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Skin Cancer: The Story Of Yasir Ibn Mohammed From Kuwait

Updated on July 24, 2013

Squamous Cell Carcinoma

Birthmarks

Birth marks or moles are major predisposing factors or even causes to skin cancers
Birth marks or moles are major predisposing factors or even causes to skin cancers

Mr. Yasir Ibn Mohammed's story

Mr. Yasir Ibn Mohammed is from Kuwait and has been working in a petrochemical company for the past 6 years. The fair-skinned Yasir has some birthmarks at the topmost part of his back. They are about 3 of which two are larger than 22 mm in size. One day he came back from work and was about to freshen up when his wife discovered something interesting when he took off his shirt. The birthmarks all seemed to have increased in size, but his wife's observation led to an argument and it was carelessly ignored.

After about eight days all the birthmarks doubled in size forming large brownish spots with dark speckles and small lesions with irregular borders having portions which appear red. This time around, his wife persisted and they went to the hospital. After some medical procedures such as scraping some parts of the spots and taken for histological analysis, radioisotopic scanning and other procedures, the Doctors came up with this diagnosis:

Skin Cancer: Malignant Melanoma, Stage IIB. Is Yasir safe? What is this?

The Skin

Beautiful Skin
Beautiful Skin

THE SKIN

The largest Organ of the Body is the Skin. It is of great physiological importance as it rids the body of waste products via the sweat glands, helps control fluid loss, helps regulate body temperature and most importantly, it is the first line of protection to the body against injury and infection.
The skin is divided into two major layers. The outer layer known as the epidermis and the inner layer known as the dermis. The outer layer has different layers of cells and they are as follows:

  • The Squamous cells (The Keratocytes) which lie just below the outer surface of the skin.
  • Basal cells which produce new cells as old ones are shed. These cells lie underneath the Squamous cells, and finally,
  • Melanocytes: These are Melanin secreting cells. Melanin is responsible for the skin normal coloration.

The dermis, being the inner layer houses inner tissues such as fats, connective tissues and blood vessels.

Squamous Cell Carcinoma

Malignant Melanoma on Chest

SKIN CANCER

Cancer or a cancerous growth is the pathological or abnormal mitotic proliferation of cells (multiplication of cells through fast growth). If this is the case in the Skin, then this abnormal mitotic growth could occur in Squamous cells (Squamous Cell Carcinoma- SCC), Basal Cells (Basal cell Carcinoma- BCC) or in the Melanocytes (Melanoma). These three types of Skin Cancer are the major and most common skin cancers.
As for the cells of the Dermis, cancerous growth can occur in fatty cells (Liposarcoma), Muscle tissue (Miosarcoma), Blood and lymphatic vessels (Angiosarcoma, angioendotelioma, Kaposi's sarcoma, lymphangiosarcoma etc.) and even on undifferentiated cells (undifferentiated sarcoma, mixosarcoma).Our major focus will be on the cancer of the epidermic cells, since they have a more than 85% occurrence of skin cancers globally.

Causes

The following can cause skin cancers:

  • Ultra-violet radiation from Sunlight especially (As in the case of Yasir, since Kuwait is a temperate and very hot region). Other sources could be commercial tanning lamps and tanning beds.
  • The human Papillomavirus (HPV)
  • Birthmarks, especially when its as large as 20 mm, also in Yasir's situation.
  • Immunosuppressive syndrome or drugs suppressing the human body immunity such as cyclosporin, Azathiopine etc.

Predisposing Factors

There are some factors which can aid or compliment the occurrence of Skin cancer. This in other words means people with such factors have a high risk of getting skin cancers. Such factors are as follows:

  1. Fair skin (Yasir's case)
  2. History of sunburns
  3. Excessive sun exposure, especially those living in the tropics.
  4. Presence of Moles, or birthmarks on the skin (also in Yasir's case)
  5. Precancerous skin lesions
  6. Cases of skin cancer in Family (Positive family history)
  7. Weakened immunity
  8. Biological factors such as high level of daily protein and adipose consumption and medical products such as exogenous oestrogens.
  9. Certain rare hereditary conditions such as Gorlin syndrome or Xeroderma pigmentosum (XP).
  10. Exposure to toxic substances such as Arsenic, Coaltar, soot, pitch, Asphalt, Creosotes, Paraffin, waxes, petroleum derivatives, cutting oils, petrochemicals, chemicals such as Nitric acids, rubber-producing plants (production of polyvinyl chloride, plastic benzol, pesticides).

Red ulcerated Lesion On the skin

WHAT ARE THE SIGNS AND SYMPTOMS?

1. In Basal Cell Carcinoma, what is observed is a pearly waxy bump or/and a flat flesh-coloured or brown scar-like lesion. These lesions grow slowly and almost never spread to other parts of the body. If detected early, it can be treated and cured. Other signs are: lesions sometimes bleed, crusts are usually formed, there is this characteristic deceiving healing signs but healing never occurs, itching and development of painless ulcers are additional symptoms. This is the most common of all cancers and occurs in 75% of skin cancer cases.


2. In Squamous cell carcinoma, most common anatomical locations affected are: face, ears, hands, and individuals with darker skins are more likely to develop SCC on their legs and feet. A red firm Nodule is usually the clinical presentation and in almost all cases with a flat lesion with a scaly crusted surface. Like the B.C.C, it also has a slow growth rate and only spreads to other body parts if left untreated for a very long time. Skin area which is affected is raised in comparison to the neighbouring areas and lesions can be very tender to touch.


3. Malignant Melanoma is the most severe and dangerous of the three. Growth and spread are very fast and that is why it is clinically identified as malignant. Presentation of this type can be on any part of the body, but mostly on the head, trunk and Neck for men and lower legs for women. Other clinical presentations are: a large brownish spot with darker speckles; small lesions with irregular borders with portions that appear red, white, blue or blue-black and dark lesions on Palms, soles, finger tips and toes, or on mucous membrane lining the mouth, Nose, vagina or Anus.The characteristic feature of Malignant Melanoma is its production of sharply circumscribed and chronic lesions of the skin called Nevus, popularly known as Moles or birthmarks. These Nevi presentation come with some certain clinical features which are as follows:

  1. disappearance of skin pattern from the nervus surface
  2. appearance of shiny, glossy nervus surface
  3. appearance of a symmetry or contours of the nevus, i.e. changes of its shape
  4. Horizontal nevus growth (Can also be vertical).
  5. Feeling of subjective sensation of heat, itching or pain in the nevus area.
  6. appearance of single nodules (satellites) around the nevus.
  7. Peeling of the nevus surface with formation of withered "Scabs".
  8. Absence or shedding of hair on the nervus surface.
  9. Partial (irregular) or complete colour change of the nevus-melanoma-appearance of areas of the so-called bound depigmentation.
  10. Vertical growth of the nevus melanoma.
  11. Change in the nevus-melanoma consistency- becomes soft (observed through palpation).
  12. Ulceration of the epidermis just above the nevus-melanoma.
  13. Inflammation of the area of nevus-melanoma and surrounding tissues.
  14. Bleeding.

