Skin cancer is the most
common form of human
cancer. It is estimated that
over 1 million new cases
occur annually. The annual
rates of all forms of skin
cancer are increasing each
year, representing a growing
public concern.
It has also
been estimated that nearly
half of all Americans who
live to age 65 will develop
skin cancer at least once.
The most common warning
sign of skin cancer is a
change in the appearance of
the skin, such as a new
growth or a sore that will not
heal.
The term "skin cancer" refers
to three different conditions.
From the least to the most
dangerous, they are:
1.Basal cell carcinoma
2.Squamous cell carcinoma
3.melanoma
The two most common forms
of skin cancer are basal cell
carcinoma and squamous
cell carcinoma.
cancers can appear in a
variety of forms. They are usually painless and grow
slowly. They can appear anywhere on your body but are
most likely to occur on exposed skin, especially on your
face or neck.
Symptoms of basal cell carcinoma:
be smooth and pearly
look waxy
appear as a firm, red lump
bleed sometimes
develop a crust or scab
begin to show signs of healing and yet never quite heal
be itchy
look like a flat, red spot which is scaly and crusty develop into a painless ulcer.
Symptoms of squamous cell carcinoma
Squamous cell cancers most often develop in areas that have
been damaged by exposure to the sun. They are mainly found
on the face, neck, bald scalps, arms, backs of hands and lower
legs.
Squamous cell cancers may:
look scaly
have a hard, horny cap
make the skin raised in the area of the cancer feel tender to touch.
How is basal cell carcinoma treated?
There are many ways to successfully treat a basal cell
carcinoma with a good chance of success of 90% or more. The
doctor's main goal is to remove or destroy the cancer
completely with as small a scar as possible. To plan the best
treatment for each patient, the doctor considers the location
and size of the cancer, the risk of scarring, and the person's
age, general health, and medical history.
Curettage and desiccation: Dermatologists often prefer this
method, which consists of scooping out the basal cell
carcinoma by using a spoon like instrument called a curette.
2.Surgical excision: The tumor is cut out and stitched up.
3.Radiation therapy: Doctors often use radiation treatments for skin cancer occurring in areas that are difficult to treat with surgery. Obtaining a good cosmetic result generally involves many treatment sessions, perhaps 25 to 30.
4.Cryosurgery: Some doctors trained in this technique achieve
good results by freezing basal cell carcinomas. Typically, liquid
nitrogen is applied to the growth to freeze and kill the
abnormal cells.
5.Mohs micrographic surgery: Named for its pioneer, Dr. Frederic Mohs, this technique of removing skin cancer is
better termed "microscopically controlled excision." The surgeon meticulously removes a small piece of the tumor and examines it under the microscope during surgery. This
sequence of cutting and microscopic examination is repeated in a painstaking fashion so that the basal cell carcinoma can be mapped and taken out without having to estimate or guess the
width and depth of the lesion. This method removes as little of the healthy normal tissue as possible. Cure rate is very high, exceeding 98%. Mohs micrographic surgery is preferred for
large basal cell carcinomas, those that recur after previous treatment, or lesions affecting parts of the body where
experience shows that recurrence is common after treatment by other methods. Such body parts include the scalp, forehead, ears, and the corners of the nose. In cases where large
amounts of tissue need to be removed, the Mohs surgeon sometimes works with a plastic (reconstructive) surgeon to
achieve the best possible postsurgical appearance.
Medical therapy using creams that attack cancer cells (5- Fluorouracil--5-FU, Efudex, Fluoroplex) or stimulate the immune system (imiquimod [Aldara]). These are applied
several times a week for several weeks. They produce brisk inflammation and irritation. The advantages of this method is that it avoids surgery, lets the patient perform treatment at home, and may give a better cosmetic result. Disadvantages include discomfort, which may be severe, and a lower cure
rate, which makes medical treatment unsuitable for treating most skin cancers on the face.
How is basal cell carcinoma prevented?
limiting recreational sun exposure;
avoiding unprotected exposure to the sun during peak
radiation times (the hours surrounding noon);
wearing broad-brimmed hats and tightly-woven protective
clothing while outdoors in the sun;
regularly using a waterproof or water resistant sunscreen
with UVA protection and SPF 30 or higher;
undergoing regular checkups and bringing any suspicious-
looking or changing lesions to the attention of the doctor; and
avoiding the use of tanning beds and using a sunscreen with
an SPF of 30 and protection against UVA (long waves of
ultraviolet light.). Many people go out of their way to get an
artificial tan before they leave for a sunny vacation, because
they want to get a "base coat" to prevent sun damage. Even
those who are capable of getting a tan, however, only get
protection to the level of SPF 6, whereas the desired level is an
SPF of 30. Those who only freckle get little or no protection at
all from attempting to tan; they just increase sun damage.
NOTE:If you notice anything unusual on your skin that doesn’t go
away within a month, show it to your doctor. It might be
helpful to take a photograph of anything unusual so you can
monitor any changes over time.
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