Patient Center


Basal Cell Carcinoma



What is Basal Cell Carcinoma?

The most common of all cancers, Basal Cell Carcinoma affects 800,000 American each year. One of three cancers in America is a skin cancer, and 75 percent of skin cancers are Basal Cell Carcinoma. This type of cancer has a 95 percent cure rate but can cause complications or even death if it is neglected.

Who is most likely to have Basal Cell Carcinoma?

This slow-growing disease affects individuals who have regular exposure to sunlight. Until recently, this cancer was most common in older people, particularly men who worked outdoors. Now, however, more woman and younger individuals are being diagnosed with Basal Cell Carcinoma, especially those who spend leisure time in the sun. People with fair skin; blonde or red hair; or blue, green, or gray eyes have a higher than average risk. People with Basal Cell Carcinoma have about a 50 percent chance of developing another tumor within the next five years. Avoid long exposure to the sun, especially at midday, to prevent Basal Cell Carcinoma. If outdoors for a long time, consider wearing a hat, sunscreen, long sleeves, and a long skirt or pants.

How does a pathologist diagnose Basal Cell Carcinoma?

Your primary care physician or specialist will gather a biopsy specimen from an area of the skin with Basal Cell Carcinoma characteristics for the pathologist to examine under a microscope.

How do doctors determine what surgery or treatment will be necessary?

The pathologist consults with your primary care physician or specialist after reviewing the biopsy test results. Together, using their combined experience and knowledge, they determine treatment options most appropriate for your condition.

What kinds of treatments are available for Basal Cell Carcinoma?

Depending upon the size, depth, and location of Basal Skin Carcinoma, it can be treated by topical medications, curettage and electrodessication, surgery or radiation therapy. It's important to learn as much as you can about your treatment options and to make the decision that's right for you. Common topical medications for the treatment of superficial Basal Cell Carcinoma include imiquimod and 5-FU. Using curettage and electrodessication, the physician scrapes off the growth and dries up the tumor site with an electrocautery needle.

Surgical approaches include excisional surgery, during which a surgeon removes the tumor along with a margin of normal skin as a safety margin. The pathologist examines the removed tissue to assure all cancer cells are gone. Another surgical approach is micrographic surgery, during which a physician removes the visible tumor and then removes surrounding skin one layer at a time. Each layer is checked under a microscope for signs of cancer until the physician is sure all the cancer is gone. This technique has the highest cure rate and can save the greatest amount of healthy tissue.

Cryosurgery is a technique that can be performed without any cutting or anesthesia. Liquid nitrogen is applied to the tumor with a cotton-tipped applicator or spray device. The tumor then becomes dry and crusted and falls off. The procedure is repeated until the cancer is gone. Side effects may include temporary redness, swelling, or loss of pigment.

Laser surgery is often used for cancers on the lip, face, or scalp because this treatment provides surgeons with greater control over the depth of skin that is removed. Often used as a secondary therapy after the first option is unsuccessful, this option has a slightly higher risk of scarring or pigment loss.

Radiation therapy uses high-energy, pinpointed x-rays to kill cancer cells. This type of treatment is directed at a specific area. It can be used to treat small tumors, minimizing the damage to normal cells or tissue surrounding the tumor, or can be used to destroy cancer cells that remain after surgery. Radiation therapy is only rarely used for Basal Cell Carcinoma.

Photodynamic therapy is best used on cancers on the face and scalp or if individuals have multiple malignancies. A physician applies a topical treatment that is activated by a strong light. The treatment destroys cancer while sparing surrounding tissue.

What characterizes Basal Cell Carcinoma?

Basal Cell Carcinoma occurs most often on areas of the body frequently exposed to the sun - the face, ears, neck, scalp, shoulders, and back. Tumors sometimes develop on areas not often exposed to the sun, but this is rare. Other contributing factors are exposure to or contact with arsenic or radiation, or complications from burns, scars, or tattoos. Basal Cell Carcinoma sometimes resembles psoriasis or eczema; therefore, a physician should examine your skin regularly and suggest regular time intervals for examination depending upon your risk factors. Watch for changes in size, color, texture, and appearance, as well as skin pain, bleeding, itching, and inflammation. Common characteristics of Basal Cell Carcinoma include a bleeding or non-healing sore, a reddish patch, a shiny bump, a pink growth, or scarred area.

Definition of Terms

Basal cell: A cell located at the bottom of the skin’s epidermis, or outer skin layer.
Carcinoma: A type of cancerous, or malignant, tumor.
Pathologist: A physician who examines tissues and fluids to diagnose disease in order to assist in making treatment decisions.



Melanoma



What is Melanoma?