Dermatoscopy

DIAGNOSIS AND TREATMENT

Diagnostics

Diagnostic procedures slightly differ due to the type of cancer. As for the Basal cell carcinoma and Squamous cell carcinoma procedures like normal palpation, the use of Dermatoscopy, cytological analysis of the scrap or smear, incisional biopsy, Ultrasound diagnosis and thoracic cavity radiography (to check for metastasis in lymph nodes and distant metastases). As for Melanoma, additional procedures such as Echography, tumor thermography and Radioisotope scanning with the help of radio-active 32 P (300%) are needed.

Differential Diagnosis

The carcinomas should be differentiated from Red Lupus, Tuberculosis, Syphilitic gumma, Actinomycosis, Melanoma and Non-malignant skin growths. On the other hand, Malignant melanoma of the skin should be adequately differentiated with Youth melanoma (spits Nevus), Blue Nevus, Galo-nevus, Displatic nevus, Cavernous thrombotic gemangioma, Non-malignant skin tumors, Malignant skin tumors, underungual and under-epidermal hematoma, Onichomycosis, Extragenital chancre and Metastasis of tumors of other histogenesis into the skin.
TreatmentBefore we begin discussing the treatment, we need to know the different stages of skin cancer because this is of great relevance to how Skin cancers should be treated. And as the trend is, the staging differ with the type of cancer. The Carcinomas have the following.Primary Tumor

  • T0- Not identified
  • Tis- Carcinoma in situ
  • T1- The tumour is 2cm in the greatest dimension
  • T2- The Tumour is >2cm but <5cm in the greatest dimension.
  • T3- the tumour is >5cm in the greatest dimension
  • T4- the tumour grows into the lower Organs (Cartilages, muscles and bones).

Regional lymph node involvement

  • N0- no evidence of regional lymph nodes affection
  • N1- the regional lymph nodes are affected

Metastatic InvolvementM0- distant metastasis has not occurred.M1- there is distant metastasis.

Staging of the Carcinoma Types of Skin Cancer

Stage
Tumor
Lymph Involvment
Metastasis
Stage 0
Tis
N0
M0
Stage I
T1
N0
M0
Stage II
T2
N0
M0
 
T3
N0
M0
Stage III
T4
N0
M0
 
Any T
N1
M0
Stage IV
Any T
Any N
M1

Radiotherapy

DIAGNOSIS AND TREATMENT: Continuation

For Basal Cell Carcinoma;

  • Electroexcision (recovery takes place in 95% cases)
  • closely-focused radiotherapy (recovery takes place in 90% cases).
  • Excision (recovery takes place in 95% cases).
  • Cryotherapy
  • Relapse is treated by wide excision.

For Squamous Cell Carcinoma;

  • Surgery is indicated for Stages I and II. Wide ablation of the tumour with the healthy skin area around it (not less than 2cm) together with the hypodermic cellular tissue and fascia.
  • Radiotherapy is indicated also for Stages I and II. Closely focused radiotherapy, total dose is 30-60 Gr.
  • Combined Medical therapy for Stages III and IV (chemotherapy).

Prognosis

Early diagnosis of the disease has an excellent prognosis of 80-100% complete recovery with no relapse. In case of absence of regional lymph node metastases, a 5 year survival is guaranteed in 75-85% cases, but if present with metastases of adjacent tissues and organs, the 5 year survival is only about 24% probable.
Melanoma

Primary Tumour

  • Tis- Melanoma in situ
  • T1- the tumour is less than 1 mm thick and (a) without ulceration; (b) with ulceration.
  • T2- the tumour is 1.01-2.0 mm thick and (a) without ulceration; (b) with ulceration.
  • T3- the tumour is 2.01-4.0 mm thick and (a) without ulceration; (b) with ulceration.
  • T4- the tumour is more than 4 mm thick and (a) without ulceration; (b) with ulceration.

Regional lymph node involvement

  • N1- Metastases in 1 gland; (a) micrometastases 1; (b) macrometastases 2.
  • N2- Metastases in 2-3 lymph nodes: (a) micrometastases 1; (b) macrometastases 2; (c) transitional metastases/satellites without metastatic lymph nodes.
  • N3-4 and more metastatic lymph nodes are a conglomeration of lymph nodes or transitional metastases/satellites with metastatic lymph nodes.

Note: Micrometastases 1 are diagnosed after observation or selective lymphodenectomia. Macrometastases 2 are clinically found in lymph nodes, confirmed by therapeutical lymphodenectomia or extracapsular spread of metastases in the lymph nodes.
Metastatic involvement

  • M1a- there are distant metastases on the skin, hypoderma or in the lymph nodes.
  • M1b- metastases in the lungs
  • M1c- other visceral or any distant metastases.

Skin Melanoma staging

Stages
Tumor
Lymph Involvment
Metastasis
Stage 0
Tis
N0
M0
Stage IA
T1a
N0
M0
Stage IB
T1b
N0
M0
 
T2a
N0
M0
Stage IIA
T2b
N0
M0
 
T3a
N0
M0
Stage IIB
T3b
N0
M0
 
T4a
N0
M0
Stage IIC
T4b
N0
M0
Stage III
Any T
N1
M0
 
 
N1-N3
M0
Stage IV
Any T
Any N
M0-M1
From the Doctor's Diagnosis, we can say Mr. Yasir Ibn Mohammed has Melanoma which is more than 4mm thick but without ulceration; no lymph node involvment and metastasis is yet to occur

Squamous Cell Carcinoma

TREATMENT: Continuation

stage Of treatment of Melanoma

The standard treatment in case of IA and IB stages is wide excision of the rumour at the distance of 2cm from the tumour borders.
In stage II treatment, the standard excision carried out should be at the distance of 3 cm from the tumour borders. Besides tumour excision, it is possible to perform immunotherapy using interferon alpha-2b 3ml ME/m2 of hypodermic injection 3 times per week during 3 years or until a relapse and melanoma metastases.
In stage III treatment, the medical standard is wide excision of the primary tumour within 3 cm and more combined with regional lymphodenectomy. Chemotherapy, immunotherapy (interferon Alpha-2b, BCG), polychemotherapy should be performed in usual or modified (hyperthermia, hyperglycemia, etc) are also ideal. Another method of treatment is polychemotherapy (decarbazine combined with platinum medications-Cisplatin, periwinkle alkaloids- Vinblastine, and medications of Urea nitromesil group-lomustin.
The standard for stage IV treatment is simply systemic chemotherapy. Surgical procedure can be performed in the presence of single metastases in the lungs, gastrointestinal tract, bones or brain. Palliative radiotherapy can relieve the patient's state. Sometimes, in addition to these procedures, anti-oestrogens (tamoksifen) are used.
Prognosis

In case of localized process, a 5-year survival is possible in 75-86% cases, 10 years-47%. In case of regional metastases- 33-52% and 13% accordingly. In case of distant metastases, a 5-year survival does not exceed 5-12%.
Skin cancers are gradually increasing in occurrence and therefore, should be taken into great consideration.

