How Is Melanoma Treated
There are numerous treatments available to address skin cancer, and your dermatologist will partner with you to determine the best plan for your specific needs, depending on the stage its discovered at, size, location, and wide range of other variables. In the early stages, surgical removal may be all thats necessary. Once melanoma has progressed into the lymph nodes or other parts of the body, more advanced treatment options like immunotherapy, chemotherapy, or radiation may be necessary.
Most Dangerous Form Of Skin Cancer
Florida isnt nicknamed The Sunshine State for no reason! Our sunny weather attracts tourists to our beaches, resorts, and theme parks year-round.
Unfortunately, all that sun can be harmful! One in five Americans will develop skin cancer over the course of a lifetime. The biggest risk factor is regular, intense exposure to UV rays. Some people are genetically predisposed to develop skin cancer, which increases their risk further.
But, you may ask, what is the most dangerous form of skin cancer?
Melanoma is the most dangerous form of skin cancer. The American Cancer Society estimates that 73,000 cases of melanoma will be diagnosed this year alone.
Melanomas cancerous growths are caused by DNA damage to skin cells. The damage causes mutations that quickly spread and form malignant tumors in the basal layer of the epidermis, usually starting in melanocytes pigment-producing cells.
If not caught at an early stage, melanoma spreads at a rapid rate. This disease can be fatal if left untreated, as it can spread to other organs and cause further complications.
Fortunately, if caught early on, melanoma is generally curable.
Melanoma Is The Most Dangerous Form Of Skin Cancer
Melanoma accounts for about 1% of all skin cancers, but it accounts for the most skin cancer deaths.
Melanoma is the third most common type of skin cancer and is also the deadliest skin cancer, particularly when it is caught late, DeClerck says.
Melanomas most frequently appear as a dark or multicolored spot on the skin, she explains.
We follow the ABCDE rule when evaluating for melanoma, she adds.
This means to watch out for moles with these traits:
- A: An asymmetric or irregular shape
- B: Borders that look irregular or poorly defined
- C: Color that varies in shades, which could include brown, black, white, red or even blue
- D: A diameter that is often more than 6 mm, about the size of a pea
- E: Evolving over time, a period of weeks to months
Although its less common than basal cell or squamous cell skin cancers, melanoma is more dangerous because its more likely to spread to other parts of the body.
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What Does Skin Cancer Look Like
Basal cell carcinoma
BCC frequently develops in people who have fair skin. People who have skin of color also get this skin cancer.
BCCs often look like a flesh-colored round growth, pearl-like bump, or a pinkish patch of skin.
BCCs usually develop after years of frequent sun exposure or indoor tanning.
BCCs are common on the head, neck, and arms however, they can form anywhere on the body, including the chest, abdomen, and legs.
Early diagnosis and treatment for BCC are important. BCC can grow deep. Allowed to grow, it can penetrate the nerves and bones, causing damage and disfigurement.
Squamous cell carcinoma of the skin
People who have light skin are most likely to develop SCC. This skin cancer also develops in people who have darker skin.
SCC often looks like a red firm bump, scaly patch, or a sore that heals and then re-opens.
SCC tends to form on skin that gets frequent sun exposure, such as the rim of the ear, face, neck, arms, chest, and back.
SCC can grow deep into the skin, causing damage and disfigurement.
Early diagnosis and treatment can prevent SCC from growing deep and spreading to other areas of the body.
SCC can develop from a precancerous skin growth
People who get AKs usually have fair skin.
AKs usually form on the skin that gets lots of sun exposure, such as the head, neck, hands, and forearms.
Because an AK can turn into a type of skin cancer, treatment is important.
After Skin Cancer Treatment
Most skin cancer is cured surgically in the dermatologist’s office. Of skin cancers that do recur, most do so within three years. Therefore, follow up with your dermatologist as recommended. Make an appointment immediately if you suspect a problem.
If you have advanced malignant melanoma, your oncologist may want to see you every few months. These visits may include total body skin exams, regional lymph node checks, and periodic chest X-rays and body scans. Over time, the intervals between follow-up appointments will increase. Eventually these checks may be done only once a year.
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Medical Treatment For Skin Cancer
Surgical removal is the mainstay of skin cancer treatment for both basal cell and squamous cell carcinomas. For more information, see Surgery.People who cannot undergo surgery may be treated by external radiation therapy. Radiation therapy is the use of a small beam of radiation targeted at the skin lesion. The radiation kills the abnormal cells and destroys the lesion. Radiation therapy can cause irritation or burning of the surrounding normal skin. It can also cause fatigue. These side effects are temporary. In addition, topical chemotherapy creams have been FDA approved for the treatment of certain low-risk nonmelanoma skin cancers. Patients with advanced or many basal cell carcinomas are sometimes prescribed oral pills to block the growth of these cancers. Side effects include muscle spasms, hair loss, taste changes, weight loss and fatigue.
