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Melanoma Skin Cancer

What is Melanoma Skin Cancer?

Melanoma is a cancer that starts in a certain type of skin cell. Melanoma is a cancer that begins in the melanocytes. Because most of these cells still make melanin, melanoma tumors are often brown or black. But this is not always the case, and melanomas can also have no color. Melanoma most often starts on the trunk (chest or back) in men and on the legs of women, but it can start in other places, too. Having dark skin lowers the risk of melanoma. But it does not mean that a person with dark skin will never get melanoma.

Melanoma can almost always be cured in its early stages. But it is likely to spread to other parts of the body if it is not caught early. Melanoma is much less common than basal cell and squamous cell skin cancers (described below), but it is far more dangerous.

Risk Factors for Skin Cancer

UV (ultraviolet) light:  Too much exposure to UV radiation is thought to be the biggest risk factor for most melanomas. The main source of UV light is the sun. Tanning lamps and booths are also sources of UV light. People with high levels of exposure to UV light are at greater risk for all types of skin cancer.The amount of UV exposure depends on the strength of the light, how long the skin was exposed, and whether the skin was covered with clothing and sunscreen. Many studies have linked melanoma in the trunk, legs, and arms to frequent sunburns (especially in childhood).

Moles:  A mole (the medical name is nevus) is a benign (not cancer) skin tumor. Certain types of moles increase a person's chance of getting melanoma. The chance of any single mole turning into cancer is very low. But a person who has many moles is more likely to develop melanoma. These people should have very thorough skin exams by a skin doctor (dermatologist). Many doctors suggest that they should also look at their own skin every month. Good sun protection is always important.

Fair skin:  The risk of melanoma is more than 10 times higher for whites than for African Americans. Whites with fair skin, freckles, or red or blond hair have a higher risk of melanoma. Red-haired people have the highest risk.

Family history of melanoma:  Around 10% of people with melanoma have a close relative (mother, father, brother, sister, child) with the disease. This could be because the family tends to spend more time in the sun, or because the family members have fair skin, or both. Less often, it is because of a gene change (mutation) along with sun exposure.

People with a strong family history of melanoma should do these things:
  • Have regular skin exams by a skin doctor (dermatologist)
  • Learn to look at their own skin and know what it should look like
  • Be very careful about sun exposure

Having had melanoma in the past:  A person who has already had melanoma has a higher risk of getting another one Weak immune systems-People who have been treated with medicines that suppress the immune system, such astransplant patients, have an increased risk of developing melanoma. Age-Melanoma is more likely to happen in older people. But it is a cancer that is also found in younger people. In fact, it is one of the most common cancers in people under 30.

Gender:  In the U.S., men have a higher rate of melanoma than women.

Xeroderma pigmentosum (XP):  This is a rare, inherited condition. People with XP are less able to repair damage caused by sunlight and are at greater risk of melanoma and other skin cancers.

Can Skin Cancer be prevented?

Not all melanomas can be prevented, but there are ways to reduce your risk.
  • Limit UV exposure
  • Protect your skin with clothing
  • Wear a hat
  • Use sunscreen
  • Avoid tanning beds and sunlamps
  • Check for abnormal moles and have them removed
  • Genetic counseling and testing

Possible Signs and Symptoms of Melanoma

The most important warning sign for melanoma is a new spot on the skin or a spot that is changing in size, shape or color. A spot that looks different from all of the other spots on your skin can also be a warning. If you have any of these warning signs, have your skin checked by a doctor.

The ABCD rule can help you tell a normal mole from an abnormal mole. Moles that have any of these signs should be checked by a doctor. ABCD stands for the following:
  • A = Asymmetry . . . one-half of a mole or birthmark does not match the other.
  • B = Border . . . the edges are irregular, ragged, notched, or blurred.
  • C = Color . . . the color is not the same all over and may include shades of brown or black, or there may be patches of pink, red, white, or blue.
  • D = Diameter . . . the spot is larger than about ¼ inch (the size of a pencil eraser), but melanomas can be smaller than this.

Another important sign of melanoma is a mole that is growing or changing in shape or color. Still, some melanomas do not fit the "rules" above. It may be hard to tell if the mole is normal or not, so you should show your doctor anything that you are unsure of.

