Carcinoma In Situ Vs Cancer
A million-dollar question lately, especially with controversy over the treatment of ductal carcinoma in situ or in situ breast cancer, is whether or not carcinoma in situ is really cancer. The answer is that it depends on who you talk to. Some physicians classify carcinoma in situ as non-invasive cancer and others may prefer calling it pre-cancer. The distinction would lie in knowing whether or not the CIS would progress to invasive cancer, and that, by definition, is not known. Nor are we apt to get answers soon, as it wouldn’t be ethical to simply watch large numbers of carcinoma in situ’s to see if they became invasive cancer and spread.
The Difference Between Invasive And Noninvasive Procedures
Doctors have a wide range of procedures, tests, and tools available for diagnosing and treating disease. Some of these procedures are more easily done and not as hard on the patient while others are difficult and present greater risk to the patient. Unfortunately, the more difficult procedures are often necessary to help the patient.
In a very broad and general sense, procedures can be put in to two categories invasive procedures and non-invasive procedures. What are the differences between these and why would you pick one over the other?
An invasive procedures is defined as a medical procedure which breaks the skin in some way. This is a huge category and includes just about all major surgery and many diagnostic tests. If it leaves a scar, its most likely an invasive procedure. Invasive procedures may be required to remove a tumor, repair a broken bone, or stop internal bleeding. Of course, thats just three examples there are literally dozens of other indications for invasive procedures.
Non-invasive procedures are also quite common. These are defined as any medical procedure which does not break the skin. Obviously, this is a massively large category. Imaging studies, including x-rays, ultrasound, MRI, and CT scans are all examples of non-invasive procedures. ECGs are also non-invasive.
Aside from this example, there are dozens of types and sub-types of non-invasive procedures.
There Are Three Ways That Cancer Spreads In The Body
- 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.
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New Imaging Technique Can Detect Skin Cancers Without Invasive Biopsy
Researchers funded by the National Institute of Biomedical Imaging and Bioengineering have developed a non-invasive imaging technique that accurately detects skin cancer without surgical biopsy. Multiphoton microscopy of mitochondriasmall organelles that produce energy in cellsaccurately identified melanomas and basal cell carcinomas by detecting abnormal clusters of mitochondria in both types of skin cancer.
A group of international collaborators led by co-senior author Irene Georgakoudi, Ph.D., in the Department of Biomedical Engineering at Tufts, found that mitochondria behave very differently in healthy versus cancerous tissue. They used a laser microscopy technique that takes advantage of the characteristics of a key molecule in mitochondria, nicotinamide adenine dinucleotide , that is central to energy production. They found that NADH, which naturally fluoresces without injecting any dye or contrast agent into the individuals being screened, can be detected using multiphoton microscopy to provide diagnostically useful information about the organization of the mitochondria in skin cells.
This research was funded by the National Institutes of Health through grant # P41EB015890 from the National Institute of Biomedical Imaging and Bioengineering. Additional funding was provided by the American Cancer Society, the Alexander S. Onassis Public Benefit Foundation, and the Arnold and Mabel Beckman Foundation.
Contact Us To Learn More About Ig
Have further questions about how to treat Squamous cell carcinoma or Basal cell cancer with IG-SRT technology? Please call us at 312-987-6543 to learn more. The skin cancer information specialists at GentleCure can provide all the details you need to feel confident about making your non-melanoma skin cancer treatment decision. Need help finding a treatment center that offers IG-SRT near you? Our Find a Practice tool makes it quick and easy to find the nearest location to you.
Non-Melanoma Skin Cancer impacts the lives of 4 million Americans each year. GentleCure is committed to raising awareness of IG-SRT and is a trademark owned by SkinCure Oncology, LLC.
The information on this website is provided without any representations or warranties. You should not rely on this website as an alternative to medical advice from your doctor or healthcare provider. The information on this site, as well as any information provided by the skin cancer information specialists on our educational hotline, is intended to help you make a better-informed treatment decision in conjunction with trained and licensed medical professionals.
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After Squamous Cell Cancer Of The Skin Has Been Diagnosed Tests Are Done To Find Out If Cancer Cells Have Spread Within The Skin Or To Other Parts Of The Body
The process used to find out if cancer has spread within the skin or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment for squamous cell carcinoma of the skin.
Basal cell carcinoma of the skin rarely spreads to other parts of the body. Staging tests to check whether basal cell carcinoma of the skin has spread are usually not needed.