In advanced cases of melanoma, immune therapies, vaccines, or chemotherapy may be used. These treatments are typically offered as clinical trials. Clinical trials are studies of new therapies to see if they can be tolerated and work better than existing therapies.
For More Information About Skin Cancer
National Cancer Institute, Cancer Information Service Toll-free: 4-CANCER 422-6237TTY : 332-8615
Skin Cancer Foundation
Media file 1: Skin cancer. Malignant melanoma.
Media file 2: Skin cancer. Basal cell carcinoma.
Media file 3: Skin cancer. Superficial spreading melanoma, left breast. Photo courtesy of Susan M. Swetter, MD, Director of Pigmented Lesion and Cutaneous Melanoma Clinic, Assistant Professor, Department of Dermatology, Stanford University Medical Center, Veterans Affairs Palo Alto Health Care System.
Media file 4: Skin cancer. Melanoma on the sole of the foot. Diagnostic punch biopsy site located at the top. Photo courtesy of Susan M. Swetter, MD, Director of Pigmented Lesion and Cutaneous Melanoma Clinic, Assistant Professor, Department of Dermatology, Stanford University Medical Center, Veterans Affairs Palo Alto Health Care System.
Media file 5: Skin cancer. Melanoma, right lower cheek. Photo courtesy of Susan M. Swetter, MD, Director of Pigmented Lesion and Cutaneous Melanoma Clinic, Assistant Professor, Department of Dermatology, Stanford University Medical Center, Veterans Affairs Palo Alto Health Care System.
Media file 6: Skin cancer. Large sun-induced squamous cell carcinoma on the forehead and temple. Image courtesy of Dr. Glenn Goldman.
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The Risks The Causes What You Can Do
Skin cancers like melanoma have damaged DNA in skin cells that lead to uncontrolled growth of these cells. Ultraviolet rays from the sun or tanning beds damage DNA in your skin cells. Your immune system repairs some of this damage but not all. Over time, the remaining DNA damage can lead to mutations that cause skin cancer. Many other factors also play a role in increasing the risk for melanoma, including genetics , skin type or color, hair color, freckling and number of moles on the body.
Understanding what causes melanoma and whether youre at high risk of developing the disease can help you prevent it or detect it early when it is easiest to treat and cure.
These factors increase your melanoma risk:
- Unprotected or excessive UV exposure from the sun or indoor tanning.
- Weakened immune system due to a medical condition or medications.
- Many moles: The more moles you have on your body, the higher your risk for melanoma. Also, having large moles , or any atypical moles, increases the risk for melanoma.
- Fair skin: Melanoma occurs more frequently in people with fair skin, light eyes and light or red hair.
- Skin cancer history: People who have already had melanoma or nonmelanoma skin cancers run a greater risk of developing melanoma in the future.
- Genetics: Melanoma can run in families one in every 10 patients has a family member who also has had the disease.
How Is Melanoma Diagnosed
If you have a mole or other spot that looks suspicious, your doctor may remove it and look at it under the microscope to see if it contains cancer cells. This is called a biopsy.
After your doctor receives the skin biopsy results showing evidence of melanoma cells, the next step is to determine if the melanoma has spread. This is called staging. Once diagnosed, melanoma will be categorized based on several factors, such as how deeply it has spread and its appearance under the microscope. Tumor thickness is the most important characteristic in predicting outcomes.
Melanomas are grouped into the following stages:
- Stage 0 : The melanoma is only in the top layer of skin .
- Stage I: Low-risk primary melanoma with no evidence of spread. This stage is generally curable with surgery.
- Stage II: Features are present that indicate higher risk of recurrence, but there is no evidence of spread.
- Stage III: The melanoma has spread to nearby lymph nodes or nearby skin.
- Stage IV: The melanoma has spread to more distant lymph nodes or skin or has spread to internal organs.
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Screening For Cancerous Moles
If a mole looks or acts at all peculiarly it is best to have it evaluated by an expert. This frequently is a dermatologist. Most dermatologists can tell if the pigmented lesion is composed of melanocytes or is something quite different with no possibility of being a melanoma. Many dermatologists now use a hand-held magnifying device which produces polarized light to evaluate colored melanocytic tumors. The use of this instrument improves the doctor’s ability to identify suspicious lesions.
