Skin cancer is the most common form of human cancer. It is estimated that over 1 million new cases occur annually. The annual rates of all forms of skin cancer are increasing each year, representing a growing public concern. It has also been estimated that nearly half of all Americans who live to age 65 will develop skin cancer at least once.
The most common warning sign of skin cancer is a change in the appearance of the skin, such as a new growth or a sore that will not heal.
The term "skin cancer" refers to three different conditions. From the least to the most dangerous, they are: -
- basal cell carcinoma (or basal cell carcinoma epithelioma)
- squamous cell carcinoma (the first stage of which is called actinic keratosis)
This article will discuss the two kinds of nonmelanoma skin cancer.
Basal cell carcinomaWhat is basal cell carcinoma?
Basal cell carcinoma is the most common form of skin cancer and accounts for more than 90% of all skin cancer in the U.S. These cancers almost never spread (metastasize) to other parts of the body. They can, however, cause damage by growing and invading surrounding tissue.
What are risk factors for developing basal cell carcinoma?
Other risk factors include : -
- exposure to sun. There is evidence that, in contrast to squamous cell carcinoma, basal cell carcinoma is promoted not by accumulated sun exposure but by intermittent sun exposure like that received during vacations, especially early in life. According to the U.S. National Institutes of Health, ultraviolet (UV) radiation from the sun is the main cause of skin cancer.
- age. Most skin cancers appear after age 50, but the sun's damaging effects begin at an early age. Therefore, protection should start in childhood in order to prevent skin cancer later in life.
- exposure to ultraviolet radiation in tanning booths. Tanning booths are very popular, especially among adolescents, and they even let people who live in cold climates radiate their skin year-round.
- therapeutic radiation. such as that given for treating other forms of cancer.
How is basal cell carcinoma diagnosed?
To make a proper diagnosis, doctors usually remove all or part of the growth by performing a biopsy. This usually involves taking a sample by injecting a local anesthesia and scraping a small piece of skin. This method is referred to as a shave biopsy. The skin that is removed is then examined under a microscope to check for cancer cells.
How is basal cell carcinoma prevented?
Avoiding sun exposure in susceptible individuals is the best way to lower the risk for all types of skin cancer. Regular surveillance of susceptible individuals, both by self-examination and regular physical examination, is also a good idea for people at higher risk. People who have already had any form of skin cancer should have regular medical checkups.
Common sense preventive techniques include : -
- limiting recreational sun exposure
- avoiding unprotected exposure to the sun during peak radiation times (the hours surrounding noon)
- wearing broad-brimmed hats and tightly-woven protective clothing while outdoors in the sun
How is basal cell carcinoma treated?
There are many ways to successfully treat a basal cell carcinoma with a good chance of success of 90% or more. The doctor's main goal is to remove or destroy the cancer completely with as small a scar as possible. To plan the best treatment for each patient, the doctor considers the location and size of the cancer, the risk of scarring, and the person's age, general health, and medical history.
Methods used to treat basal cell carcinomas include: -
- Curettage and desiccation: - Dermatologists often prefer this method, which consists of scooping out the basal cell carcinoma by using a spoon like instrument called a curette.
- Surgical excision: - The tumor is cut out and stitched up.
- Radiation therapy: - Doctors often use radiation treatments for skin cancer occurring in areas that are difficult to treat with surgery. Obtaining a good cosmetic result generally involves many treatment sessions, perhaps 25 to 30.
- Cryosurgery: - Some doctors trained in this technique achieve good results by freezing basal cell carcinomas. Typically, liquid nitrogen is applied to the growth to freeze and kill the abnormal cells.
- Mohs micrographic surgery: - Named for its pioneer, Dr. Frederic Mohs, this technique of removing skin cancer is better termed "microscopically controlled excision." The surgeon meticulously removes a small piece of the tumor and examines it under the microscope during surgery.
- Medical therapy using creams - that attack cancer cells (5-Fluorouracil--5-FU, Efudex, Fluoroplex) or stimulate the immune system (imiquimod [Aldara]). These are applied several times a week for several weeks. They produce brisk inflammation and irritation.
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