SKIN CANCER

There are three major types of skin cancers: basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. The first two skin cancers are grouped together as non-melanoma skin cancers. Other unusual types of skin cancer include Merkel cell tumors and dermatofibrosarcoma protruberans.

Here are the basics on skin cancers:

• The vast majority of skin cancers are basal cell carcinomas and squamous cells carcinomas. Both of them are unlikely to spread to other parts of the body.
• A small but significant number of skin cancers are malignant melanomas. It is a highly aggressive cancer that tends to spread to other parts of the body, so it will be fatal if not treated early.

Skin cancer symptoms depend on the type of skin cancer that has developed.

A basal cell carcinoma (BCC) usually looks like a raised, smooth, pearly bump on the sun-exposed skin of the head, neck, or shoulders. Others signs include:

• Small blood vessels may be visible within the tumor.
• A central depression with crusting and bleeding (ulceration) frequently develops.
• A BCC often appears as a sore that does not heal.

A squamous cell carcinoma (SCC) is commonly a well-defined, red, scaling, thickened bump on sun-exposed skin. It may ulcerate and bleed, and left untreated, may develop into a large mass.

The majority of malignant or cancerous melanomas are brown-to-black pigmented lesions. Other signs of a cancerous melanoma include:

• A change in size, shape, color, or elevation of a mole
• The appearance of a new mole during adulthood, or new pain, itching, ulceration, or bleeding of an existing mole

The following easy-to-remember guideline, “ABCDE,” is useful for identifying malignant melanoma:

• Asymmetry — One side of the lesion does not look like the other.
• Border irregularity — Margins may be notched or irregular.
• Color — Melanomas are often a mixture of black, tan, brown, blue, red, or white.
• Diameter — Cancerous lesions can be larger than 6 mm across (about the size of a pencil eraser), although with early detection they will not reach this size.
• Evolution — has a mole changed over time?

DIAGNOSIS

To check for melanoma and whether or not it has spread, your doctor may:

• Do a physical exam of your skin.
• Do a skin biopsy.
• Check your lymph nodes to see if they are larger than normal.
• Use imaging tests to see if the cancer has spread to other parts of your body. These tests include emission tomography (PET scan), computed tomography (CT scan), and magnetic resonance imaging (MRI).

Other techniques may include total-body photography to look for changes in any mole and to watch for new moles appearing in normal skin. A series of photos of the suspicious lesions may be taken. Then the photos can be used as a baseline to compare with follow-up photos.

Finding skin cancer early

• Do a skin self-exam once a month. Your partner or a close friend can help you check places that are hard to see, such as your scalp and back.
• Have your doctor check any suspicious skin changes. Be sure you see your doctor at least once a year. You may need checkups more often if you have:
• Familial atypical mole and melanoma (FAM-M) syndrome, which is an inherited tendency to develop melanoma. Your doctor may need to check you every 4 to 6 months.
• Increased exposure to ultraviolet (UV) radiation.
• Abnormal moles called atypical moles. These moles aren’t cancerous. But their presence is a warning of an inherited tendency to develop melanoma.

RECOMMENDED MEDICATIONS

Medicines for melanoma include:

• Immunotherapy medicines, such as ipilimumab and interleukin-2 (IL-2).
• Chemotherapy medicines, such as dacarbazine and temozolomide.
• Inhibitors, such as sorafenib and vemurafenib.

Medicines used to treat melanoma may be given as an outpatient treatment. But sometimes people need a short hospital stay.