Deadly Skin Cancer Types

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An important warning for us all with regard to skin cancer types. Today more patients than ever survive dangerous melanoma than in past generations, but the rate of death for one form of this disease hasn't budged in 30 years.

Nodular melanoma accounts for 14% of melanomas that are diagnosed, but makes up a startling 37% of untimely deaths from the disease according to a recent study.

The reason this form of cancer contributes to so many deaths is that it doesn't always look like what we expect to see. It can appear without warning on the surface of the skin and can be hard to spot because it's often light or nearly colorless, and doesn't adhere to the ABCD characteristics we've all been taught to look for.

Just like the more well known radial melanoma, nodular melanomas start out in skin cells that are called melanocytes that product melanin. Most melanomas stay in the skin's top layer, going down no more than one tenth of a millimeter. Radial melanomas are easier to see as the diameter goes up.

For nodular melanoma the cancerous cells reach a point where they start to grow vertically, sending roots into the fat and other tissues of the body. The depth of the cancer determines how likely you are to survive. For a cancerous growth that goes 3.5 to 4 millimeters deep, only 60% of patients will live for five years.

This latest study examined over 100,000 cases of melanoma diagnosed between the years 1978 and 2007.

They saw that at least 20% of nodular melanomas were fatal. You should understand that there's an acknowledged limitation of the work - not all physicians report the type of melanoma and the team was unable to double check the reports during the study.

While public health officials and others have done a great job of getting the word out about ABCD characteristics when it comes to identifying skin cancer, experts now believe other letters should be added to the mix to help identify the nodular types of these cancers. We've been taught to watch for any of these...

- Asymmetry, one side doesn't match the other

- Borders, where moles have irregular edges

- Color, color changes or a variety of colors

- Diameter, anything over 6 millimeters wide

But we should also be watching our skin surface for E, F and G as well. Any mole or other growth that has all of these characteristics should be checked by a dermatologist at once. They are...

- Evolving, where the mole or nodule is changing quickly over a short period of time

- Firm to the touch

- Growing for more than two to three weeks

Also good to know, nodular melanoma can happen in a mole, but are more likely to develop without warning on normal skin

In most cases the various skin cancer types, including melanomas are easy to detect, treat and cure. Dermatologists suggest that you get to know your own skin by doing full body self-exams once each month. If you're worried about something you see... get to the doctor right away. Often patients realize something is wrong. Don't give up if the first physician you see doesn't respond as you like... keep looking until you find one who will take action.

Skin Cancer - Basal Cell Carcinoma (BCC)

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In the United States, Basal Cell Carcinoma (BCC) accounts for 90 percent of all skin cancers in the southern states, and 47 percent in the northern states. Basal Cell Carcinoma is the most common form of skin cancer in Australia and New Zealand, representing 70-80% of diagnosed skin cancers. Occurrence of Basal Cell Carcinoma mainly occurs on the head and neck. It occurs less often in Asians and rarely among darker skinned races. As with all skin cancers the risk is considered to be related to sun exposure. The positive about Basal Cell Carcinoma is that it is slow-growing and rarely metastasizes throughout the body. However, it is locally destructive and can invade neighboring bone and nerve tissue.

Description - BCC is a malignant epithelial cell tumor that begins as a papule (a small, circumscribed, solid elevation of the skin) and enlarges peripherally, developing into a crater that erodes, crusts and bleeds. BCC originates in the basal layer of the epidermis, the lowest layer of skin.

Signs and Symptoms of Basal Cell Carcinoma - There are five typical characteristics of basal cell carcinoma that are quite different from each other. Two or more features are frequently present in one tumor. BCC sometimes resembles non-cancerous skin conditions such as psoriasis or eczema and requires diagnosis by a trained person. The five warning signs of basal cell carcinoma are:

1. An open sore that bleeds, oozes or crusts, and remains open for three or more weeks. A persistent, non-healing sore is a very common early manifestation.
2. A reddish patch or an irritated area, frequently occurring on the chest, shoulders, arms or legs. Sometimes the patch crusts. It may also itch or hurt. At other times, it persists with no noticeable discomfort.
3. A smooth growth with an elevated, rolled border and an indentation in the centre. As the growth slowly enlarges, tiny blood vessels may develop on the surface (telangiectases).
4. A shiny bump (nodule) that is pearly or translucent and is often pink, red or white. The nodule can also be tan, black or brown, especially in dark-haired people, and can be confused with a mole or melanoma.
5. A scar-like area (white, yellow, or waxy in appearance) which often has poorly defined borders. The skin itself appears shiny or taut. Although a less frequent sign, it can indicate the presence of a more aggressive tumor.

