Most doctors and health organizations recommend not using tanning beds and sun lamps.
What Are The Four Main Types Of Melanoma Of The Skin
Superficial spreading melanoma
What you should know: This is the most common form of melanoma.
How and where it grows: It can arise in an existing mole or appear as a new lesion. When it begins in a mole that is already on the skin, it tends to grow on the surface of the skin for some time before penetrating more deeply. While it can be found nearly anywhere on the body, it is most likely to appear on the torso in men, the legs in women and the upper back in both.
What it looks like: It may appear as a flat or slightly raised and discolored, asymmetrical patch with uneven borders. Colors include shades of tan, brown, black, red/pink, blue or white. It can also lack pigment and appear as a pink or skin-tone lesion .
Lentigo maligna
What you should know: This form of melanoma often develops in older people. When this cancer becomes invasive or spreads beyond the original site, the disease is known as lentigo maligna melanoma.
How and where it grows: This form of melanoma is similar to the superficial spreading type, growing close to the skin surface at first. The tumor typically arises on sun-damaged skin on the face, ears, arms or upper torso.
What it looks like: It may look like a flat or slightly raised, blotchy patch with uneven borders. Color is usually blue-black, but can vary from tan to brown or dark brown.
Acral lentiginous melanoma
What you should know: This is the most common form of melanoma found in people of color, including individuals of African ancestry.
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How To Protect Yourself From Melanoma
Fortunately, most melanomas are diagnosed in early, localized stages, says Dr. González, and most patients treated for melanoma make a full recovery. But we do have patients that have ignored that funny looking mole for way too long, and its not uncommon to see cases that have metastasized to other organs, she adds.
Melanoma tends to a very aggressive form of cancer, and it can progress quickly from one stage to another. Says Dr. González: As soon as you see something unusual you should get it checked out, and as soon as you get a diagnosis, you need to be on top of the appropriate treatment.
Risk factors for melanoma include ultraviolet light exposure , having fair skin and light hair, and having a close relative whos also had melanoma. But monitoring skin for abnormal growths and changes is important for everyone, whether or not they are predisposed to skin cancer.
Going to see your board-certified dermatologist yearly and doing regular skin exams may not seem that important, Dr. González says, “but these are the things that could save your life.”
What Should You Do If You Think You Might Be Suffering From Skin Cancer
“The best advice would be to visit a GP or dermatologist if you spot any area of the skin that is changing in colour, shape or size,’ Dr Arun suggests. “If moles appear to be getting bigger, becoming itchy, inflamed or bleeding these can be an indication of something more serious going on.
“If you spend a lot of time exposed in the sun, you are at a greater risk of developing skin cancer.”
He adds: “With most non-melanoma cancers, they can be treated if found early enough so pay close attention to your body if you are concerned about a certain area. Taking photographs of concerning areas is a great way to monitor change. If you start to see differences, book an appointment to get it looked at by a professional. Its better to be safe than sorry!”
Dr Vishal Madan is a Consultant Dermatologist, Laser and Dermatological Surgeon. Dr Madan specializes in the diagnosis and treatment of all skin conditions. He has a special interest in skin cancer treatment.
Dr Arun Thiyagarajan is Medical Director at Bupa Health Clinics.
For more information on skin cancer visit the NHS. Book an appointment with your GP via the NHS or Bupa.
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What Is A Melanocyte
Melanocytes are skin cells found in the upper layer of skin. They produce a pigment known as melanin, which gives skin its color. There are two types of melanin: eumelanin and pheomelanin. When skin is exposed to ultraviolet radiation from the sun or tanning beds, it causes skin damage that triggers the melanocytes to produce more melanin, but only the eumelanin pigment attempts to protect the skin by causing the skin to darken or tan. Melanoma occurs when DNA damage from burning or tanning due to UV radiation triggers changes in the melanocytes, resulting in uncontrolled cellular growth.
About Melanin
Naturally darker-skinned people have more eumelanin and naturally fair-skinned people have more pheomelanin. While eumelanin has the ability to protect the skin from sun damage, pheomelanin does not. Thats why people with darker skin are at lower risk for developing melanoma than fair-skinned people who, due to lack of eumelanin, are more susceptible to sun damage, burning and skin cancer.