Melanoma is a type of cancer occurring in cells that color the skin called melanocytes. Located in the lower part of the epidermis, these cells produce melanin. When the skin is exposed to the sun melanocytes produce more pigment, causing the skin to darken, or tan. The most aggressive form of skin caner, Melanoma can occur anywhere on the body. If detected or treated early, it is curable in most instances. Once it advances, however, it can be difficult to treat. Melanoma cases have increased over the past 10 years more rapidly than that of any other cancer, with more than 50,000 cases reported each year. The best defense against Melanoma is to stay out of the sun, use potent topical sunblocks, and have a physician or dermatologist regularly check pigmented areas of your skin for changes.

Who is most likely to have Melanoma?

In men, Melanoma is often found on the upper trunk (between the shoulders and hips), head, or neck. In women, this cancer often develops on the arms and legs. More common in adults, Melanoma often develops in children and teens. Risk factors include unusual moles, sun exposure, ultraviolet light exposure (tanning booths), and a personal or family history of Melanoma. Caucasians – especially those with blue eyes, red or blonde hair, or freckles – have an increased likelihood of having Melanoma.

How does the pathologist diagnose Melanoma?

Your primary care physician or specialist conducts a thorough skin examination, looking for abnormalities in moles, birthmarks, or other pigmented areas. If a suspicious lesion or area is found, the physician will take a biopsy specimen for the pathologist to examine under a microscope. In some cases, a physician may use a diagnostic tool called dermoscopy to examine a lesion before taking a biopsy sample. This tool magnifies the lesion to 10 times the size. To highlight the pigmented skin’s features, a special type of oil is spread on the area before viewing.

What else does a pathologist look for?

If the pathologist finds malignant cells in the biopsy, your primary care physician may order other tests to find out whether or not the cancer has spread. These tests include a local excision or wide local excision to see if cancer has spread into the normal area surrounding the Melanoma and lymph node mapping or biopsy to find and remove cancer from the lymph nodes.

A chest x-ray or a CT (computed tomography), MRI (magnetic resonance imaging), or PET (position emission tomography) scan gives physicians views inside the body. The pathologist may also examine blood and urine samples. These tests help the pathologist assess the location, spread, and stage of the Melanoma. Stage 1 Melanomas are relatively small tumors confined to the location of the original tumor. In stage 4, cancer has spread throughout the body. Stages 2 and 3 describe conditions in between these two extremes. About 70 percent of Melanomas are detected at an early stage.

How do doctors determine what treatment will be necessary?

The pathologist consults with your primary care physician after reviewing the test results and determining the stage of the cancer. Together, using their combined experience and knowledge they determine treatment options appropriate for your condition.

What kinds of treatments are available for Melanoma?

Melanoma can be treated through one or more of the following: surgery, chemotherapy, radiation therapy, as well as new investigative treatments such as biologic therapy or chemoimmunotherapy. It’s important to learn as much as you can about the nature of your cancer and your treatment options and to make the decision that’s right for you.

The purpose of surgery is to remove the tumor. If the cancer cannot be removed through local excision or wide local excision, the surgeon may conduct a lymphadectomy (removal and examination of lymph nodes for cancer). Skin grafting (taking skin from another part of the body) may be performed to replace the skin that is removed.

Chemotherapy uses drugs to stop the growth of cancer cells. Systemic chemotherapy kills or stops cells from dividing throughout the body. Regional chemotherapy is directed at a specific part of the body, focusing the treatment there and sparing normal cells from damage. To treat Melanoma in an arm or leg, chemotherapy drugs may be given as hyperthermic isolated limb perfusion. This technique sends anti-cancer drugs directly to the arm or leg where the cancer is located. Radiation therapy uses high-energy, pinpointed x-rays to kill cancer cells.

This type of treatment is directed at specific areas. It can be sued to treat small tumors, minimizing the damage to normal cells or tissue surrounding the tumor, or can be used to destroy cancer cells that remain after surgery. Biologic therapy uses the natural defenses of the immune system to fight cancer. Chemoimmunotherapy uses anti-cancer drugs along the biologic therapy to boost the immune system.

What characterizes Melanoma?

A possible sign of Melanoma is a change in a mole or pigmented area. The change could be in size, shape, height, or color. In some cases, there may be an irregular edge or border, itching, oozing, or bleeding. Asymmetry (two sides of a mole looking or shaped differently) or new moles growing near an existing mole are other signs of possible Melanoma.

Definition of Terms

Epidermis: The outer layer of the skin.
Malignant: Cancerous and capable of spreading.
Melanin: A pigment that gives skin its natural color.
Pathologist: A physician who examines tissues and fluids to diagnose disease in order to assist in making treatment.
Lymphatic: Relating to lymph glands.