Diagnosis of Basal Cell Carcinoma - Diagnosis is almost always by biopsy. Tissue is cut away from the site and examined under a microscope.

Medical Treatment of Basal Cell Carcinoma - Allopathic treatment depends on the size and type of tumor. There are various types of surgery or non-surgical treatments chosen from.

Non-surgical treatment of BCC - Allopathic non-surgical treatments have low success rates.

• Topical application of 5-fluorouracil for 2 to 12 weeks is only beneficial for superficial BCC. Fluorouracil is used to prevent excess cell proliferation as found in skin cancer and psoriasis. It prevents the formation of RNA which in turn prevents the formation of DNA.
• Imiquinoid cream -currently the use of Imiquinoid cream is considered experimental. It is an immune response modifier that stimulates the immune system to release cytokines that destroy cancer cells. Treatment causes significant skin irritation. Not all types of BCC are affected.
• Ionizing radiation: Superficial x-ray. It results in radiation damage, therefore it is used more with older patients. Impaired immune function and general malaise also usually results. Used for facial BCC and appears less effective for BCC occurring elsewhere.

Surgical Removal of BCC - Surgery is the most studied, and most used treatment for removal of a BCC in allopathic medicine. The effectiveness of surgery depends very much on the skill of the surgeon. Various surgical methods:

• Electrodessication and Curettage - the BCC is burned and removed with a scalpel. The main disadvantage of this method is that the tumor often tracks down hair follicles. (9)
• Cryosurgery - liquid nitrogen to freeze burn the BCC.
• Excision surgery- the BCC is cut from the skin with a scalpel. To increase the likelihood of complete removal of the tumor, a portion of normal-appearing skin surrounding the BCC is removed.
• Microscopic or MOHS surgery - the BCC is cut from the skin, along with some of the healthy surrounding tissue. This is examined under a microscope to check for any remaining cancer cells. Tissue is then taken in increments of thin layers of skin, until no more cancer cells are detected. Mohs is the most effective allopathic medical treatment (99% cure rate for primary BCC, 90-95% for recurrent BCC).
• Laser surgery. Lasers are also used as a secondary therapy when topical medications or other techniques are unsuccessful.

Recurrence of BCC - Once a basal cell carcinoma has been removed, another growth can develop in the same place or nearby area. It has been found that 36% of people who develop a basal cell carcinoma will develop a secondary primary BCC within the next 5 years. Radiotherapy can result in more aggressive and invasive cells in a recurrent BCC.

Effective Alternative Treatments - Allopathic medicine is often successful in completely removing BCC's but obviously also often fails, given the high number of recurrences suffered by many people with repeat visits to the doctor and then specialist. These treatments don't always work as well as expected or hoped.

Prognosis of Melanomas

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Features that affect prognosis of melanomas are tumor thickness in millimeters, depth related to skin structures, type of melanoma, presence of ulceration, presence of lymphatic/perineural invasion, presence of tumor infiltrating lymphocytes, location of lesion, presence of satellite lesions, and presence of regional or distant metastasis. Certain types of melanoma have worse prognoses but this is explained by their thickness.

Interestingly, less invasive melanomas even with lymph node metastases carry a better prognosis than deep melanomas without regional metastasis at time of staging. Local recurrences tend to behave similarly to a primary unless they are at the site of a wide local excision since these recurrences tend to indicate lymphatic invasion. When melanomas have spread to the lymph nodes, one of the most important factors is the number of nodes with malignancy.

Extent of malignancy within a node is also important; micrometastases in which malignancy is only microscopic have a more favorable prognosis than macrometastases. In some cases micrometastases may only be detected by special staining, and if malignancy is only detectable by a rarely-employed test known as the polymerase chain reaction (PCR), the prognosis is better.

