Precancerous lesions
- Actinic keratosis (AK) or solar keratosis. This is a precancerous condition that affects people with fair skin. They are usually found on the skin of the head, neck, hands and forearms. Most AKS develop after years of sun exposure. The AK is skin that has been damaged by the UV rays of the sun and indoor tanning. They are dry, rough, scaly patches or growths. They may itch, burn or be painful. If left untreated, they will turn into squamous cell carcinoma. Sometimes an AK may appear and later flake off and disappear, only to reappear later, especially in people who spend a lot of time outdoors without sun protection.
- Atypical cells. These are cells that appear on a biopsy report. This cells are often called dysplasia. It doesn’t mean they are cancerous. Atypical cells may be normal cells that are inflamed or infected. But, to be sure, it is important for the patient to be closely followed to make sure they don’t turn into abnormal cells.
- Atypical moles (Dysplastic Nevi) are unusual looking but benign or noncancerous, dysplastic moles. They are larger than common moles and have irregular borders. They can be tan or dark brown, and fade into the surrounding skin similar to a melanoma mole.
Atypical moles can predispose the patient to melanoma. But, most never become cancerous. Dysplastic moles are common, affecting 1 out of 10 people. The more atypical moles one has the greater the risk of melanoma. People with 10 atypical moles are 12 times more likely to develop melanoma. They are hereditary and tend to run in families. 2-8% of white people have atypical moles and often have a family history of melanoma, which creates a very high risk of developing melanoma. All people at high risk of melanoma are advised to be rigorous about daily sun protection, conduct frequent self- exams and to be examined by a dermatologist regularly.
When atypical moles are identified, or new moles appear after age 40, the patient may need a biopsy. Treatment depends on the risk. But, if the mole is moderately or seriously dysplastic it should be removed.
Skin Cancer
Skin cancer is much more common in men than women. Most are diagnosed between ages 45-50. If any relatives have had skin cancer, it increases your risk for this disease. Because most skin cancer becomes visible it is often easily detected and curable.
The Three Main Types of Skin Cancer
These three types account for 75% of all cancer diagnoses. Most skin cancer is curable if caught early.
- Basal cell carcinoma (BCC) is the most common skin cancer. They occur in fair skinned people though they can occur in darker skinned people. It develops on skin that has been exposed to the sun for years, especially the face, chest, neck and back of the hands. BCC’s look like flesh-colored, pearl like bumps or pinkish patches of skin. They are often on the nose, but any part of the body can develop a BCC. Tanning beds create an increased risk of BCC. BCC grows slowly and rarely spreads, but can grow deep and wide destroying tissue and bone, causing disfigurement. Early diagnosis and treatment is important.
- Squamous cell carcinoma (SCC) is skin cancer that develops on skin that has been exposed to the sun for years. They occur in fair skinned people though they can occur in darker skinned people. Women often get SCC on their legs. But SCC can appear anywhere including the mouth, lips and genitals. They look like firm, red bumps or scaly patches, or sores that won’t heal. SCC can spread to other parts of the body. Tanning beds create an increased risk of SCC. IF caught early and treated it is highly curable.
- Melanoma is the deadliest form of skin cancer. Often it develops in a mole, birth mark or a new dark spot that forms on normal skin. It often occurs on the chest, back, arms and legs, but also on the palms and soles of the feet. They can even form under a toenail or fingernail and in the mouth, vagina, anus or eye.
Diagnosis and Staging
Melanoma is diagnosed with a biopsy. After diagnosis the Melanoma will be staged – a process that determines the extend of the disease. It includes determining the thickness, and whether it has spread to lymph nodes or other organs. Imaging tests will often be used. The stage determines the type of treatment. If it has spread to the lymph nodes, a biopsy of the affected nodes will be conducted.
Treatments
Surgery
- The cancer may be excised or cut out, along with a margin of normal skin.
- Mohs Surgery is a special type of surgery that removes very thin layers of skin. Each layer is examined under a microscope to see if the cancer cells are still there, if so, another layer is removed, reviewed etc., until a layer shows no signs of cancer. It is tissue sparing and is considered to be the most effective approach. Mohs surgery requires special training.
Immunotherapy
This the use of immune system proteins to boost the body’s ability to fight the disease. This is used when melanoma has spread to the lymph nodes or other organs. This is advanced disease which requires surgical removal followed immunotherapy.
Targeted therapy
It uses drugs to identify and target specific cancer cells or block the action of genes, enzymes and proteins that promote the growth and spread of cancer.
Chemotherapy
Uses drugs, single or in combination, to fight cancer cells. It is often used to supplement other treatments, but is rarely used as a first line therapy, because immunotherapy and targeted therapy product better results.
Radiation
Radiation therapy uses x-rays to kill the cancer cells. It is often used to reduce the chance of recurrence when lymph nodes have been removed. Sometimes it can help treat melanoma that has come back after surgery. it is often used to treat melanoma that has spread to the brain, to shrink the tumor and to relieve symptoms and pain.
New treatments are being developed all the time. Clinical trials are an important option for advanced melanoma.
When diagnosed in the earliest stages, when the cancer is contained and has not spread, the treatment is surgery, and checking the lymph nodes. Most melanomas are diagnosed at this early stage. For metastatic melanoma that has spread, surgery, and immunotherapy or targeted therapy will reduce the risk of death. The most effective way to survive is prevention.
Your Jacksonville, Florida Advantage Dermatology provider will explain to you what to look for. Ask about the A, B, C’s of melanoma.
