Skin Cancer (cont.)
IN THIS ARTICLE
Self-Care at Home
Home treatment is not appropriate for skin cancer. These conditions require the care of a dermatologist or specialist in skin cancers.
Be active in preventing and detecting skin cancer on yourself and others. Perform regular self-examinations of your skin and note any changes. Avoid unnecessary exposure to direct sunlight. Wear sunscreen daily.
Surgical removal is the mainstay of therapy for both basal cell and squamous cell carcinomas. For more information, see Surgery.
People who cannot undergo surgery may be treated by external radiation therapy. Radiation therapy is the use of a small beam of radiation targeted at the skin lesion. The radiation kills the abnormal cells and destroys the lesion. Radiation therapy can cause irritation or burning of the surrounding normal skin. It can also cause fatigue. These side effects are temporary. In addition, a topical cream has recently been approved for the treatment of certain low-risk nonmelanoma skin cancers.
In advanced cases, immune therapies, vaccines, or chemotherapy may be used. These treatments are typically offered as clinical trials. Clinical trials are studies of new therapies to see if they can be tolerated and work better than existing therapies.
Small lesions may be removed through a variety of techniques, including simple excision (cutting it away), electrodesiccation and curettage (burning the tissue with an electric needle), and cryosurgery (freezing the area with liquid nitrogen).
Larger tumors, lesions in high-risk locations, recurrent tumors, and lesions in cosmetically sensitive areas are removed by Mohs micrographic surgery. The surgeon carefully removes tissue, layer by layer, until cancer-free tissue is reached.
Malignant melanoma is treated more aggressively than just surgical removal. To ensure the complete removal of this dangerous malignancy, 1-2 cm of normal-appearing skin surrounding the tumor is also removed by wide excision with or without skin grafting to cover the defect left by the procedure. Another technique called Moh's micrographic surgery can be used in melanoma, but some controversy exists about this. Moh's technique is more commonly used for non-melanoma skin cancers. Depending on the thickness of the melanoma, neighboring lymph nodes may also be removed and tested for cancer. The sentinel node method uses a small amount of radioactive substance injected into the region of the tumor to identify which lymph nodes the cancer is most likely to have first spread to if it has spread at all. The sentinel node is then removed. Only if it is positive melanome are other lymph nodes are considered for removal in that region. Extensive lymph node removal can result in some chronic problems if performed, thus, the sentinel node techinque may reduce both the extent and problems with a more extensive lymph node removal procedure.
Michael S Lehrer, MD
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