Macrometastases in which malignancy is clinically apparent (in some cases cancer completely replaces a node) have a far worse prognosis, and if nodes are matted or if there is extracapsular extension, the prognosis is still worse. When there is distant metastasis, the cancer is generally considered incurable. The five year survival rate is less than 10%.

The median survival is 6 to 12 months. Treatment is palliative, focusing on life-extension and quality of life. In some cases, patients may live many months or even years with metastatic melanoma (depending on the aggressiveness of the treatment). Metastases to skin and lungs have a better prognosis. Metastases to brain, bone and liver are associated with a worse prognosis.

There is not enough definitive evidence to adequately stage, and thus give a prognosis for ocular melanoma and melanoma of soft parts, or mucosal melanoma, although these tend to metastasize more easily. Even though regression may increase survival, when a melanoma has regressed, it is impossible to know its original size and thus the original tumor is often worse than a pathology report might indicate.

Radiation therapy is often used after surgical resection for patients with locally or regionally advanced melanoma or for patients with unresectable distant metastases. It may reduce the rate of local recurrence but does not prolong survival. Radioimmunotherapy of metastatic melanoma is currently under investigation. What's more, moles are classically removed by laser, surgery, or electrocautery.

Most of these treatments require multiple visits to the doctor. Laser and electrocautery treatments are not always effective because they only reach the outermost layers of the skin, while moles penetrate very deep into the dermal tissue, often beyond the reach of these treatments. Surgery, the other option doctors commonly offer, involves cutting out the mole. The resulting wound requires stitches, which will in turn leave a scar.

Skin Cancer Chart

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Skin cancer is a deadly and common disease. Skin cancer charts graphs is at least partially preventable. Overexposure to the sun and tanning beds are two causes of the disease. Some forms of the disease are also hereditary.

Skin cancer is cancer that can be found on the skin, including the face, arms, and legs. Typically, it comes from moles or spots on the skin that form into cancer at a later time. There are several ways to detect if a mole on your skin is suspicious. If it is irregular or asymmetrical, then it should be checked by a doctor called a dermatologist. Everyone is recommended to have at least one exam a year by a dermatologist to check the entire body for skin cancer.

There are many types of skin cancer as well. The deadliest type is melanoma. There is also basal cell carcinoma and squamous cell carcinoma. Skin cancer charts graphs are different depending on the kind of skin cancer that is found. Treatment is dependent on the type of cancer found also. The prognosis for survival and recovery depends on how soon the cancer was found and the type of cancer. Biopsies are used to find out this information after the suspicious spot is discovered. Charts and graphs have been made showing how common different types of the disease are.

How common is skin cancer relating to tanning? It is very common. People who have spent their entire lives baking in the sun are putting themselves at a huge risk for deadly skin cancer. It is good to stay out of the sun whenever possible. If you have to be in the sun, wear sunscreen and/or protective clothing to block out the harmful rays. Any tanning or sunburns put you at a higher risk for the disease. Skin cancer charts graphs prove that this disease are not worth messing around with!

The skin, also called the derma, is a very important organ. It covers all our internal organs, bones and muscles. It is the first impression we make on others. We should limit our sun exposure as much as possible in order to protect it! If you have been tanning or staying in the sun too much, make sure to get your skin checked often. It is not too late to start wearing sunscreen! Even if you have been taking care of your skin, still get checked out yearly by a dermatologist.

Skin cancer is a serious, common, and preventable disease. Although it is mostly treatable, people die every year from the disease. Many others wear scars from painful and embarrassing surgeries relating to cancer. They wish they had taken care of themselves while they had the chance to.

The Skin Doesn't Forget

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The end of winter, no more short, cold and dark days. Spring is finally here and summer is fast approaching. Hot days and lots of sunshine. But not all fun and sun. The hot sun can pose a great danger for our skin and our children’s skin. In fact, one of the most important factors for feeling young and healthy is the way we take care of our skin during the summer months.

