Symptoms of skin cancer:
Skin cancer develops primarily on areas of sun-exposed skin, including the scalp, face, lips, ears, neck, chest, arms and hands, and on the legs in women. But it can also form on areas that rarely see the light of day — your palms, beneath your fingernails, the spaces between your toes or under your toenails, and your genital area.
Skin cancer affects people of all skin tones, including those with darker complexions. When melanoma occurs in those with dark skin tones, it’s more likely to occur in areas not normally considered to be sun-exposed.
A cancerous skin lesion can appear suddenly or develop slowly. Its appearance depends on the type of cancer.
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. Desiccation is the additional application of an electric current to control bleeding and kill the remaining cancer cells. The skin heals without stitching. This technique is best suited for small cancers in non-crucial areas such as the trunk and extremities.
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. This sequence of cutting and microscopic examination is repeated in a painstaking fashion so that the basal cell carcinoma can be mapped and taken out without having to estimate or guess the width and depth of the lesion. This method removes as little of the healthy normal tissue as possible. Cure rate is very high, exceeding 98%. Mohs micrographic surgery is preferred for large basal cell carcinomas, those that recur after previous treatment, or lesions affecting parts of the body where experience shows that recurrence is common after treatment by other methods. Such body parts include the scalp, forehead, ears, and the corners of the nose. In cases where large amounts of tissue need to be removed, the Mohs surgeon sometimes works with a plastic (reconstructive) surgeon to achieve the best possible postsurgical appearance.
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. The advantages of this method is that it avoids surgery, lets the patient perform treatment at home, and may give a better cosmetic result. Disadvantages include discomfort, which may be severe, and a lower cure rate, which makes medical treatment unsuitable for treating most skin cancers on the face.
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Early signs
The most important warning sign for melanoma is any change in size, shape, or color of a mole or other skin growth, such as a birthmark. Watch for changes that occur over a period of weeks to a month. Use the American Cancer Society’s ABCD rule to evaluate skin changes, and call your health professional if you have any of the following changes.4
A is for asymmetry. One half of the mole or skin growth doesn’t match the other half.
B is for border irregularity. The edges are ragged, notched, or blurred.
C is for color. The pigmentation is not uniform. Shades of tan, brown, and black are present. Dashes of red, white, and blue add to the mottled appearance. Changes in color distribution, especially the spread of color from the edge of a mole into the surrounding skin, also are an early sign of melanoma.
D is for diameter. The mole or skin growth is larger than 6mm or about the size of a pencil eraser. Any growth of a mole should be of concern.
Signs of melanoma in an existing mole include changes in:
Elevation, such as thickening or raising of a previously flat mole.
Surface, such as scaling, erosion, oozing, bleeding, or crusting.
Surrounding skin, such as redness, swelling, or small new patches of color around a larger lesion (satellite pigmentations).
Sensation, such as itching, tingling, or burning.
Consistency, such as softening or small pieces that break off easily (friability).
Melanoma can develop in an existing mole or other mark on the skin, but it often develops in unmarked skin. Although melanoma can grow anywhere on the body, it frequently occurs on the upper back of men and women and on the legs in women. Less commonly, it can develop on the soles, palms, nail beds, or mucous membranes that line body cavities such as the mouth, the rectum, and the vagina.5
Many other skin conditions (such as seborrheic keratosis, warts, and basal cell cancer) have features similar to those of melanoma.
Later symptoms
Later signs of melanoma include:
A break in the skin or bleeding from a mole or other colored skin lesion.
Pain in a mole or lesion.
Symptoms of metastatic melanoma may be vague and include:
Swollen lymph nodes, especially in the armpit or groin.
A colorless lump or thickening under the skin.
Unexplained weight loss.
Gray skin (melanosis).
Ongoing (chronic) cough.
Headaches.
Seizures.
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