The following tests and procedures may be used in the staging process for squamous cell carcinoma of the skin:
Early Signs Of Skin Cancer On The Neck
Knowing the early signs of skin cancer helps you stay on top of your skins health, although looking for a cancerous growth on the back of your neck may be more challenging. Performing a self examination on a regular basis is a good preventative measure, keeping you aware of any new bumps, sores, or discolorations. Skin cancer on the neck is a slow developing disease, meaning it will often start small and build over time. Scheduling an annual skin cancer screening will give you professional guidance for any troublesome developments.
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Different Types Of Cancer Start In The Skin
Skin cancer may form in basal cells or squamous cells. Basal cell carcinoma and squamous cell carcinoma are the most common types of skin cancer. They are also called nonmelanoma skin cancer. Actinic keratosis is a skin condition that sometimes becomes squamous cell carcinoma.
This summary is about basal cell carcinoma, squamous cell carcinoma of the skin, and actinic keratosis. See the following PDQ summaries for information on melanoma and other kinds of cancer that affect the skin:
Scanning With Lasers To Diagnose Skin Cancer
One new tool is reflectance confocal microscopy . This technology uses a low-power laser to scan skin lesions. The laser can penetrate slightly below the skins surface. The natural reflectivity of different cellular elements in a lesion provides important clues about whether it is cancerous or not. The reflected information can be collected in still and video images in microscopic detail.
We can send these images electronically for examination and diagnosis by our doctors, Dr. Rossi says. In many cases, it eliminates the need for a conventional biopsy. Anything that does look suspicious can be followed up with a biopsy to confirm a cancer diagnosis.
Since RCM is noninvasive, this method allows doctors to reexamine the same area repeatedly over time without hurting or changing the tissue, he explains. By contrast, taking several biopsies can damage tissue, and scarring can make it harder to study later.
Dr. Rossi says that MSK dermatologists are exploring the use of RCM in combination with another imaging technique called optical coherence tomography . This tool works at a greater depth than RCM up to 1.5 millimeters although the clarity is limited. By combining RCM with OCT, dermatologists obtain a fuller view of a lesion without cutting the skin.
RCM also provides guidance for surgery to remove skin cancers on the face and neck.
Tests Or Procedures That Examine The Skin Are Used To Diagnose Basal Cell Carcinoma And Squamous Cell Carcinoma Of The Skin
The following procedures may be used:
- Physical exam and health history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patients health habits and past illnesses and treatments will also be taken.
- Skin exam: An exam of the skin for bumps or spots that look abnormal in color, size, shape, or texture.
- Skin biopsy: All or part of the abnormal-looking growth is cut from the skin and viewed under a microscope by a pathologist to check for signs of cancer. There are four main types of skin biopsies:
- Shave biopsy: A sterile razor blade is used to shave-off the abnormal-looking growth.
- Punch biopsy: A special instrument called a punch or a trephine is used to remove a circle of tissue from the abnormal-looking growth. Enlarge Punch biopsy. A hollow, circular scalpel is used to cut into a lesion on the skin. The instrument is turned clockwise and counterclockwise to cut down about 4 millimeters to the layer of fatty tissue below the dermis. A small sample of tissue is removed to be checked under a microscope. Skin thickness is different on different parts of the body.
- Incisional biopsy: A scalpel is used to remove part of a growth.
- Excisional biopsy: A scalpel is used to remove the entire growth.
Surgical Skin Cancer Treatments
In most cases, there are many surgical options for skin cancers depending on several factors: type of skin cancer, tumor location, medical history, surgical history and medications. Surgical options include freezing, curettage, chemical peels, routine excision and Mohs surgery. Tru-Skin Dermatology providers are trained to perform your skin cancer surgery comfortably and effectively in our offices.
For your comfort we provide local anesthesia and use proven techniques to reduce the pain of injection. There is no need for general anesthesia or hospitalization. After your skin cancer removal is completed, our providers assess your individual level of anxiety and pain tolerance, and may prescribe medications to make your recovery as comfortable as possible.
Mohs surgery is the most advanced and effective skin cancer surgery available today. Cure rates are the highest of any surgical procedure: 99% for basal cell carcinoma and 95% for squamous cell carcinoma.