Other Warning Signs are:
  • A sore that does not heal
  • Spread of color from the border of a spot to the skin around it
  • Redness or a new swelling beyond the border
  • Itchiness, tenderness or pain
  • Change in the surface of a mole -- scaliness, oozing, bleeding, or a new bump or nodule

Test to Find Melanoma Skin Cancer

It's important to check your own skin about once a month. You should know the pattern of moles, freckles, and other marks on your skin so that you'll notice any changes. Self-exam is best done in front of a full-length mirror. A hand-held mirror can be used for places that are hard to see. A family member can check your lower back or the back of your thighs.

Spots on the skin that change in size, shape, or color should be seen by a doctor right away. Any unusual sore, lump, blemish, marking, or change in the way an area of the skin looks or feels should also be checked by a doctor. It is sometimes hard to tell the difference between melanoma and a normal mole, so it is important to show your doctor any mole that you are unsure of.
  • Skin biopsy
  • Shave biopsy
  • Punch biopsy
  • Incisional and excisional biopsies
  • Biopsies of melanoma that may have spread:
  • Fine needle aspiration biopsy (FNA)
  • Surgical (excisional) lymph node biopsy
  • Sentinel lymph node biopsy
  • Chest X-rays
  • CT
  • MRI
  • PET (positron emission tomography) scans
  • Bone scans

Treatment for Melanoma Skin Cancer

  • Chemotherapy
  • Immunotherapy
  • Radiation therapy

Treatment is based on the type of tumor, and in many cases a combination of treatments is used. The effectiveness of the treatment depends on the number of factors including the type, size and location of the tumor.

Skin Cancer Squamous Cell and Basal Cell

What is Squamous cell and Basal cell Skin Cancer?

Basal cell cancer

Basal cell cancer begins in the lowest layer of the epidermis, the basal cell layer. About 8 out of 10 skin cancers are basal cell carcinomas. They usually begin on skin exposed to the sun, such as the head and neck. Basal cell carcinoma was once found mostly in middle-aged or older people. But now it is also being seen in younger people. This may be because people are spending more time in the sun without protecting their skin.

Basal cell carcinoma tends to grow slowly. It is very rare for a basal cell cancer to spread to distant parts of the body. But if it is not treated, it can grow into nearby areas and spread into the bone or other tissues under the skin.

After treatment, basal cell carcinoma can come back (recur) in the same place on the skin. New basal cell cancers can also start in other places on the skin. As many as half of the people who have one basal cell cancer will get a new skin cancer within 5 years.

Squamous cell cancer

This type of cancer starts in the squamous cells in the upper part of the epidermis. It accounts for about 2 out of 10 skin cancers. It most often starts on skin that is often exposed to the sun, like the face, ears, neck, lips, and backs of the hands. It can also start within scars or skin ulcers other places on the body. Less often, it forms in the skin of the genital area.

Squamous cell carcinomas are more likely than basal cell carcinomas to spread into fatty tissues just beneath the skin. They are also more likely to spread to lymph nodes (the bean-shaped collections of immune system cells) or to distant parts of the body, but this is not common.

Risk Factors for Skin Cancer:

  • Ultraviolet (UV) light
  • Fair skin
  • Older age
  • Gender
  • Chemicals
  • Radiation
  • Having had a skin cancer
  • Certain long-term or severe skin problems
  • Psoriasis treatment
  • Family diseases
  • Xeroderma pigmentosum
  • Basal cell nevus syndrome
  • Weakened immune system
  • HPV infection
  • Smoking
  • Genetics

Can Skin Cancer be prevented?

Test to Find Skin Cancer:

  • History and physical exam
  • Skin biopsy
  • Shave biopsy
  • Punch biopsy
  • Incisional and excisional biopsies
  • Lymph node biopsy
  • Treatment for Skin Limit ultraviolet (UV) exposure
  • Protect your skin with clothing
  • Wear a hat
  • Use sunscreen
  • Wear sunglasses
  • Stay in the shade
  • Avoid other sources of UV light
  • Avoid harmful chemicals

Signs and Symptoms

  • A new growth
  • A spot or bump that's getting bigger
  • A sore that doesn't heal within 3 months

Treatment for Skin Cancer

  • Surgery
  • Radiation therapy
  • Systemic chemotherapy

Treatment is based on the type of tumor, and in many cases a combination of treatments is used. The effectiveness of the treatment depends on the number of factors including the type, size and location of the tumor.