Skin Cancer: Cutaneous Horns
A cutaneous horn is a mass of dead skin cells. Essentially they have a lot in common with hair and nails since these are also composed of dead skin cells. The base which generates the horn can be an actinic keratosis, a squamous cell carcinoma, or a benign keratosis. The only way to differentiate between the three is by performing a surgical procedure called a biopsy and having it examined in a laboratory by a pathologist.
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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.
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.
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Skin Cancer Support Groups And Counseling
Living with skin cancer presents many new challenges for you and for your family and friends. You will probably have many worries about how the cancer will affect you and your ability to “live a normal life,” that is, to care for your family and home, to hold your job, and to continue the friendships and activities you enjoy.
Many people with a skin cancer diagnosis feel anxious and depressed. Some people feel angry and resentful others feel helpless and defeated. For most people with skin cancer, talking about their feelings and concerns helps. Your friends and family members can be very supportive. They may be hesitant to offer support until they see how you are coping. Don’t wait for them to bring it up. If you want to talk about your concerns, let them know.
Some people don’t want to “burden” their loved ones, or prefer talking about their concerns with a more neutral professional. A social worker, counselor, or member of the clergy can be helpful. Your dermatologist or oncologist should be able to recommend someone.
Many people with cancer are profoundly helped by talking to other people who have cancer. Sharing your concerns with others who have been through the same thing can be remarkably reassuring. Support groups for people with cancer may be available through the medical center where you are receiving your treatment. The American Cancer Society also has information about support groups throughout the U.S.
The Most Deadly Forms Of Melanoma
Researchers at the University of North Carolina at Chapel Hill found that people with scalp or neck melanoma die at almost twice the rate of those with melanoma on the extremities, and people with melanomas on the arms, legs, face or ears have the best prognosis.
The results appear in the April issue of the journal Archives of Dermatology.
The study’s senior author, Dr. Nancy Thomas, associate professor of dermatology in the UNC School of Medicine, urges physicians to pay special attention to the scalp when examining patients for signs of skin cancer.
The study helps address a controversy among cancer researchers about whether scalp and neck skin cancer is more lethal mainly because it’s diagnosed later than other melanomas – in part because hair covers it up.
“That was the thinking of a lot of people in the field,” Thomas says.But the study points to the presence of the melanoma on the scalp or neck, in itself, as an indicator of a poorer prognosis.
“We think there’s something different about scalp and neck melanomas,” Thomas continues. “This gives us directions for research to look at tumor cell types in those areas at the molecular level and to see if there are differences.
On The Early Show Saturday, New York dermatologist Lisa Airan said she asks some of her patients to wet their hair, making it easier to examine their scalps. If you have a regular hairdresser, you can ask him or her to keep an eye on your scalp and watch for potential problems, she added.
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Melanoma Causes And Symptoms
Intense UV exposure, especially in cases leading to sunburn, is a leading cause of melanoma. Sun tanning beds, frequent lie-outs at the beach, and improper use of suntan lotion are all ways to become overexposed to UV rays.
Even if youve practiced good sun exposure habits, you can still be at risk for melanoma. Other risk factors include being light or fair-skinned, a family history of melanoma, old age, and a weak immune system.
Melanomas can resemble moles, as many are black or brown like a mole. However, they come in a variety of colors, including white, blue, red, pink, or skin-colored. They may or may not hurt, but this varies between individuals.
What Are The Risk Factors For Skin Cancer
About 90% of skin cancers are caused by UV rays, but there are other factors that can determine your risk. Some of these factors are:
- Your complexion: Fair-skinned people have less melanin in their skin and therefore less protection against the suns damaging UV rays.
- Number of moles: The risk is greater for people with 50 or more moles.
- Tanning bed use: People are more likely to develop skin cancer from using tanning beds than developing lung cancer from smoking. Their use causes a 75 percent increase in melanoma risk when indoor tanning beds have been used before age 30.
- Family history: Having a family member with skin cancer means you are at greater risk. The risk is especially strong if a close relative, such as a parent, sibling, or child, has skin cancer.
- History of sunburn: People who have had one or more severe, blistering sunburns as a child or teenager have an increased risk for melanoma. Sunburns in adulthood are also a risk factor for melanoma.
- History of skin cancer: Once youve had one skin cancer, your risks for developing another increases.
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What Happens If Merkel Cell Carcinoma Is Left Untreated
Merkel cell carcinoma is a rare but aggressive and potentially fatal form of skin cancer. It typically affects people above the age of 50 and those who have weakened immune systems. In most cases, Merkel cell carcinoma begins as a skin-toned growth that may bleed easily. The bumps or nodules may also have blue, purple, or red coloring. Because the Merkle cells are near nerve endings, this form of cancer has numerous health risks, and if left untreated, Merkle cell cancer may spread to the brain, lungs, or bones, becoming fatal.