Skin Cancer/Melanoma
What is skin cancer?
Skin cancer is the uncontrolled growth of abnormal skin cells. Skin cancers can be divided into two groups.:
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Non-melanoma skin cancer
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Melanoma
Non-Melanoma Skin Cancer
Non-melanoma skin cancers are typically slow growing cancers that occur on the skin. They very rarely spread (metastasize) to other areas of the body. The most common types of non-melanoma skin cancers are:
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Basal cell carcinomas (BCC): These occur in round cells called basal cells found in the top layer of the skin (epidermis). BCC accounts for 75-80% of all skin cancers.
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Squamous cell carcinomas (SCC): These occur in the squamous cells of the skin which are flat cells found in the outer part of the epidermis. SCC account for 20% of all skin cancers.
Melanoma
Melanoma is a type of skin cancer that occurs in the melanocyte cells of the skin. Melanocytes can group together and form moles of the skin. These are usually non-cancerous but, in some cases, they evolve into melanoma. Melanoma is rarer than BCC and SCC, but it can spread (metastasize) to other parts of the body so it is important to treat it quickly.
What are the risk factors for skin cancer?
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The most common risk factor is ultraviolet (UV) radiation exposure. Frequent sun or tanning bed exposure greatly increases your risk of developing skin cancers.
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Having many moles. If you have many moles on your body, you are more likely to have one of them develop into a cancer. Also, if you have any atypical moles (uneven shape, odd coloring, large size) they are more likely to develop into cancer.
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Personal history of skin cancer or a family history of skin cancer
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Light colored skin, eyes and hair. Risk is greater because they have less melanin, so they are less protected from UV radiation.
What are the signs and symptoms of skin cancer?
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Look for the “ABCDE” warning signs of skin cancer
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Asymmetry: Do the two halves not match if you imagine drawing a line through the mole?
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Borders: Are the edges uneven?
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Color: Are there many shades of color (brown, red, white, blue or black)? Has it changed color over time?
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Diameter greater than 6mm. Is the mole the size of a pencil eraser or larger?
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Evolution. Has there been a change in size, shape, color, or height? Has a new symptom developed (like bleeding, itching or crusting)?
What are the risk factors for skin cancer?
Non-Melanoma Skin Cancer Treatment
Almost all basal cell carcinoma and squamous cell carcinoma skin cancers can be completely treated through surgical excision. This can usually be done in the Ambulatory Care Unit at the hospital under a local anesthetic. The surgeon will remove the cancerous tissue along with some of the normal surrounding tissue (called the surgical margin). Typically, there is no further treatment necessary, and your surgeon will recommend that your family doctor do a yearly skin assessment to monitor for any future skin cancers.
Melanoma Treatment
Treatment for melanoma depends on many factors including:
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The stage of the cancer: Whether it is early stage (only in the skin), locoregional (cancer has spread to nearby lymph nodes) or metastatic (cancer has spread to a different part of the body)
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Location of the cancer
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Risk of it reoccurring
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How treatments will affect how you look
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Your personal preference
Treatment for Melanoma may include:
Surgery: Surgery is the main treatment for most melanoma skin cancers. Depending on the stage and risk of the cancer coming back, you may have one or more of the following types of surgery.
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Wide local excision removes the cancer along with some normal tissue around it (called the surgical margin). It is the first treatment for early stage, locoregional and locally recurrent melanoma skin cancers.
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Sentinel lymph node biopsy (SLNB) finds and removes the first lymph node (or first few lymph nodes) in a group of lymphnodes to see if it contains cancer cells. This helps the surgeon stage your cancer and determine if it has started to spread (metastasize).
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Complete lymph node dissection removes a group of lymph nodes from the body. It is done for locoregional or locally recurrent melanoma skin cancer that has spread to nearby lymph nodes.
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Reconstructive surgery repairs the skin and nearby area after the tumor is removed. When a large area of skin has been removed to make sure the cancer is completely gone, the doctor rebuilds the area using a piece of skin from another part of the body, called a skin graft or skin flap.
Chemotherapy: Chemotherapy is a method to destroy cancer cells using medication. It is a systemic therapy, meaning that it affects your entire body and is administered either through pills or an intravenous device. If chemotherapy is necessary, you will be referred to the North East Cancer Center, in Sudbury, to speak to a Medical Oncologist
Radiation: Radiation uses a high energy beam to destroy cancer cells. This works by damaging the DNA of cancer cells so that they can’t continue to grow. Radiation is a local treatment because it is applied and takes effect in a specific area of the body (where the tumor is located). Your surgeon will refer you to the North East Cancer Center located in Sudbury to speak with a Radiation Oncologist if indicated.