Skin Cancer

Many people don’t think of their skin as being an organ, but in reality, it is the largest organ in your body. It is important to remember that your skin needs as much care – and is at as much risk for disease – as the rest of you.

According to the American Cancer Society, skin cancer is the most-diagnosed cancer in the United States. Your risk of skin cancer increases with age; however, melanomas can also occur in younger people.

Melanoma

Melanoma is caused by changes in cells called melanocytes, which produce melanin, a skin pigment responsible for skin and hair color. Melanoma can appear on normal skin, or it may begin as a mole or other area that changes in appearance. Some moles present at birth may develop into melanomas.

There are 4 major types of melanoma:

• Superficial spreading melanoma is the most common. Flat and irregular in shape and color, with different shades of black and brown, it is most common in Caucasians.
• Nodular melanoma usually starts as a dark blackish-blue or bluish-red raised area; some have no color.
• Lentigo maligna melanoma usually occurs in older adults. Most common in sun-damaged skin on the face, neck and arms, this type of melanoma is usually large, flat and tan with areas of brown.
• Acral lentiginous melanoma, the least common form, usually occurs on the palms, soles or under the nails and is more common in African Americans.

Basal Cell Carcinoma

Basal cell carcinoma is a type of non-melanoma skin cancer, and is the most common form of cancer in the United States. According to the American Cancer Society, 75% of all skin cancers are basal cell carcinomas.

Squamous Cell Carcinoma

Squamous cell carcinoma may occur in normal skin or in skin that has been injured or inflamed. Although it usually occurs on the face, ears, neck, hands or arm, it may occur on other areas.

Regular screenings and self-exams are a great way to monitor any changes in your skin. If you notice any of your existing or new spots or moles have any of the following characteristics, it is recommended to see a dermatologist right away. Follow the ABCs of skin cancer detection:

• Asymmetry; look for spots that are asymmetrical, not round
• Border; look for spots with uneven borders
• Color; look for spots with an unusual or uneven color
• Diameter; look for spots larger than 7 mm
• Evolving; has the mole or spot changed during the past few weeks or months?

Protecting your skin from the sun’s Ultraviolet (UV) rays is the best way to prevent skin cancer. Here are some ways you can do this:

• Always seek shade, and make sure to stay out of the sun during peak hours (10 a.m.-4 p.m.)
• Avoid tanning beds and sun lamps
• Wear sunscreen every day and make sure to apply it properly. A good rule of thumb is to use one ounce (approximately the amount that would fit in the palm of your hand) every two hours while in the sun.
• Wear clothing to cover your arms and legs, and sunglasses to prevent damage to your eyes.

Skin cancer is divided into two major groups: non-melanoma and melanoma. Non-melanoma includes basal cell carcinoma and squamous cell carcinoma. Customized treatment is required for each type of skin cancer.

Melanoma and other forms of skin cancer are diagnosed by a skin biopsy that removes all or part of the growth. A sentinal lymph node biopsy may be done in some people with melanoma to ensure that the cancer has not spread to nearby lymph nodes.

Once melanoma has been diagnosed, CT scans or other types of imaging tests may be ordered by your oncologist to determine whether the cancer has spread.

Treatment of Melanoma

Melanoma is the most dangerous type of skin cancer and the leading cause of death from skin disease.

Surgery and Other Treatments

Surgery is necessary to treat melanoma. The cancer itself and some surrounding tissue will be removed. The amount of skin removed depends on how deep the melanoma has grown. If the cancer has spread to nearby lymph nodes, the lymph nodes may also be removed.

Treatment is more difficult when the melanoma has spread to other organs. You may receive:

• Chemotherapy to kill the cancer cells
• Immunotherapy, such as interferon or interleukin, to help your immune system fight the cancer
• Radiation therapy to relieve pain or discomfort

If you have melanoma that is hard to treat, you might consider enrolling in a clinical trial. Researchers continue to study new treatments. Ask your doctor for more information.

Treatment of Basal Cell Carcinoma and Squamous Cell Carcinoma

Treatment varies depending on the size, depth and location of the basal cell cancer. Your dermatologist will remove it using one of the following procedures:

• Excision to remove the tumor
• Curettage and electrodessication to scrape away the cancer and kill any remaining cancer cells
• Surgery, including Mohs or Johns surgery, in which skin is cut out and immediately examined under a microscope to check for cancer. The process is repeated until the skin sample is free of cancer.
• Cryosurgery to freeze and kill the cancer cells
• Radiation if the cancer has spread to organs or lymph nodes or for tumors that can't be treated with surgery
• Skin creams with the medications imiquimod or 5-fluorouracil to treat superficial basal cell carcinoma
• Photodynamic therapy, or treatment using light, may be used for Bowen's disease.

Radiation therapy may be used for squamous cell skin cancer that has spread to organs or lymph nodes, or when it cannot be treated with surgery.

Memorial Hermann Cancer Centers are accredited by the American College of Surgeons’ (ACoS) Commission on Cancer (CoC). This rare distinction is given to cancer programs that uphold the highest standard of care for patients. When you choose Memorial Hermann Cancer Centers for your cancer treatment, you can rest assured you will receive the best possible care delivered by a compassionate team of caregivers in a calm, healing environment.