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      Dr. Dave Gray 17 months ago

      We are urgently in need of kidney donors

      in Appolo Hospitals India for the sum of $290,000.00 USD,

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      Robert Morgan 2 years ago from Hutchinson Island, FL - Myrtle Beach, SC - Scottsdale AZ

      This is an excellent article. I hope you are doing well in your medical en-devours. I am a Naturopath and I work with many people who have been turned away by medical doctors. I wish you well. Blessings

    • Funom Makama 3 profile image
      Author

      Funom Theophilus Makama 4 years ago from Europe

      Pls DDE, do regular examination on it and consult a professional.

    • DDE profile image

      Devika Primić 4 years ago from Dubrovnik, Croatia

      I have a mole and got to have it checked it has been for a while and has grown since 2002, and fails to go away no matter what I do. thanks for this information

    • profile image

      Facts about skin cancer treatment 4 years ago

      In adults 65 or older, melanoma treatment costs total about $249 million annually. About 40 percent of the annual cost for melanoma goes to treating stage IV (advanced) cancers, though they account for only three percent of melanomas.43

      The number of nonmelanoma skin cancers in the Medicare population went up an average of 4.2 percent every year between 1992 and 2006.1

      In 2004, the total direct cost associated with the treatment for nonmelanoma skin cancer was $1.4 billion.

    • profile image

      Aging/Sun Damage facts 4 years ago

      More than 90 percent of the visible changes commonly attributed to skin aging are caused by the sun.42

      Contrary to popular belief, 80 percent of a person’s lifetime sun exposure is not acquired before age 18; only about 23 percent of lifetime exposure occurs by age 18.

    • profile image

      Ethnicity Facts 4 years ago

      The overall 5-year melanoma survival rate for African Americans is only 77 percent, versus 91 percent for Caucasians.14

      Skin cancer represents approximately two to four percent of all cancers in Asians.36

      Skin cancer comprises one to two percent of all cancers in African Americans and Asian Indians. 36

      Melanomas in African Americans, Asians, Filipinos, Indonesians, and native Hawaiians most often occur on non-exposed skin with less pigment, with up to 60-75 percent of tumors arising on the palms, soles, mucous membranes and nail regions.36

      Basal cell carcinoma (BCC) is the most common cancer in Caucasians, Hispanics, Chinese Asian and the Japanese.36

      Squamous cell carcinoma (SCC) is the most common skin cancer among African Americans and Asian Indians.36

      Squamous cell carcinomas in African Americans tend to be more aggressive and are associated with a 20-40 percent risk of metastasis (spreading).36

      Late-stage melanoma diagnoses are more prevalent among minority patients than Caucasian patients; 52 percent of non-Hispanic black patients and 26 percent of Hispanic patients receive an initial diagnosis of advanced stage melanoma, versus 16 percent of non-Hispanic white patients.37

      Asian American and African American melanoma patients have a greater tendency than Caucasians to present with advanced disease at time of diagnosis.38

      While melanoma is uncommon in African Americans, Latinos, and Asians, it is frequently fatal for these populations.

    • profile image

      Indoor Tanning Facts 4 years ago

      Ultraviolet radiation (UVR) is a proven human carcinogen.24

      The International Agency for Research on Cancer, an affiliate of the World Health Organization, includes ultraviolet (UV) tanning devices in its Group 1, a list of the most dangerous cancer-causing substances. Group 1 also includes agents such as plutonium, cigarettes, and solar UV radiation.25

      Currently tanning beds are regulated by the FDA as Class I medical devices18, the same designation given elastic bandages and tongue depressors.26

      Frequent tanners using new high-pressure sunlamps may receive as much as 12 times the annual UVA dose compared to the dose they receive from sun exposure.24

      Just one indoor tanning session increases users’ chances of developing melanoma by 20 percent, and each additional session during the same year boosts the risk almost another two percent.46

      People who tan indoors just four times per year increase their risk of basal cell carcinoma and squamous cell carcinoma by 15 percent.27

      Just one indoor tanning session per year in high school or college boosts the risk of basal cell carcinoma by 10 percent. That risk is increased to 73 percent if one tans six times per year.27

      Indoor tanners have a 69 percent increased risk of early-onset basal cell carcinoma.28

      Approximately 25 percent of early-onset basal cell carcinomas could be avoided if an individual never tanned indoors.28

      Indoor ultraviolet (UV) tanners are 74 percent more likely to develop melanoma than those who have never tanned indoors.29 Those who begin tanning before the age of 35 increase their melanoma risk by 87 percent.46

      Ten minutes in a sunbed matches the cancer-causing effects of 10 minutes in the Mediterranean summer sun.30

      Nearly 30 million people tan indoors in the U.S. every year.31 Two to three million of them are teens.32

      The indoor tanning industry has annual estimated revenue of $5 billion.32

      People who use tanning beds are 2.5 times more likely to develop squamous cell carcinoma and 1.5 times more likely to develop basal cell carcinoma.33

      Seventy-one percent of tanning salon patrons are females.34

      On an average day, more than one million Americans use tanning salons.

    • profile image

      Skin Cancer In relation to men and women 4 years ago

      An estimated 44,250 new cases of invasive melanoma in men and 32,000 in women will be diagnosed in the US in 2012.2

      An estimated 6,060 men and 3,120 women in the US will die from melanoma in 2012.2

      Melanoma is the fifth most common cancer for males and sixth most common for females.2

      Five percent of all cancers in men are melanomas; four percent of all cancers in women are melanomas.2

      One in 36 men and one in 55 women will develop melanoma in their lifetimes.2

      Up until age 40, significantly more women develop melanoma than men (1 in 377 women vs. 1 in 677 men). After age 40, significantly more men develop melanoma than women (1 in 36 vs. 1 in 55).2

      Women aged 39 and under have a higher probability of developing melanoma than any other cancer except breast cancer.2

      The majority of people diagnosed with melanoma are white men over age 50.11

      Caucasian men over age 65 have had an 5.1 percent annual increase in melanoma incidence since 1975, the highest annual increase of any gender or age group.21

      The number of women under age 40 diagnosed with basal cell carcinoma has more than doubled in the last 30 years; the incidence of squamous cell carcinoma among women under age 40 has increased almost 700 percent.22

      Adults over age 40, especially men, have the highest annual exposure to UV.