Additional benefits of Mohs surgery are:
- Doesnt require hospitalization or general anesthesia
- Complete cancer removal is confirmed the same day
- Removes the smallest possible amount of normal skin
- Minimal discomfort due to local anesthesia
- Excellent cosmetic results
Surgery For Basal And Squamous Cell Skin Cancers
Surgery is a common treatment for basal cell and squamous cell skin cancers. Different surgical techniques can be used. The options depend on the type of skin cancer, how large the cancer is, where it is on the body, and other factors. Most often the surgery can be done in a doctors office or hospital clinic using a local anesthetic . For skin cancers with a high risk of spreading, surgery sometimes will be followed by other treatments, such as radiation or chemotherapy.
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.
Recurrent Basal Cell Carcinoma
Basal cell carcinomas are the most common type of skin cancer, according to the American Cancer Society. These cancers develop within the basal cell layer of the skin, in the lowest part of the epidermis.
Patients who have had basal cell carcinoma once have an increased risk of developing a recurrent basal cell cancer. Basal cell cancers may recur in the same location that the original cancer was found or elsewhere in the body. As many as 50 percent of cancer patients are estimated to experience basal cell carcinoma recurrence within five years of the first diagnosis.
Basal cell carcinomas typically grow slowly, and it is rare for them to metastasize or spread to nearby lymph nodes or other parts of the body. But early detection and treatment are important.
After completing treatment for basal cell carcinoma, it is important to perform regular self-examinations of the skin to look for new symptoms, such as unusual growths or changes in the size, shape or color of an existing spot. Skin cancers typically develop in areas of the body that are exposed to the sun, but they may also develop in areas with no sun exposure. Tell your oncologist or dermatologist about any new symptoms or suspicious changes you may have noticed.
- Have a history of eczema or dry skin
- Have been exposed to high doses of UV light
- Had original carcinomas several layers deep in the skin
- Had original carcinomas larger than 2 centimeters
Diagnosis And Staging What It Means For You
How is melanoma diagnosed?
To diagnose melanoma, a dermatologist biopsies the suspicious tissue and sends it to a lab, where a dermatopathologist determines whether cancer cells are present.
After the disease is diagnosed and the type of melanoma is identified, the next step is for your medical team to identify the stage of the disease. This may require additional tests including imaging such as PET scans, CT scans, MRIs and blood tests.
The stage of melanoma is determined by several factors, including how much the cancer has grown, whether the disease has spread and other considerations. Melanoma staging is complex, but crucial. Knowing the stage helps doctors decide how to best treat your disease and predict your chances of recovery.
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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.
Staying Safe Before Or After Skin Cancer
Even those proficient in their ABCDEs will attest that keeping an eye out for potential skin cancer growths can be tricky especially in those hard-to-reach areas. But that is not an excuse for inaction. Performing self-checks alongside annual visits to the dermatologist is a must, but Dr. Markowitz advises everyone to ensure all of their most-visited experts have their back.
Due to the nature of skin cancer, it can appear anywhere on the body, so speaking with your gynecologist or urologist, hairdresser, and even partner will be beneficial to early diagnosis. That means everyone who comes in close contact with you on a semi-regular basis should be on the lookout for any new or unexpected growth. Another requirement that Dr. Markowitz instills in her patients? Say it with us: sunscreen. Its far and away the best form of prevention for skin cancer.
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Recovery & Life After
Those who have had BCC removal with Dr. Markowitz through this non-surgical method know that the aftercare is virtually nonexistent. OTC, when combined with a non-ablative laser, allows for a quick and painless recovery that leaves no scarring and a lot of physical relief. After this treatment, they can go run a marathon the next day if they choose to, Dr. Markowitz says. Those with more advanced cases, however, may experience some crusting and bruising post-treatment. After the removal, patients are told to apply a gentle moisturizer and limit sun exposure .
For the majority of her patients, Dr. Markowitz only needs only one session, though she does require a follow-up appointment at the two-month mark to ensure the full eradication of the tumor. In a pilot study, 82 percent of the patients were able to have 100 percent of their BCC removed in one treatment, but Dr. Markowitz continues to refine her skill set. Im still evolving my treatment protocols to get the most optimal cosmetic outcome and to get to the point where 100 percent of my patients are treated in one visit, she notes.
Because of the nature of this cancer, recurrence is possible, which is why patients must be extra diligent with their skin cancer screenings. Dr. Markowitz has her own technique for these cases, too. In my studies, we look under the skin for recurrences of cancer, she says. In the past, it was done by looking at it with the naked eye.