Over the last century, ever-increasing rates of skin cancer have taken some of the greatest tolls on all age groups, young and old. Yet most people don’t realize that skin cancer is a very preventable form of skin cancer, and, that if recognized early enough, is very treatable. The simple fact is, if we take care of our skin during the summer, we can dramatically reduce the chances of ever getting skin cancer in the first place. The chance of getting skin cancer is directly related to the amount of sunlight we expose our skin to, especially during the summer. Furthermore, it has been shown that going to the solarium on a regular basis is also a risk for the development of skin cancer.

Overexposure to UV A and B light from the sun and the solarium damages skin cells. UV A light in spite of its lower energy, is received by the body in much larger doses, and penetrates into the skin easily causing damage. UV light mainly affects the skin and underlying connective tissues by decreasing the quantities of collagen and elastic fibers present in these tissues. With passing time, the skin becomes more wrinkled and flaccid. One of the most important factors in the pathogenesis of cancer is the fact that the absorbed UV light breaks down water molecules and induces the formation of free-oxygen radicals, which are toxic to certain elements of the skin.

For those of us who have a light or very fair complexion, (type I skin tone) avoidance of the sun and solarium as much as possible is recommended. The rest of us should adjust the amount of sun (UV light) exposure to our proper skin tones.

The reason its important to know what type of skin tone you have is because the lighter the skin, the less it is capable of dealing with the damaging elements of the sunlight and thus, more the skin needs to be protected.

It’s not difficult to determine what your skin type is. There are six types and by using the scale below, you can determine for yourself how much skin protection you may need.

Skin type I never turns brown, only burns.
Skin type II browns very slowly and easily burns.
Skin type III browns easily and rarely burns.
Skin type IV is typical of that of southern Europeans (Mediterranean type).
Skin type V is slightly pigmented similar to those living in India.
Skin type VI is black.

If you fall into either of the first two categories, your skin must be protected at all times from the dangerous effects of the sun!!!!!

Skin cancer can be broken down into Melanoma- and non-Melanoma types. The latter consists of both squamous cell- and basal cell skin cancer. Melanoma is the most dangerous type of skin cancer. The proliferation of pigmented skin cells anywhere in the body can, if not diagnosed and treated early, cause death. The frequency of Melanoma around the world is increasing at very rapid rates!!

Squamous cell type of skin cancer is also a malignant form of skin cancer that is directly related to the amount of sun exposure and can quickly spread to other parts of the body.

Basal cell type skin cancer is not malignant and thus wont spread to other parts of the body. However, there is local destruction of the affected skin areas and thus excision of the lesion is a must.

Well, you may ask how do I protect myself from the dangers of the skin cancer? The answers may not be as difficult to follow as you may think. First and foremost, always protect skin of young children and kids. Their skins are sensitive to sun exposure and burning the skin only increases the risk in later years of developing cancer. It is important to remember that the many years of continuous sun exposure increase the chance of getting skin cancer. In other words, the skin doesn’t forget!! Sporadic sun exposure is more than enough to guarantee a nice brown skin color and the proper production of vitamin D in the body.

If someone wants to get a quick tan, than be sure to use self-browning creams, but remember, they wont protect your skin from sun overexposure and burning. Carotin derivative products have been shown to protect the skin from within and in general have an anti-cancer effect.

During the hot months, a good rule of thumb is to avoid strong sun exposure in the middle of the day, say between 2 and 3 pm, when the sun is hottest. Try to stay in the shade as much as possible and when going into the sun, put on a hat, sunglasses and a shirt just to be sure. Sun tanning protective creams are also a must. A wide spectrum UV protection and a minimum factor of 15 should be applied to the skin at all times for maximum protection. But remember, the best protection from skin cancer is to avoid the exposure to the skin.

Finally, and equally important, is that we recognize on ourselves any first signs of potential cancer. Especially be aware of any small wounds or scars on the skin that don’t seem to heal after a month or so. Be aware of skin moles that suddenly begin to itch, bleed, peel, grow, change color or become painful. In any of the above instances, be sure to contact your dermatologist immediately for a full check up. Remember, early diagnosis and treatment along with regular screening is the best way to ensure many happy, healthy summers to come.