    • profile image

      General skin cancer facts 4 years ago

      Skin cancer is the most common form of cancer in the United States. More than 3.5 million skin cancers in over two million people are diagnosed annually.1

      Each year there are more new cases of skin cancer than the combined incidence of cancers of the breast, prostate, lung and colon.2

      Treatment of nonmelanoma skin cancers increased by nearly 77 percent between 1992 and 2006.1

      Over the past three decades, more people have had skin cancer than all other cancers combined.3

      One in five Americans will develop skin cancer in the course of a lifetime.5

      13 million white non-Hispanics living in the US at the beginning of 2007 had at least one nonmelanoma skin cancer, typically diagnosed as basal cell carcinoma (BCC) or squamous cell carcinoma (SCC).3

      Basal cell carcinoma is the most common form of skin cancer; an estimated 2.8 million are diagnosed annually in the US. BCCs are rarely fatal, but can be highly disfiguring if allowed to grow.6

      Squamous cell carcinoma is the second most common form of skin cancer. An estimated 700,000 cases of SCC are diagnosed each year in the US.6,7

      An estimated 3,010 deaths from nonmelanoma skin cancers will occur in the US in 2012.2

      Between 40 and 50 percent of Americans who live to age 65 will have either BCC or SCC at least once.4

      Actinic keratosis is the most common precancer; it affects more than 58 million Americans.8

      Approximately 65 percent of all squamous cell carcinomas and 36 percent of all basal cell carcinomas arise in lesions that previously were diagnosed as actinic keratoses.9

      About 90 percent of nonmelanoma skin cancers are associated with exposure to ultraviolet (UV) radiation from the sun

    • profile image

      Sunscreen 4 years ago

      Since its inception in 1979, The Skin Cancer Foundation has always recommended using a sunscreen with an SPF of 15 or higher as one important part of a complete sun protection regimen which includes seeking shade, covering up with clothing including a wide-brimmed hat and UV-blocking sunglasses and avoiding tanning and UV tanning booths. Recent attacks on sunscreens in the media point to imperfections and potential risks, but miss the point that sunscreen continues to be one of the safest and most effective sun protection methods available.

      We are concerned that the criticisms will raise unnecessary fears and cause people to stop using sunscreen, doing their skin serious harm.

      In general, the criticisms have not been based on hard science. In fact, The Chair of the Skin Cancer Foundation’s Photobiology Committee, an independent panel of top experts on sun damage and sun protection, reviewed the same studies cited in the media, and found that their determination of what made a sunscreen bad or good was based on “junk science.”

      Below, the Photobiology Committee responds to the criticisms and explains why sunscreen remains an essential part of anyone’s daily sun safety program.

    • profile image

      Anderson Cooper, temporarily blinded 4 years ago

      Anderson Cooper is used to reporting the news, but in early December the CNN anchor was the subject of a story himself after a boat trip in Portugal left him temporarily blind. While out on the water reporting for CBS’s 60 Minutes, Cooper was not wearing sunglasses. The sunlight both from above and reflected off the water burnt his eyes.

      Cooper explained, “I wake up in the middle of the night and it feels like my eyes are on fire…I think, oh maybe I have sand in my eyes or something…It turns out I have sunburned my eyeballs...I went blind for 36 hours.”

      The condition experienced by Cooper is known as keratitis, which occurs when the outermost layer of the eye becomes inflamed. The outer layer on the front of the eyeball, known as the cornea, is similar to the outer layer of our skin. When it gets burned by the sun’s rays, it can lead to intense pain and temporary blindness. There is a higher risk of burning for individuals like Anderson Cooper, who have lighter-colored eyes.

      “We have sunscreen we can put on our skin, but we don’t have eye drops that offer a protective film for the cornea, so it is really important that everyone, and especially people with fair or light eyes, wear sunglasses that protect against both UVA and UVB rays,” said Deborah S. Sarnoff, MD, Senior Vice President of The Skin Cancer Foundation.

      To lower your risk for future eye conditions such as cataracts, macular degeneration, or skin cancer around the eyes, be sure to wear sun protection every day. “To keep your eyes safe, wear sunglasses and a hat with a three-inch brim. If you do get a burn, see your ophthalmologist right away,” advises Dr. Sarnoff.

    • profile image

      Vitamin D sources 4 years ago

      Cod liver oil 1 tbsp. 1,360

      Vitamin D-fortified

      soy milk 8 oz. Up to 120

      Vitamin D-fortified orange juice 8 oz. 98

      Vitamin D-fortified milk 8 oz. 98

      Vitamin D-fortified yogurt 6 oz. Up to 80

      Vitamin D-fortified margarine 1 tbsp. 60

      Vitamin D-fortified

      cereal 6-8 oz. 40

      Egg yolk 1 yolk 0

      Beef liver, cooked 3.5 oz. 15

    • profile image

      vitamin D sources 4 years ago

      While oily fish are the best food source of Vitamin D (See "Oily Fish: Your Route to Vitamin D"), several other foods supply significant amounts, including the choices below.

      Look for products labeled "for bone health" or "with calcium"; these usually contain vitamin D to aid in calcium absorption.

      So maximize your health by getting enough vitamin D the safe way your body will thank you!

    • profile image

      How much Vitamin D do we need? 4 years ago

      The Skin Cancer Foundation supports The Institute of Medicine of the National Academies’ Recommended Dietary Allowance (RDA) for vitamin D, which is 600 IU (International Units) a day for people between the ages of 1 and 70, and 800 IU a day for people ages 70 and older. For children under 1 year, adequate intake (AI) is 400 IU a day.

    • profile image

      UV exposure is not the answer 4 years ago

      Our bodies manufacture vitamin D when the sun's ultraviolet B (UVB) rays interact with 7-dehydrocholesterol (7-DHC) present in the skin. "However, we can produce only a limited amount of vitamin D from UVB. A few minutes at midday are sufficient for many Caucasians," says Roy Geronemus, MD, clinical professor of dermatology at New York University Medical Center and director of the Skin/Laser Division at the New York Eye & Ear Infirmary. "After reaching the production limit, further exposure actually destroys the vitamin, decreasing vitamin D levels."

      Furthermore, UV exposure is unlikely to produce enough vitamin D in darker skin, so African-Americans and dark-skinned Hispanics relying on UV alone are especially at risk for deficiency. The National Institutes of Health's Office of Dietary Supplements also warns that the elderly have a reduced ability to synthesize vitamin D from sunlight; and between November and February, UV radiation (UVR) is insufficient to produce vitamin D in people living above 42 north latitude, which includes Boston, northern California, and other areas north.

      Finally, prolonged exposure to UVR is linked to skin cancer, immune system suppression, photoaging (sun-induced skin aging), cataracts, and other eye damage. Therefore, The Skin Cancer Foundation recommends obtaining vitamin D largely from food or supplements while continuing to follow the Foundation's skin cancer Prevention Guidelines.

    • profile image

      Make Vitamin D not UV a priority 4 years ago

      Sometimes the cure can be worse than the condition. For thousands of vitamin D-deficient people in the U.S., can obtaining this so-called "sunshine vitamin" actually endanger health?

