Skin cancer

Most of new cases of skin cancer each year (740,000 in Australia and 50,000 in New Zealand) do fine, thanks to nearly 98 percent cure rate for basal cell and squamous cell carcinomas. And now more options are appearing for rare melanomas, too.

What is happening

The skin is composed of many different cells--basal cells, squamous cells, melanocytes, others--that naturally grow and slough off over time. A dianosis of skin cancer means that some of these cells have become abnormal (or mutated) and are starting to reproduce out of control. This happens largely as a result of accumulated sun damage, although other factors, such as skin type, genetics and envirnomental exposure, are also involved.
   Accounting for about 80 percent of skin cancers diagnosed, basal cell carcinoma, the most prevalent form of skin cancer, occurs in the skin's top layer (called the epidermis). The cells gather into cluster and replicate, growing very slowly and forming painless, translucent bumps. Most appear on the face although any part of you that's seen the sun is vulnerable: ear, neck, back, chest, arms, legs. It's rare, however, for these cancers to grow deep down into the skin or to spread to any internal organs.
    Squamous cell carcinoma also starts in the epidermis, often appearing in its earliest precancerous form as solar keratosis lesions, or sun spots (see on shortly). Squamous cell cancer may begin as raised, reddish lumps, which can become open sores (ulcerate). It's relatively unusual for it to spread beyond the skin but it can be deadly if this does occur. You're at risk for a more involved type of squamous cell cancer if the lesion develops on the penis or the vulva as a sequel to an infection with certain strains of genital warts.
   Far less common but more dangerous is malignant melanoma, a cancer that arises from melanocytes--cells that produce melanin, the pigment that gives colour tour the skin, hair and eyes. Melanin is concentrated in most moles and also acts to protect your skin from the sun's ultraviolet (UV) radiation, giving you a tan as a defence mechanism. Melanocytes that reproduce too quickly and appear as irregularly shaped, light-brown to black blemishes signal trouble. This can occur within an existing mole, on unblemished signal trouble. This can occur within an existing mole, on unblemished skin or rarely in the eye or under nails. Left unattended, a melanoma will penetrate deep into skin and then may spread  (metastatise) via the lymphatic system or the bloodstream.
 

LIKELY FIRST STEPS

• Surgery  or other lesion-eliminating procedures (currettage and electro-desiccation, Moths surgery, cryosurgery).
• For skin cancers that have spread beyond the skin, chemotherapy, radiation therapy, photodynamic therapy, immunotheraphy.
• Sun protection, regular skin examination and other lifestyle measures to help detect new problems early and prevent recurrences.

QUESTIONS TO ASK

• What number sunscreen is the best for my skin type?
• Given my history, how often should I schedule a checkup with a dermatologist?
• How will I know when a mole change signifies cancer?

Treatments

The purpose of skin cancer treatment is to halt further growth of any malignancy. The specific approaches that your doctor will use are tied to your particular type of lesion. For most basal cell and squamous cell cancers that 

                                                                     Treatment Options

PROCEDURES
------------------------------------------------------------------------------------------------------------------------------------------Surgical excision                                     Literally cutting out problem tissue.
------------------------------------------------------------------------------------------------------------------------------------------    Cryosurgery                                             Liquid  nitrogen to freeze and kill cells.
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Laser therapy                                          Beam of light burns off superficial cells.
-----------------------------------------------------------------------------------------------------------------------------------------    Radiation                                                 X-ray treatment of metastasised lesions.
--------------------------------------------------------------------------------------------------------------------------------------------   Photodynamic therapy                          For basal and squamous cell cancers

MEDICATIONS
---------------------------------------------------------------------------------------------------------------------------------------------
Imiquimod                                               Aldara for basal and squamous cell cancers.
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Chemotherapy                                         Immunotherapy, vaccines, perfusion.

LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------     Avoid UV rays                                       Stay out of the sun and protect against it.
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have not spread, the strategy is the same: destroy and lesion by burning, freezing or scraping it off. Usually not painful, these procedures are done in a doctors's surgery after numbing the site with a local anaesthetic.

Taking Control

• Push for an appointment. If there is something suspicious on your skin, be proactive about getting it checked out and, if necessary, removed.
• Give up the tanning parlour and sun lamp. Neither is safe. A recent study found that people who used any type of tanning device have a 2.5 times greater risk for squamous cell cancer and a 1.5 times greater risk for basal cell cancer.
• Reachout. adiagnosis of skin cancer, especially a malignant melanoma, can very frightening. Talk to your doctor. Look to friends, family and support groups. De-stress with exercise and yoga.
• Question Internet info. A study from the University of Michigan found many popular melanoma websites are simply wrong about diagnosis and treatment options.
• Sign up for a clinical trial if your melanoma is advacnced. It's a chance to benefit from new treatments.
• Catch the next one early. Every month, use a mirror to examine every section of your skin. Have someone check hard-to-see places. See the doctor about alterations in lesion shape, colour or size.
• A recent cancer study found that of nearly 500 melanoma patients, 57% detected the cancer on their own.
• Tell family members to get screened regularly, especially  if you've had a melanoma; your cancer means they're at increased risk as well. 

  For basal cell or squamous cell cancers that have spread, non-surgical techniques (medication, radiation or other therapies) are generally used. In choosing the appropriate treatment, you and your doctor will weigh factors such as where the lesion is, how deep it is and how quickly it's growing. Before any treatment begins, make sure your diagnosis has been confirmed with a biopsy, a laboratory analysis of the excised tissue.