Dr. Randy Simor is a medical graduate from the Semmelweis Medical University in Budapest, Hungary, 1999. Since 1999, he has worked continuously within the healthcare industry as a clinical research associate, a consultant for a multi-national pharmaceutical company, and a business development director for one of Budapest's largest private outpatient, one-day surgery clinics. As an entrepreneur, Randy is owner and director of a newly established management company for medical tourism, CARE Ltd. The company primarily focuses on medical tourism for plastic surgery, dental & oral surgery, Laser eye surgery and a wide variety of other diagnostic, surgical and wellness services.

Excisional Skin Biopsy for Melanoma

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Melanoma is a malignant tumor of melanocytes which are found predominantly in skin but also in the bowel and the eye. It is one of the less common types of skin cancer but causes the majority of skin cancer related deaths. Melanocytes are normally present in skin, being responsible for the production of the dark pigment melanin.

Around 60,000 new cases of invasive melanoma are diagnosed in the US each year, more frequently in males and in Caucasians. It is more common in Caucasian populations living in sunny climates than in other groups, or in those who use tanning salons. According to a WHO report about 48,000 melanoma related deaths occur worldwide per year.

Excisional skin biopsy is the management of choice for melanoma diagnosis; this is where the suspect lesion is totally removed with an adequate ellipse of surrounding skin and tissue. The preferred surgical margin for the initial biopsy should be narrow in order to prevent the disruption of the local lymphatic drainage.

The biopsy will include the epidermal, dermal, and subcutaneous layers of the skin, enabling the histopathologist to determine the thickness of the melanoma by microscopic examination. This is described by Breslow's thickness. Large initial excision will disrupt the local lymphatic drainage and can affect further lymphangiogram directed lymphnode dissection.

A small punch biopsy can be utilized at any time where for logistical and personal reasons a patient refuses more invasive excisional biopsy. Small punch biopsies are minimally invasive and heal quickly, usually without noticeable scarring. Thus, a small punch biopsy in representative areas will give adequate information and will not disrupt the final staging or depth determination.

For large lesions such as suspected lentigo maligna, or for lesions in surgically difficult areas (face, toes, fingers, eyelids), a small punch biopsy in representative areas would be enough. In no circumstances should the initial biopsy include the final surgical margin, as a misdiagnosis can result in excessive scarring and morbidity from the procedure.

Lactate dehydrogenase (LDH) tests are often used to screen for metastases, although many patients with metastases have a normal LDH; extraordinarily high LDH often indicates metastatic spread of the disease to the liver. It is common for patients diagnosed with melanoma to have chest X-rays and an LDH test, and in some cases CT, MRI, PET or PET/CT scans.

Although controversial, sentinel lymph node biopsies and examination of the lymph nodes are also performed in patients to assess spread to the lymph nodes. Sometimes the skin lesion may bleed, itch, or ulcerate, although this is a very late sign. A slow-healing lesion should be watched closely, as that may be a sign of melanoma. Some patients with metastatic melanoma do not have an obvious detectable primary tumor.

Be aware also that in circumstances that are still poorly understood, melanomas may 'regress' or spontaneously become smaller or invisible; however the malignancy is still present. Amelanotic melanomas do not have pigment and may not even be visible. Lentigo maligna, a superficial melanoma confined to the topmost layers of the skin is often described as a 'stain' on the skin.

The treatment includes surgical removal of the tumor, adjuvant treatment, chemotherapy, immunotherapy, or radiation therapy.

The Skin Doesn't Forget

To contact us Click HERE

The end of winter, no more short, cold and dark days. Spring is finally here and summer is fast approaching. Hot days and lots of sunshine. But not all fun and sun. The hot sun can pose a great danger for our skin and our children’s skin. In fact, one of the most important factors for feeling young and healthy is the way we take care of our skin during the summer months.

Over the last century, ever-increasing rates of skin cancer have taken some of the greatest tolls on all age groups, young and old. Yet most people don’t realize that skin cancer is a very preventable form of skin cancer, and, that if recognized early enough, is very treatable. The simple fact is, if we take care of our skin during the summer, we can dramatically reduce the chances of ever getting skin cancer in the first place. The chance of getting skin cancer is directly related to the amount of sunlight we expose our skin to, especially during the summer. Furthermore, it has been shown that going to the solarium on a regular basis is also a risk for the development of skin cancer.