      Vitamin D has been a mainstay in the news recently, with stories claiming it protects against everything from high blood pressure to cancer. Though its ability to prevent these conditions remains unproven, vitamin D is essential for bone health, immune system functioning, and more.

      An organic compound, Vitamin D is fat-soluble (meaning some dietary fat is necessary for its absorption). A lack of the vitamin puts us at risk for painful, weak muscles, inadequate bone mineralization, and skeletal deformities in children (rickets), as well as mineral loss and soft bones in adults (osteomalacia).

    • profile image

      Prevention Guidelines 4 years ago

      Since its inception in 1979, The Skin Cancer Foundation has always recommended using a sunscreen with an SPF 15 or higher as one important part of a complete sun protection regimen. Sunscreen alone is not enough, however. Read our full list of skin cancer prevention tips.

      Seek the shade, especially between 10 AM and 4 PM.

      Do not burn.

      Avoid tanning and UV tanning booths.

      Cover up with clothing, including a broad-brimmed hat and UV-blocking sunglasses.

      Use a broad spectrum (UVA/UVB) sunscreen with an SPF of 15 or higher every day. For extended outdoor activity, use a water-resistant, broad spectrum (UVA/UVB) sunscreen with an SPF of 30 or higher.

      Apply 1 ounce (2 tablespoons) of sunscreen to your entire body 30 minutes before going outside.

      Reapply every two hours or immediately after swimming or excessive sweating.

      Keep newborns out of the sun. Sunscreens should be used on babies over the age of six months.

      Examine your skin head-to-toe every month.

      See your physician every year for a professional skin exam.

    • profile image

      Facts about Tanning 4 years ago

      No one should go to tanning salons, let alone a child. A recent study showed that children of women who tan indoors are more likely to be indoor tanners themselves. The study found that young women whose first indoor ultraviolet (UV) tanning experience is with their mothers are more than 4.6 times more likely to become heavy tanners.

      Here are the facts on indoor tanning:

      Indoor ultraviolet (UV) tanners are 74 percent more likely to develop melanoma than those who have never tanned indoors.1

      People who use tanning beds are 2.5 times more likely to develop squamous cell carcinoma and 1.5 times more likely to develop basal cell carcinoma.2

      Ten minutes in a sunbed matches the cancer-causing effects of 10 minutes in the Mediterranean summer sun.3

      Nearly 30 million people tan indoors in the U.S. every year4; 2.3 million of them are teens.

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      Epidemiology 4 years ago

      A study of the incidence of non-melanoma skin cancer from 1992 to 2006 in the United States was performed by the dermatologist Howard Rogers, MD, PhD, and his colleagues based on the evaluation of Medicare databases. The results of their research showed that cases of non-melanoma skin cancer rose an average of 4.2% a year.

      More than 3.5 million cases of skin cancer are diagnosed annually in the United States, which makes it the most common form of cancer in that country. According to the Skin Cancer Foundation, one in five Americans will develop skin cancer at some point of their lives. The first most common form of skin cancer is basal cell carcinoma, followed by the squamous cell carcinoma. Although the incidence of many cancers in the United States is falling, the incidence of melanoma keeps growing, with approximately 68,729 melanomas diagnosed in 2004 according to reports of the National Cancer Institute.

      The survival rate for patients with melanoma depends upon when they start treatment. The cure rate is very high when melanoma is detected in early stages, when it can easily be removed surgically. The prognosis is less favorable if the melanoma has spread to other parts of the body.

      In the UK, 84,500 non-melanoma skin cancers were registered in 2007 although a study estimated that at least 100,000 cases are diagnosed each year. Most NMSCs were basal cell carcinomas or squamous cell carcinomas. In 2007, 10,672 cases of malignant melanoma were diagnosed.

      Australia and New Zealand exhibits one of the highest rates of skin cancer incidence in the world, almost four times the rates registered in the United States, the UK and Canada. Around 434,000 people receive treatment for non-melanoma skin cancers and 10,300 are treated for melanoma. Melanoma is the common type of cancer in people between 15–44 years in both countries. This is largely due to the ozone hole located over the Tasman Sea, making prolonged unprotected outdoor sun exposure very dangerous. The risk of skin cancer in Australia is predicted to increase. The reason given for the increase is that ozone levels are not expected to recover to pre-depletion levels until the middle of this century, UV levels are expected to continue to rise. Combined with Australians favoring an outdoor life-style, when temperatures are warmer, under high levels of UV, the associated risk of skin cancer will increase.

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      Prognosis 4 years ago

      The mortality rate of basal cell and squamous cell carcinoma are around 0.3% causing 2000 deaths per year in the US. In comparison the mortality rate of melanoma is 15-20% and it causes 6500 deaths per year.:29,31 Even though it is much less common, malignant melanoma is responsible for 75% of all skin cancer-related deaths.

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      Reconstruction 4 years ago

      Currently, surgical excision is the most common form of treatment for skin cancers. The goal of reconstructive surgery is restoration of normal appearance and function. The choice of technique in reconstruction is dictated by the size and location of the defect. Excision and reconstruction of facial skin cancers is generally more challenging due to presence of highly visible and functional anatomic structures in the face.

      When skin defects are small in size, most can be repaired with simple repair where skin edges are approximated and closed with sutures. This will result in a linear scar. If the repair is made along a natural skin fold or wrinkle line, the scar will be hardly visible. Larger defects may require repair with a skin graft, local skin flap, pedicled skin flap, or a microvascular free flap. Skin grafts and local skin flaps are by far more common than the other listed choices.

      Skin grafting is patching of a defect with skin that is removed from another site in the body. The skin graft is sutured to the edges of the defect, and a bolster dressing is placed atop the graft for seven to ten days, to immobilize the graft as it heals in place. There are two forms of skin grafting: split thickness and full thickness. In a split thickness skin graft, a shaver is used to shave a layer of skin from the abdomen or thigh. The donor site, regenerates skin and heals over a period of two weeks. In a full thickness skin graft, a segment of skin is totally removed and the donor site needs to be sutured closed.

      Split thickness grafts can be used to repair larger defects, but the grafts are inferior in their cosmetic appearance. Full thickness skin grafts are more acceptable cosmetically. However, full thickness grafts can only be used for small or moderate sized defects.

      Local skin flaps are a method of closing defects with tissue that closely matches the defect in color and quality. Skin from the periphery of the defect site is mobilized and repositioned to fill the deficit. Various forms of local flaps can be designed to minimize disruption to surrounding tissues and maximize cosmetic outcome of the reconstruction. Pedicled skin flaps are a method of transferring skin with an intact blood supply from a nearby region of the body. An example of such reconstruction is a pedicled forehead flap for repair of a large nasal skin defect. Once the flap develops a source of blood supply form its new bed, the vascular pedicle can be detached.