Precancerous Types Of Skin Cancer
Some precancerous growths, often attributable to sun exposure, can lead to skin cancer over time. However, if they are recognized and removed early, you could avoid a cancer diagnosis. These growths include:
- Actinic keratosis: About 40-60% of squamous cell cancer cases began as actinic keratosis. Anywhere between 2-10% of these growths will develop into SCC, sometimes in as little as a couple of years. Actinic cheilitis is a type of actinic keratosis that appears on the lower lip, and is at higher risk for developing into skin cancer
- Bowens disease: This early, noninvasive form of SCC is at high risk of becoming skin cancer if not addressed. It presents as an eczema-like scaly patch and is usually red or brown in color. These growths have been linked to sun exposure, radiation, carcinogen exposure, genetics, and trauma
- Leukoplakia: These white patches on the lips, tongue, and gums may be caused by alcohol and tobacco use, and can turn into squamous cell carcinoma. Cancer sites on the lips may be caused by sun damage
- Keratoacanthoma: This dome-shaped growth is usually found on sun-exposed skin and usually grows quickly at first, then slows down. Many shrink and go away on their own, but if they continue to grow, this tumor can turn into squamous cell carcinoma. They are usually removed surgically
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Signs Of Merkel Cell Cancer
Merkel cell cancer growths usually appear as firm, painless bumps or sores. They are found on sun-exposed areas of the body, especially the head, neck, and eyelids. The growths look like pearly pimple-like lumps and may be difficult to recognize. They can be pink, red, or purplish-blue. They usually grow quickly, which is why they are three to five times deadlier than melanoma.
A helpful way to spot Merkel cell cancer is by using the AEIOU tool:
- Asymptomatic: Most lesions are not painful or tender to the touch
- Expanding: Merkel cell cancer growths expand and grow quickly
- Immunocompromised: A compromised immune system puts someone at higher risk
- Older: More common in individuals over age 50
- UV-exposed skin: Lesions are more likely to present on sun-exposed skin
Benign Tumors That Develop From Other Types Of Skin Cells
- Seborrheic keratoses: tan, brown, or black raised spots with a waxy texture
- Hemangiomas: benign blood vessel growths, often called strawberry spots
- Lipomas: soft growths made up of fat cells
- Warts: rough-surfaced growths caused by some types of human papilloma virus
Most of these tumors rarely, if ever, turn into cancers. There are many other kinds of benign skin tumors, but most are not very common.
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When To Seek Medical Care For Skin Cancer
Many people, especially those who have fair coloring or have had extensive sun exposure, periodically check their entire body for suspicious moles and lesions.
Have your primary health care provider or a dermatologist check any moles or spots that concern you.
See your health care provider to check your skin if you notice any changes in the size, shape, color, or texture of pigmented areas .
If you have skin cancer, your skin specialist or cancer specialist will talk to you about symptoms of metastatic disease that might require care in a hospital.
Treatment For Nodular Melanoma
Nodular melanoma is highly curable when diagnosed early. However, because nodular melanoma grows so quickly, it is often found at a more advanced stage. The goals for treatment of nodular melanoma are to:
- cure the cancer
- preserve the appearance of your skin
- prevent the cancer from coming back
The extent and depth of the melanoma guides your care plan. Treatment often involves surgery to remove the melanoma. If the melanoma is more advanced and has spread to other parts of the body, such as the lymph nodes or internal organs, then immunotherapy, targeted therapy, chemotherapy, radiation, surgery, or a combination of therapies may be used to shrink the tumor.
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Melanomas With Unknown Primary
In rare cases, melanoma is found to have spread to lymph nodes or organs, but the original tumor site is unknown. When this type of melanoma occurs, it is called melanoma of unknown primary . Only about 3% of melanomas are MUP.
Current hypotheses suggest that most of these melanomas originate on the skin and arise from:
- Melanomas of the skin that were incompletely removed
- Regressed melanomas: When your bodys immune system may have destroyed a portion of the cancerous cells in a cutaneous melanoma but not before some melanoma cells were able to get into lymph nodes or blood vessels
- Pigmented cells that traveled to the lymph nodes and were transformed into melanoma.
