Skin Cancer

Skin Cancer, malignancy in the skin, and the most common of all cancers. There are three main types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and melanoma. Basal cell carcinoma, the most common type, develops in the basal, or bottom, layer of the epidermis, the top layer of skin. Squamous cell carcinoma, the second most common type, develops in the upper layers of the epidermis.

The third type of skin cancer is melanoma. It develops in the melanocytes, or pigment cells, which are found throughout the basal layer. Melanoma is the most dangerous type of skin cancer and is responsible for about three-quarters of all skin cancer deaths.

Skin cancers can grow in any part of the skin, but approximately 90 percent develop in areas exposed to the sun, especially the face, neck, backs of the hands, and the scalps of bald men. Exposure to direct sunlight, especially during childhood, is the chief risk factor for skin cancer, and the greater the number of blistering sunburns a person has had, the greater the risk of developing skin cancer later in life. People with pale skin are at greatest risk for skin cancer, particularly if their skin burns or freckles easily.

SYMPTOMS AND DIAGNOSIS

Early detection and treatment are the keys to survival, especially for melanoma. Any of several skin changes may signal skin cancer and should be reported to a physician. These include any change in the size, shape, color, or texture of a mole or other darkly pigmented area; any mole that begins to itch or becomes tender; the development of a new mole or other growth, particularly if it feels hard; any mole or other growth that spontaneously or persistently bleeds; a skin ulcer that does not heal; and a black spot under a toenail or fingernail that extends beneath the cuticle. To confirm a diagnosis a physician may perform a biopsy, removing a small piece of the skin to examine under a microscope for the presence of cancerous cells.

TREATMENT

One of several surgical methods is used to remove the cancerous tissue. In some cases, the tissue is destroyed through the application of intense cold (cryosurgery). In advanced cases, surgical removal of the tissue coupled with radiation, chemotherapy, or both may be required.

A class of vitamin-based drugs called retinoids have been shown to reduce the number of basal cell and squamous cell carcinomas. However, the drugs can cause liver abnormalities, bone problems, fetal malformation, and other undesirable side effects.

Potential skin cancer treatment studies now underway include the use of the drugs interleukin-2 and interferon. A vaccine to reduce the recurrence of melanoma has shown promise in early tests.

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