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Types of Cancer - Skin Cancer

The skin is the body's largest organ and serves as its primary level of defense against heat, light, injury, and infection. The skin is comprised of two layers: the outer epidermis, which is made of squamous cells, basal cells, and melanocytes, and the inner dermis, which contains oil and sweat glands, hair follicles, nerves, and fatty tissue.

Types of Cancer

What is Skin Cancer?

Skin cancer occurs when cells of the skin begin to replicate at an uncontrolled rate to form a tumor. Skin cancer is caused by a variety of factors, some of which are preventable. People with fair skin that easily freckles and light-colored hair and/or eyes are at an especially high risk of skin cancer. A lifetime of exposure to UV radiation, whether it is from the sun or a tanning booth, greatly increases the risk for skin cancer; although most skin cancers appear after the age of fifty, they are usually the result of years of exposure to the sun's rays, beginning in early childhood. Just one severe sunburn in childhood dramatically inflates a person's chance of getting skin cancer.

There are three main types of skin cancer, the two most common of which are basal cell carcinoma and squamous cell carcinoma. More than 90% of all skin cancers in the United States are basal cell carcinomas, a relatively slow-growing cancer that usually does not spread to other parts of the body. Squamous cell carcinoma, which affects the outermost layer of the epidermis, also rarely spreads, although it does so more often than basal cell carcinoma. Nevertheless, if these cancers are not found and treated early they can still invade and destroy nearby tissue.

Melanoma

Melanoma, the most dangerous form of skin cancer, affects the skin's melanocytes. Melanocytes produce melanin, the pigmentation which gives the skin its color. Melanoma usually begins as cutaneous melanoma in the skin; however, melanoma can also occur in the eye (ocular or intraocular melanoma), the meninges, the digestive tract, or any other place where melanocytes are found. One of the reasons that melanoma is more dangerous than nonmelanoma skin cancers is its tendency to metastasize, or spread, to other parts of the body like the lymph nodes, liver, lungs, or brain. Melanomas can often be identified as an abnormal growth or mole, and are best treated when they are found early.

Treatment

When treating skin cancer, the main goal is to remove or destroy the cancer completely with as little scarring as possible. The cancer's location, size, and likelihood of scarring, as well as the person's age and medical history, are all important factors when choosing a treatment.

Skin cancer is usually treated with some type of surgery, although in some cases radiation therapy or chemotherapy may be used. Many skin cancer can be cut from the skin quickly and easily, sometimes even at the time of biopsy. There are several surgical options for skin cancer.

Curettage and Electrodesiccation

After applying a local anesthetic, the cancer is scooped out with a curette, an instrument with a sharp, spoon-like end. The area is then treated by electrodesiccation. An electric current is used to control the bleeding and to kill any cancer cells left around the edge of the wound. The resulting scar is usually flat and white.

Mohs' Surgery

This special type of surgery was developed uniquely for skin cancer to remove all of the cancerous tissue and as little healthy tissue as possible. This method is often used when the doctor is unsure of the shape and depth of the tumor, when the tumor is recurrent, in a difficult-to-treat place, or is especially large. After a local anesthetic is applied, the cancer is shaved away one thin layer at a time; each layer is checked under a microscope to be certain that the entire cancer is removed.

Cryosurgery

In cryosurgery, extreme cold in the form of liquid nitrogen is applied to precancerous conditions of small skin cancers. The cells are frozen, killed, and then fall off once thawed.

Laser Therapy

A narrow beam of light is used to remove or destroy cancer cells, usually only on the outer layer of skin.

Grafting

Sometimes, especially when a large cancer is removed, a skin graft is needed to close the wound and reduce the amount of scarring. For this procedure, the doctor takes a piece of healthy skin from another part of the body to replace the skin that was removed.

Radiation

Skin cancer responds well to radiation therapy (also called radiotherapy), which uses high-energy rays to damage cancer cells and stop them from growing. Doctors often use this treatment for cancers that occur in areas that are hard to treat with surgery, such as cancers of the eyelid, the tip of the nose, or the ear.

Topical Chemotherapy

Anticancer drugs (chemotherapy) in a cream or lotion are applied to the skin; this option, although it often causes inflammation during treatment, does not leave a scar.

Many patients and their families want to learn all they can about skin cancer and the treatment choices so they can take an active part in decisions about medical care. The doctor is the best person to answer these questions. When discussing treatment, the patient may want to talk with the doctor about research studies of new treatment methods. Such studies, called clinical trials, are designed to improve cancer treatment. More information about clinical trials is in the Clinical Trials section.

Researchers are finding better ways to treat skin cancer, and the chances of recovery keep improving. Still, it is natural for patients and their families to be concerned about the future. There are many resources available both on and off the web for patients and their families. Links to some good web sites can be found on our web resources page, or check out our recommended reading list for patients and their families.

Source: NCI Cancernet