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      Management 4 years ago

      Treatment is dependent on type of cancer, location of the cancer, age of the patient, and whether the cancer is primary or a recurrence. Treatment is also determined by the specific type of cancer. For a small basal cell cancer in a young person, the treatment with the best cure rate (Mohs surgery or CCPDMA) might be indicated. In the case of an elderly frail man with multiple complicating medical problems, a difficult to excise basal cell cancer of the nose might warrant radiation therapy (slightly lower cure rate) or no treatment at all. Topical chemotherapy might be indicated for large superficial basal cell carcinoma for good cosmetic outcome, whereas it might be inadequate for invasive nodular basal cell carcinoma or invasive squamous cell carcinoma. In general, melanoma is poorly responsive to radiation or chemotherapy.

      For low-risk disease, radiation therapy (external beam radiotherapy or brachytherapy), topical chemotherapy (imiquimod or 5-fluorouracil) and cryotherapy (freezing the cancer off) can provide adequate control of the disease; both, however, may have lower overall cure rates than certain type of surgery. Other modalities of treatment such as photodynamic therapy, topical chemotherapy, electrodesiccation and curettage can be found in the discussions of basal cell carcinoma and squamous cell carcinoma.

      Mohs' micrographic surgery (Mohs surgery) is a technique used to remove the cancer with the least amount of surrounding tissue and the edges are checked immediately to see if tumor is found. This provides the opportunity to remove the least amount of tissue and provide the best cosmetically favorable results. This is especially important for areas where excess skin is limited, such as the face. Cure rates are equivalent to wide excision. Special training is required to perform this technique. An alternative method is CCPDMA and can be performed by a pathologist not familiar with Mohs surgery.

      In the case of disease that has spread (metastasized), further surgical procedures or chemotherapy may be required.

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      Prevention 4 years ago

      Sunscreen is effective and thus recommended to prevent melanoma and squamous cell carcinoma. There is little evidence that it is effective in preventing basal cell carcinoma. Other advice to reduce rates of skin cancer includes: avoiding sunburning, wearing protective clothing, sunglasses and hats, and attempting to avoid periods of peak sun exposure. The U.S. Preventive Services Task Force recommends that people aged between 9 and 25 years of age are advised to avoid ultraviolet light.

      The risk of developing skin cancer can be reduced through a number of measures including: decreasing indoor tanning and mid day sun exposure, increasing the use of sunscreen, and avoiding the use of tobacco products.

      There is insufficient evidence either for or against screening for skin cancers. Vitamin supplements and antioxidant supplements have not been found to have an effect in prevention. Evidence for a benefit from dietary measures is tentative.

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      Pathophysiology 4 years ago

      Squamous cell carcinoma is a malignant epithelial tumor which originates in epidermis, squamous mucosa or areas of squamous metaplasia.

      Macroscopically, the tumor is often elevated, fungating, or may be ulcerated with irregular borders. Microscopically, tumor cells destroy the basement membrane and form sheets or compact masses which invade the subjacent connective tissue (dermis). In well differentiated carcinomas, tumor cells are pleomorphic/atypical, but resembling normal keratinocytes from prickle layer (large, polygonal, with abundant eosinophilic (pink) cytoplasm and central nucleus).

      Their disposal tends to be similar to that of normal epidermis: immature/basal cells at the periphery, becoming more mature to the centre of the tumor masses. Tumor cells transform into keratinized squamous cells and form round nodules with concentric, laminated layers, called "cell nests" or "epithelial/keratinous pearls". The surrounding stroma is reduced and contains inflammatory infiltrate (lymphocytes). Poorly differentiated squamous carcinomas contain more pleomorphic cells and no keratinization.

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      Causes 4 years ago

      Ultraviolet radiation from sun exposure is the primary cause of skin cancer. Other factors that play a role include:

      Smoking tobacco

      HPV infections increase the risk of squamous cell carcinoma.

      Some genetic syndromes including congenital melanocytic nevi syndrome which is characterized by the presence of nevi (birthmarks or moles) of varying size which are either present at birth, or appear within 6 months of birth. Nevi larger than 20 mm (3/4") in size are at higher risk for becoming cancerous.

      Chronic non-healing wounds. These are called Marjolin's ulcers based on their appearance, and can develop into squamous cell carcinoma.

      Ionizing radiation, environmental carcinogens, artificial UV radiation (e.g. tanning beds), aging, and light skin color. It is believed that tanning beds are the cause of hundreds of thousands of basal and squamous cell carcinomas.

      The use of many immunosuppressive medication increase the risk of skin cancer. Cyclosporin A, a calcineurin inhibitor for example increases the risk approximately 200 times, and azathioprine about 60 times.

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      Others 4 years ago

      Merkel cell carcinomas are most often rapidly growing, non-tender red, purple or skin colored bumps that are not painful or itchy. They may be mistaken for a cyst or other type of cancer

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      Melanoma 4 years ago

      Most melanomas are brown to black looking lesions. Unfortunately, a few melanomas are pink, red or fleshy in color; these are called amelanotic melanomas. These tend to be more aggressive. Warning signs of malignant melanoma include change in the size, shape, color or elevation of a mole. Other signs are the appearance of a new mole during adulthood or new pain, itching, ulceration or bleeding. An often-used mnemonic is "ABCDE", where A= asymmetrical, B= "borders" (irregular= "Coast of Maine sign"), C= "color" (variegated), D= "diameter" (larger than 6 mm—the size of a pencil eraser) and E= "evolving."

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      Squamous cell carcinoma 4 years ago

      Squamous cell carcinoma is commonly a red, scaling, thickened patch on sun-exposed skin. Some are firm hard nodules and dome shaped like keratoacanthomas. Ulceration and bleeding may occur. When SCC is not treated, it may develop into a large mass. Squamous cell is the second most common skin cancer. It is dangerous, but not nearly as dangerous as a melanoma.

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      Basal Cell Carcinoma 4 years ago

      Basal cell carcinoma usually presents as a raised, smooth, pearly bump on the sun-exposed skin of the head, neck or shoulders. Sometimes small blood vessels can be seen within the tumor. Crusting and bleeding in the center of the tumor frequently develops. It is often mistaken for a sore that does not heal. This form of skin cancer is the least deadly and with proper treatment can be completely eliminated, often without scarring.

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      Signs & Symptoms 4 years ago

      There are a variety of different skin cancer symptoms. These include changes in the skin that do not heal, ulcering in the skin, discolored skin, and changes in existing moles, such as jagged edges to the mole and enlargement of the mole.

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      Classification 4 years ago

      There are three main types of skin cancer: basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and malignant melanoma.

