Skin Cancer <ul><li>Understanding the disease </li></ul><ul><li>Treatment options </li></ul><ul><li>Results </li></ul>
Standard photograph for grading severe solar damage on the shoulders. Standard photographs for grading freckling of the back: (B) mild (C) moderate (D) extensive People with a lot of sun damage are more prone to skin cancers Journal of Clinical Oncology , Vol 24, No 22 (August 1), 2006: pp. 3590-3596
Basal Cell Carcinoma Basal cell carcinoma (BCC): About 80% of all skin cancers are BCC, a cancer that develops in the basal cells - skin cells located in the lowest layer of the epidermis. BCC can take several forms. It can appear as a shiny translucent or pearly nodule, a sore that continuously heals and then re-opens, a pink slightly elevated growth, reddish irritated patches of skin, or a waxy scar. Most BCCs appear on skin with a history of exposure to the sun, such as the face, ears, scalp, and upper trunk. These tumors tend to grow slowly and can take years to reach ½ inch in size. While these tumors very rarely metastasize
Squamous Cell Carcinoma Squamous cell carcinoma (SCC): About 16% of diagnosed skin cancers are SCC. This cancer begins in the squamous cells, which are found in the upper layer of the epidermis. SCC tends to develop in fair-skinned middle-aged and elderly people who have had long-term sun exposure. It most often appears as a crusted or scaly area of skin with a red inflamed base that resembles a growing tumor, non-healing ulcer, or crusted-over patch of skin. While most commonly found on sun-exposed areas of the body, it can develop anywhere, including the inside of the mouth and the genitalia. SCC requires early treatment to prevent metastasis (spreading).
Typical appearance of a well differentiated squamous cancer on the shin called keratoacanthoma
Malignant Melanoma Melanoma: Accounting for about 4% of all diagnosed skin cancers, melanoma begins in the melanocytes, cells within the epidermis that give skin its color. With early detection and proper treatment, the cure rate for melanoma is about 95%. Once its spreads, the prognosis is poor. Melanoma most often develops in a pre-existing mole or looks like a new mole, which is why it is important for people to know what their moles look like and be able to detect changes to existing moles and spot new moles.
Distribution of superficial spreading melanoma of the skin in men and women.
Superficial spreading melanomas in all stages of development. The small early lesions have irregular borders, irregular pigmentation, and small white areas indicating regression. The largest tumors show an accentuation of all of these features.
Radiation for areas difficult to operate, squamous cancer of the finger before and 19 days after electron beam
Squamous Cancer of the Ear Helix The radiation healed the cancer and prevented further destruction of the ear
Side Effects of Skin Radiation The treated skin will get red, itchy and sunburned. There are a number of good creams than can be used including Aloe, Aquaphor, Sween, Biafine. The skin reaction may show up in a delayed manner (worse at 1-2 weeks) and may develop slight, superficial ulceration or crusting, but heals quickly (1-2 weeks) except the shin which heals more slowly
Side Effects of Skin Radiation most people get mild sun burn effect , but some get blistering or crusting (scab formation) but they heal quickly Prior to radiation 1 week after radiation
Side Effects of Skin Radiation Prior to radiation last day of radiation
Typical delayed reaction where the lesion forms a scab at 1 – 2 weeks after completion, the scab usually falls off in another week or two
Radiation side effects may show up in delayed manner after HDR Basal cell Last day Three weeks later Three months later