 Overview
Coping
Skin cancer is a disease in which malignant cells are found in the outer layers of the skin. There are several types of cancer that start in the skin. The most common are basal cell cancer and squamous cell cancer. These types of skin cancer are called non-melanoma skin cancer. Melanoma is a type of skin cancer that starts in the melanocytes (cells that give the skin its color.) It is not as common as basal cell or squamous cell skin cancer, but much more serious.
Non-melanoma
Skin cancer is more common in people with light-colored skin who have spent a lot of time in the sunlight. It can occur anywhere on the body, but is most common in places that have been exposed to more sunlight -- such as the face, neck, hands, and arms.
Skin cancer can look many different ways. The most common sign is a change on the skin, such as a growth or a sore that won't heal. Sometimes there may be a small lump. This lump can be smooth, shiny and waxy looking, or it can be red or reddish brown. Skin cancer may also appear as a flat red spot that is rough or scaly. Not all changes in the skin are cancer, but a doctor should be seen if changes are noticed.
Most non-melanoma skin cancers can be cured. The chance of recovery (prognosis) and choice of treatment depend on the type of skin cancer and how far it has spread.
Other kinds of cancer that may affect the skin include cutaneous T-cell lymphoma, a cancer of the lymph system, and Kaposi's sarcoma. Cancers that start in other parts of the body may also spread (metastasize) to the skin.
Surgery is the most common treatment of skin cancer. Often, however, surgery may leave a scar on the skin. Depending on the size of the cancer, skin may be taken from another part of the body and put on the area where the cancer was removed. This is called a skin graft. New ways of doing surgery and grafting may reduce scarring.
Radiation therapy uses x-rays to kill cancer cells and shrink tumors. At PCI, doctors target focused electrons to treat skin cancer using advanced linear accelerator technology (external radiation therapy).
Chemotherapy uses drugs to kill cancer cells. In treating skin cancer, chemotherapy is often given as a cream or lotion placed on the skin to kill cancer cells (topical chemotherapy). Chemotherapy may also be taken by pill, or it may be put into the body by a needle in a vein or muscle. Chemotherapy given in this way is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells outside the skin. Systemic chemotherapy is being tested in clinical trials.
Melanoma
Although not as common as the non-melanoma type of skin cancer, melanoma is still the most serious. In some parts of the world, especially among Western countries, the number of people who develop melanoma is increasing faster than any other cancer. In the United States, for example, the number of new cases of melanoma has more than doubled in the past 20 years.
Melanoma occurs when melanocytes (pigment cells) become malignant. When melanoma starts in the pigment cells of the skin, the disease is called cutaneous melanoma. Melanoma may also occur in the eye and is called ocular melanoma or intraocular melanoma.
The disease can occur on any skin surface. In men, it is often found on the trunk (the area from the shoulders to the hips) or the head and neck. In women, melanoma often develops on the lower legs.
Melanoma is rare in black people and others with dark skin. When it does develop in dark-skinned people, it tends to occur under the fingernails or toenails, or on the palms or soles. The chance of developing melanoma increases with age, but this disease affects people of all age groups. It is one of the most common cancers in young adults.
Surgery to remove a melanoma is the standard treatment for this disease. It is necessary to remove not only the tumor but also some normal tissue around it in order to minimize the chance that any cancer will be left in the area.
The width and depth of surrounding skin that needs to be removed depends on the thickness of the melanoma and how deeply it has invaded the skin. In cases in which the melanoma is very thin, enough tissue is often removed during the biopsy, and no further surgery is necessary.
Lymph nodes near the tumor may be removed during surgery because cancer can spread through the lymphatic system. If the pathologist finds cancer cells in the lymph nodes, it may mean that the disease has spread to other parts of the body.
Surgery is generally not effective in controlling melanoma that is known to have spread to other parts of the body. In such cases, doctors may use other methods of treatment, such as chemotherapy, biological therapy, radiation therapy, or a combination of these methods.
Chemotherapy is the use of drugs to kill cancer cells. It is generally a systemic therapy, meaning that it can affect cancer cells throughout the body. In chemotherapy, one or more anticancer drugs are given by mouth or by injection into a blood vessel. Either way, the drugs enter the bloodstream and travel through the body.
Chemotherapy is usually given in cycles: a treatment period followed by a recovery period, then another treatment period, and so on. Usually a patient has chemotherapy as an outpatient (at the hospital, at the doctor's office, or at home). However, depending on which drugs are given and the patient's general health, a short hospital stay may be needed.
Biological therapy is a form of treatment that uses the body's immune system, either directly or indirectly, to fight cancer or to lessen side effects caused by some cancer treatments. Biological therapy is also a systemic therapy and involves the use of substances called biological response modifiers (BRMs).
Radiation therapy is used in certain cases to relieve some of the symptoms caused by melanoma. Radiation therapy is the use of high-energy rays to kill cancer cells. Radiation therapy is a local therapy; it affects cells only in the treated area. Radiation therapy is most commonly used to help control melanoma that has spread to the brain, bones, and other parts of the body.
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Chemotherapy and You
Information about what to expect during chemotherapy and what patients can do to take care of themselves during and after treatment.
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Radiation Therapy and You
Information about what to expect during radiation therapy, including the general effects of treatment and how to deal with specific side effects.
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