      Basal cell carcinomas are present on sun-exposed areas of the skin, especially the face. They rarely metastasize and rarely cause death. They are easily treated with surgery or radiation. Squamous cell carcinomas (SCC) are common, but much less common than basal cell cancers. They metastasize more frequently than BCCs. Even then, the metastasis rate is quite low, with the exception of SCC of the lip, ear, and in immunosuppressed patients. Melanomas are the least frequent of the 3 common skin cancers. They frequently metastasize, and could potentially cause death once they spread.

      Less common skin cancers include: Dermatofibrosarcoma protuberans, Merkel cell carcinoma, Kaposi's sarcoma, keratoacanthoma, spindle cell tumors, sebaceous carcinomas, microcystic adnexal carcinoma, Pagets's disease of the breast, atypical fibroxanthoma, leimyosarcoma, and angiosarcoma.

      The BCC and the SCCs often carry a UV-signature mutation indicating that these cancers are caused by UV-B radiation via the direct DNA damage. However the malignant melanoma is predominantly caused by UV-A radiation via the indirect DNA damage.The indirect DNA damage is caused by free radicals and reactive oxygen species. Research indicates that the absorption of three sunscreen ingredients into the skin, combined with a 60-minute exposure to UV, leads to an increase of free radicals in the skin, if applied in too little quantities and too infrequently. However, the researchers add that newer creams often do not contain these specific compounds, and that the combination of other ingredients tends to retain the compounds on the surface of the skin. They also add the frequent re-application reduces the risk of radical formation.

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      Skin cancer 4 years ago

      Skin cancers (neoplasms) are named after the type of skin cell from which they arise. Basal cell cancer originates from the lowest layer of the epidermis, and is the most common but least dangerous skin cancer. Squamous cell cancer originates from the middle layer, and is less common but more likely to spread and, if untreated, become fatal. Melanoma, which originates in the pigment-producing cells (melanocytes), is the least common, but most aggressive, most likely to spread and, if untreated, become fatal. Still, melanoma has one of the higher survival rates among major cancer, with over 75% of patients surviving 10 years in the UK during 2005-2007.

      In the UK in 2010, 12,818 people were diagnosed with malignant melanoma, and about 100,000 people were diagnosed with non-melanoma skin cancer. There were 2,746 deaths from skin cancer, 2,203 from malignant melanoma and 546 from non-malignant melanoma. In the US in 2008, 59,695 people were diagnosed with melanoma, and 8,623 people died from it.

      Most cases are caused by over-exposure to UV rays from the sun or sunbeds.

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      Reality T.V. Star Becomes Melanoma Patient 4 years ago

      Sure, it's vanity. But healthy looks good. Clear eyes, shiny hair -- we all want that.

      You've been forward about getting breast implants. Any regrets?

      I researched the procedure; spoke with my doctor; weighed the risks. I felt solid in my appearance, but I did it for my husband. He got a vasectomy for me, so we traded surgeries.

      You are a fitness fanatic who regularly hikes, surfs, and takes Pilates. Have you always been so active?

      My parents were active, so I have always been. But with any cancer, you need to exercise, eat right, and sleep to keep your immune system strong. So I am doubly motivated.

      What about nutrition? Do you follow a special regimen, diet, or simply try to eat well?

      Tons of water, veggies, green tea ... the works.

      How would you react if your teenaged daughter asked for breast implants?

      This was a major issue for me. I have never wanted her to have a false or bad body image. And I didn't want to contradict all the things I've told her, her whole life. I sat her down, explained that I had made this decision well into my 40s. I told her that once she is settled, has her children, and chooses whether or not to nurse, then if she decides to have implants, I'll even pay for them. I'll take care of her while she's recovering. But if she wants implants to help define herself or nab the right guy, then I'll fight her tooth and nail!

      What is your health philosophy?

      Eat right. Exercise. Have fun. Stay active -- but active out of the sun!

      What's better: real life or what we see on "reality" TV?

      Real life! But reality TV is a kick in the pants.

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      Reality T.V. Star Becomes Melanoma Patient 4 years ago

      On The Real Housewives of Orange County, you faced a serious health threat. What happened?

      My doctor found a malignant mole -- a shallow melanoma in early stages -- on my thigh, a few inches above my knee. I've faced skin cancer before, but I never intended to share this "reality" on the show. Now, I'm glad I did. Since the show has aired, several people have told me they've gotten their skin checked because of me -- and it thrills me to hear it.

      Recommended Related to Melanoma/Skin Cancer

      Overview

      Note: Separate PDQ summaries on Skin Cancer Prevention, Skin Cancer Treatment, and Levels of Evidence for Cancer Screening and Prevention Studies are also available. Interventions The only widely proposed screening procedure for skin cancer is visual examination of the skin, including both self-examination and clinical examination. Benefits In asymptomatic populations, the effect of visual skin examination on mortality from nonmelanomatous skin cancers is unknown. Further, the evidence...

      Read the Overview article

      When were you first diagnosed with skin cancer?

      At age 27 -- 17 years ago. I went in for acne treatments and my doctor gasped. He removed 22 moles from my body. He tested them all, and one came back malignant.

      Were you a sun worshipper when you were young?

      I got a tremendous amount of sun exposure as a child. All the damage was done before I was 25.

      You write on your Bravo blog that you had an eye sewn shut for two months after half of your lower eyelid was removed due to skin cancer. Tell us about this experience.

      I had a tiny tumor near my tear duct. It was not malignant, but I still tell everyone: Wear sunglasses! Make sure your children wear sunglasses! Protect your eyes!

      How much has changed in the last two decades, in terms of prevention and treatment of skin cancers?

      Not enough. It will take someone like Brad Pitt getting melanoma to get the kind of funding needed to get the research done that this cancer needs.

      Any advice for other mothers trying to keep their families safe from UV rays?

      When my kids were little, it wasn't hard keeping them covered up. Now they want to be at the beach with their friends -- and not look dorky in long sleeves. But there are companies that make cute clothes that have sunscreen built into the fabrics. Also, be creative. Don't tell your teenager she can't go to the beach. Instead, plan an indoor activity for her and her friends -- like going to a cool sushi bar or a museum -- then take them to the beach after 4 p.m. Watch the sunset together.

      Since facing cancer, do you view your life or relationships differently?

      Completely. Yes, plan for the future. But enjoy the moment. Share your feelings for someone right now. Take more risks. Have a sense of adventure.

      How do you feel about aging?

      I like it. I am more confident in my 40s than I was in my 20s. I've got a great husband, great kids; I'm more direct. And physically? Well, I do look at my skin and wish I didn't get so much sun.

      As a society, are we are growing more obsessed with appearance? Or is it a matter of wanting to look and feel great to be healthy?

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      10 Questions to Ask Your Doctor About Melanoma 4 years ago

      Since you’ve recently been diagnosed with melanoma, ask your doctor these questions at your next visit.

      How far has my melanoma spread? How did you determine that?

      Can you remove all of the cancer through surgery alone?

      If I need any treatments besides surgery, what do you recommend, and why?