How Do I Learn More
It is very important to take newly occurred changes on your skin seriously. If you have been suffering from skin cancer or have noticed unusual changes in your skin, call us today to make an appointment with our provider. If you have been suffering from skin cancer, we are here to guide you and be part of your healing journey. At the Dermatologic Surgery Center in Medina, Ohio, our surgeon, Dr. Popovisky is here to help you with the treating process.
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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.
Why Choose Memorial Sloan Kettering For Mucosal Melanoma Care
To treat mucosal melanoma in the best possible way, it takes a dedicated team of experts. Memorial Sloan Ketterings mucosal melanoma doctors have extensive experience in caring for people with this rare condition. We take a multidisciplinary approach to care. We bring together leading experts in surgery, drug therapy, and radiation therapy to create the most effective personalized treatment plan possible.
Our mucosal melanoma doctors are also leading researchers in the field. We may be able to offer new drug treatments, such as immunotherapy or targeted therapy, through our program of melanoma clinical trials. We are constantly looking for ways to make our approach to surgery and radiation more effective.
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Risk Of Further Melanomas
Most people treated for early melanoma do not have further trouble with the disease. However, when there is a chance that the melanoma may have spread to other parts of your body, you will need regular check-ups. Your doctor will decide how often you will need check-ups everyone is different. They will become less frequent if you have no further problems. After treatment for melanoma it is important to limit exposure to the sun’s UV radiation. As biological family members usually share similar traits, your family members may also have an increased risk of developing melanoma and other skin cancers. They can reduce their risk by spending less time in the sun and using a combination of sun protection measures during sun protection times. It is important to monitor your skin regularly and if you notice any changes in your skin, or enlarged lymph glands near to where you had the cancer, see your specialist as soon as possible.
Treatment For Nevoid Melanoma
Nevoid melanoma is highly curable when diagnosed early. The goals for treatment of nevoid melanoma are to:
- cure the cancer
- preserve the appearance of your skin
- prevent the cancer from coming back
The extent and depth of the melanoma guides your care plan. Treatment often involves surgery to remove the melanoma. If the melanoma is more advanced and has spread to other parts of the body, such as the lymph nodes or internal organs, immunotherapy, targeted therapy, chemotherapy, radiation, surgery, or a combination of therapies may be used to shrink the tumor.
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Treatment For Spitzoid Melanoma
Spitzoid melanoma is highly curable when diagnosed early. The goals for treatment of spitzoid melanoma are to:
- cure the cancer
- preserve the appearance of your skin
- prevent the cancer from coming back
The extent and depth of the melanoma guides your care plan. Treatment often involves surgery to remove the melanoma. If the melanoma is more advanced and has spread to other parts of the body, such as the lymph nodes or internal organs, immunotherapy, targeted therapy, chemotherapy, radiation, surgery, or a combination of therapies may be used to shrink the tumor.
Squamous Cell Carcinoma: Common In Sun
Squamous cell carcinoma, also called squamous cell cancer, is the second most common type of skin cancer. It accounts for about 20 percent of cases.
This type of cancer starts in flat cells in the outer part of the epidermis. It commonly crops up on sun-exposed areas, such as the face, ears, neck, lips, and hands. It can also develop on scars or chronic sores.
Squamous cell carcinomas may develop from precancerous skin spots, known as actinic keratosis .
These cancers might look like:
- A firm, red bump
- A flat lesion with a scaly, crusted surface
- A sore that heals and then reopens
People with lighter skin are more at risk for developing squamous cell carcinoma, but the skin cancer can also affect those with darker skin.
Other risk factors include:
- Having light eyes, blond or red hair, or freckles
- Being exposed to the sun or tanning beds
- Having a history of skin cancer
- Having a history of sunburns
- Having a weakened immune system
- Having the genetic disorder xeroderma pigmentosum
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A Dangerous Skin Cancer
Melanoma is a serious form of skin cancer that begins in cells known as melanocytes. While it is less common than basal cell carcinoma and squamous cell carcinoma , melanoma is more dangerous because of its ability to spread to other organs more rapidly if it is not treated at an early stage.
Learn more about melanoma types, risk factors, causes, warning signs and treatment.
Melanoma Fact
Only 20-30% of melanomas are found in existing moles.
While 70-80% arise on normal-looking skin.