Overexposure to UV A and B light from the sun and the solarium damages skin cells. UV A light in spite of its lower energy, is received by the body in much larger doses, and penetrates into the skin easily causing damage. UV light mainly affects the skin and underlying connective tissues by decreasing the quantities of collagen and elastic fibers present in these tissues. With passing time, the skin becomes more wrinkled and flaccid. One of the most important factors in the pathogenesis of cancer is the fact that the absorbed UV light breaks down water molecules and induces the formation of free-oxygen radicals, which are toxic to certain elements of the skin.

For those of us who have a light or very fair complexion, (type I skin tone) avoidance of the sun and solarium as much as possible is recommended. The rest of us should adjust the amount of sun (UV light) exposure to our proper skin tones.

The reason its important to know what type of skin tone you have is because the lighter the skin, the less it is capable of dealing with the damaging elements of the sunlight and thus, more the skin needs to be protected.

It’s not difficult to determine what your skin type is. There are six types and by using the scale below, you can determine for yourself how much skin protection you may need.

Skin type I never turns brown, only burns.
Skin type II browns very slowly and easily burns.
Skin type III browns easily and rarely burns.
Skin type IV is typical of that of southern Europeans (Mediterranean type).
Skin type V is slightly pigmented similar to those living in India.
Skin type VI is black.

If you fall into either of the first two categories, your skin must be protected at all times from the dangerous effects of the sun!!!!!

Skin cancer can be broken down into Melanoma- and non-Melanoma types. The latter consists of both squamous cell- and basal cell skin cancer. Melanoma is the most dangerous type of skin cancer. The proliferation of pigmented skin cells anywhere in the body can, if not diagnosed and treated early, cause death. The frequency of Melanoma around the world is increasing at very rapid rates!!

Squamous cell type of skin cancer is also a malignant form of skin cancer that is directly related to the amount of sun exposure and can quickly spread to other parts of the body.

Basal cell type skin cancer is not malignant and thus wont spread to other parts of the body. However, there is local destruction of the affected skin areas and thus excision of the lesion is a must.

Well, you may ask how do I protect myself from the dangers of the skin cancer? The answers may not be as difficult to follow as you may think. First and foremost, always protect skin of young children and kids. Their skins are sensitive to sun exposure and burning the skin only increases the risk in later years of developing cancer. It is important to remember that the many years of continuous sun exposure increase the chance of getting skin cancer. In other words, the skin doesn’t forget!! Sporadic sun exposure is more than enough to guarantee a nice brown skin color and the proper production of vitamin D in the body.

If someone wants to get a quick tan, than be sure to use self-browning creams, but remember, they wont protect your skin from sun overexposure and burning. Carotin derivative products have been shown to protect the skin from within and in general have an anti-cancer effect.

During the hot months, a good rule of thumb is to avoid strong sun exposure in the middle of the day, say between 2 and 3 pm, when the sun is hottest. Try to stay in the shade as much as possible and when going into the sun, put on a hat, sunglasses and a shirt just to be sure. Sun tanning protective creams are also a must. A wide spectrum UV protection and a minimum factor of 15 should be applied to the skin at all times for maximum protection. But remember, the best protection from skin cancer is to avoid the exposure to the skin.

Finally, and equally important, is that we recognize on ourselves any first signs of potential cancer. Especially be aware of any small wounds or scars on the skin that don’t seem to heal after a month or so. Be aware of skin moles that suddenly begin to itch, bleed, peel, grow, change color or become painful. In any of the above instances, be sure to contact your dermatologist immediately for a full check up. Remember, early diagnosis and treatment along with regular screening is the best way to ensure many happy, healthy summers to come.

Dr. Randy Simor is a medical graduate from the Semmelweis Medical University in Budapest, Hungary, 1999. Since 1999, he has worked continuously within the healthcare industry as a clinical research associate, a consultant for a multi-national pharmaceutical company, and a business development director for one of Budapest's largest private outpatient, one-day surgery clinics. As an entrepreneur, Randy is owner and director of a newly established management company for medical tourism, CARE Ltd. The company primarily focuses on medical tourism for plastic surgery, dental & oral surgery, Laser eye surgery and a wide variety of other diagnostic, surgical and wellness services.