Squamous Cell Carcinoma



What is Squamous Cell Skin Carcinoma?

The second most common skin cancer, Squamous Cell Skin Carcinoma affects 200,000 Americans each year. This type of cancer begins and usually is confined to the epidermis for some time. This type of cancer has a high cure rate but can cause disfiguring, complications or even death, if it is neglected and allowed to spread.

Who is most likely to have Squamous Cell Skin Carcinoma?

This slow-growing disease affects individuals who have regular exposure to sunlight. Until recently, this cancer was most common in older people, particularly men who worked outdoors. Now, however, more women and younger individuals are being diagnosed with Squamous Cell Skin Carcinoma, especially those who spend leisure time in the sun. People with fair skin; blonde or red hair; or blue, green or gray eyes have higher than average risk. Avoid long exposure to the sun especially at midday, to prevent Squamous Cell Skin Carcinoma. If outdoors for a long time, consider wearing a hat, sunscreen, long sleeves and a long skirt or pants.

How does a pathologist diagnose Squamous Cell Skin Carcinoma?

Your primary care physician or specialist will gather a biopsy specimen from an area of the skin with Squamous Cell Skin Carcinoma characteristics for the pathologist to examine under a microscope.

How do doctors determine what surgery or treatment will be necessary?

The pathologist consults with your primary care of specialist physician after reviewing the biopsy test results. Together, using their combined experience and knowledge, they determine treatment options most appropriate for your condition.

What kinds of treatments are available for Squamous Cell Skin Carcinoma?

Depending upon the size, depth and location of Squamous Skin Carcinoma, it can be treated by topical medications, curettage and electrodessication, surgery and radiation therapy. It’s important to learn as much as you can about your treatment options and to make the decision that’s right for you.

Common topical medications for the treatment of precancerous conditions or superficial Squamous Cell Skin Carcinoma include imiquimod. Using curettage and electrodessication, the physician scrapes off the growth and desiccates the tumor site with an electrocautery needle.

Surgical approaches include excisional surgery, during which a surgeon removes the tumor along with a margin of normal skin as a safety margin. The pathologist examines the removed tissue to assure all cancer cells have been removed.

Another surgical approach is micrography surgery, during which a physician removes the visible tumor and then removes surrounding skin one layer at a time. Each layer is checked under a microscope for signs of cancer until the physician is sure all the cancer is gone. This technique has a highest cure rate and can save the greatest amount of healthy tissue.

Cryosurgery is a technique that can be performed without any cutting or anesthesia. Liquid nitrogen is applied to the tumor with a cotton-tipped applicator or spray device. The tumor then becomes dry and crusted and falls off. The procedure is repeated until the cancer is gone. Side effects may include temporary redness, swelling or loss of pigment.

Laser surgery is often used for cancers on the lips, face or scalp because this treatment provides surgeons with greater control over the depth of skin that is removed. Often used as a secondary therapy after the first option is unsuccessful, this option has a slightly higher risk of scarring or pigment loss.

Radiation therapy uses high-energy, pinpointed x-rays to kill cancer cells. This type of treatment is directed at a specific area. It can be used to treat small tumors minimizing the damage to normal cells or tissue surrounding the tumor, or can be used to destroy cancer cells that remain after surgery.

Photodynamic therapy is best used on cancers on the face and scalp or if individuals have multiple malignancies. A physician applies a topical treatment that is activated by a strong light. The treatment destroys cancer while sparing surrounding tissue.

What characterizes Squamous Cell Skin Carcinoma?

Squamous Cell Skin Carcinoma occurs most frequently on areas of the body frequently exposed to the sun – the face, ears, neck, scalp, shoulders and back. The rim of the ear and lower lip are especially vulnerable to these cancers. Tumors sometimes develop on areas where the skin has suffered injury; sun damage, burns, scars, sores or sites exposed to x-rays or chemicals. Chronic skin inflammation also may encourage the development of Squamous Cell Skin Carcinoma. Depending upon your risk factors, your physician may recommend that your skin be examined regularly to detect skin cancer. Watch for changes in size, color, texture, and appearance, as well as skin pain, bleeding, itching, crusting or inflammation. Common characteristic of Squamous Cell Skin Carcinoma include a bleeding or non-healing sore, a reddish patch, or an elevated or wart-like growth. Also, pre-cancerous conditions such as actinic keratosis, leukoplakia and Bowen’s disease can develop into Squamous Cells Skin Carcinoma.

Definition of Terms

Squamous cell: A thin, flat cell of the surfaces of the skin and linings of various organs.
Epidermis: The top layer of skin.
Carcinoma: A type of cancerous, or malignant, tumor originating on the surface of the body or in a solid organ.

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