      How successful have these treatments been in cases like mine?

      What side effects can I expect from my treatments? What steps can I take to manage them?

      How long will I need these treatments?

      Will my surgery leave a noticeable scar? Is there a way to minimize scarring?

      Am I at high risk for a return of melanoma? What should I do to prevent a recurrence?

      Am I at higher risk for other types of cancer?

      How often should I see you for follow-up? Are there any symptoms I should look for in between visits?

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      Get to know your skin 4 years ago

      Skin cancer, including melanoma, is curable if spotted early. A careful skin exam may identify suspicious growths that may be cancer or growths that may develop into skin cancer (precancers).

      Examine your skin once every month. Get to know your moles and birthmarks, and look for any abnormal skin growth and any change in the color, shape, size, or appearance of a skin growth.

      Check for any area of skin that does not heal after an injury.

      Have your doctor check your skin during any other health exams. Most experts recommend having your skin examined regularly.

      Bring any suspicious skin growths or changes in a mole to the attention of your doctor.

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      Know the ABCDEs of early detection 4 years ago

      Skin cancer can be cured if found and treated early. If it is not discovered or treated until too late, it can spread throughout the body and may be fatal. Skin cancer often appears on the trunk of men and on the legs of women. Learn your ABCDEs, the changes in a mole or skin growth that are warning signs of melanoma:

      Asymmetry : One half doesn't match the other half.

      Border irregularity : The edges are ragged, notched, or blurred.

      Color : The pigmentation is not uniform. Shades of tan, brown, and black are present. Dashes of red, white, and blue add to the mottled appearance. Color may spread from the edge of a mole into the surrounding skin.

      Diameter : The size of the mole is greater than 6 mm (0.2 in.), or about the size of a pencil eraser.

      Evolution : There is a change in the size, shape, symptoms (such as itching or tenderness), surface (especially bleeding), or color of a mole.

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      Skin Protection 4 years ago

      Avoiding skin cancer can be as simple as protecting your skin and taking a good look at it regularly. While sunscreen plays a vital role in protecting your skin from UV radiation, it can't prevent skin damage if you are exposed to the sun's rays for long periods of time. Experts recommend that you use multiple methods to fully protect your skin.

      Protect your skin

      Stay out of the sun during the peak hours of UV radiation, from 10 a.m. to 4 p.m.

      Wear protective clothing:

      Wide-brimmed hats that protect the face and neck

      Tightly-woven clothing made of thick material, such as unbleached cotton, polyester, wool, or silk

      Dark clothing with dyes added that help absorb UV radiation

      Loose-fitting long-sleeved clothing that covers as much of the skin as possible

      Clothing that has sun protection factor (SPF) in the fabric that does not wash out

      Wear sunscreen with an SPF of 15 or higher, summer and winter, on both cloudy and clear days:

      SPF of 11 offers minimal protection.

      SPF of 12 to 29 offers moderate protection.

      SPF of 30 and above offers high protection.

      Apply sunscreen that blocks both UVA and UVB radiation to all exposed skin, including lips, ears, back of the hands, and neck. Apply sunscreen 30 minutes before going in the sun, and reapply it every 2 hours and after swimming, exercising, or sweating.

      Wear wraparound sunglasses that block at least 99% of UVA and UVB radiation.

      Be careful when you are on sand, snow, or water, because these surfaces can reflect 85% of the sun's rays.

      Avoid artificial sources of UVA radiation, including sunlamps and tanning booths. Like the sun, they can cause skin damage and increase the risk of skin cancer.

      A child's skin is more sensitive to the sun than an adult's skin and is more easily burned. Babies younger than 6 months should always be completely shielded from the sun. Children 6 months and older should have their skin protected from too much sun exposure.

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      Skin Protection 4 years ago

      You can stop skin cancer before it starts.

      Exposure to the sun is the most common cause of skin cancer. Sunburns do the most damage, but sustained time in the sun increases the risk of skin damage and mole growth.

      Most early skin cancers are easily seen on the skin and may be curable if treated early.

      Some people have a higher risk of developing skin cancer. If you are aware that you have a higher risk, have regular skin exams and take steps to protect your skin.

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      UV And My Skin 4 years ago

      The sunlight that reaches the earth has ultraviolet A and B (UVA and UVB) rays. These ultraviolet (UV) rays are the main causes of damage to the skin from the sun. Some people are more susceptible than others to skin damage. Certain factors may mean that you have an increased risk of developing skin cancer:

      A personal history of skin cancer

      A family member with skin cancer

      More than 50 moles

      Abnormal moles (atypical moles), or moles larger than 6 mm (0.2 in.), about the size of a pencil eraser

      A weakened immune system

      Severe sunburns-even one-as a child, or sunburns as an adult

      Living in a sunny or high-altitude climate or near the equator

      Fair skin that burns or freckles easily and does not tan

      Sunburns in childhood are the most damaging to the skin. The earlier in life that you are burned by the sun, the greater the risk of developing skin cancer later in life.

      Some people believe that tanning protects against a sunburn. But the amount of sun exposure needed to get a tan can by itself cause excessive skin damage and outweigh any possible benefit.

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      Protecting Your skin 4 years ago

      Excessive exposure to the sun and its ultraviolet (UV) rays can cause skin cancer. You can reduce your risk for skin cancer by:

      Protecting your skin, and that of your family members, from UV radiation.

      Performing frequent skin self-examinations.

      Finding out whether you have an increased risk of developing melanoma and other skin cancers.

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      WebMD 4 years ago

      It's important to tell your doctors or nurses when you feel any nausea. Sometimes people worry about bothering the doctor or nurse. Sometimes they think there is nothing that can be done, so it is not worth bringing up. Speak up about your fears and about any nausea you are feeling, no matter how slight. You may need a different medicine for nausea a few days after chemotherapy than the one you used right afterward.

      To help you and your health care team deal with any nausea and vomiting, you may want to keep track of how you feel. You can use this symptoms diary or one like it to write down how you are feeling. Take your diary with you whenever you visit your doctor.

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      Nutrition 4 years ago

      Eating well may seem to be an odd way to treat nausea and vomiting, but it’s very important. As a cancer patient, you need nutritious foods to help you feel better, keep up your strength and energy, keep up your weight, and keep up your ability to fight infection and recover as quickly as possible.

      Here are some tips for eating well during chemotherapy:

      Eat small, frequent meals or snacks. Treat yourself by choosing the foods you like best.

      Make the most of the days when your appetite is good.

      Ask friends and family for help with shopping and preparing meals. Consider having meals delivered to your home or have lunch at a community or senior center.

      Nutritional supplements are convenient and can help you get the extra calories and protein you need. Try a variety to find out which ones work best. Your doctor, nurse, or dietitian can help and may have samples for you to try.

      Is there a time of day when you are able to eat more? Many people find that breakfast time is best. Try eating more during that time of day when you can.

      Don't force yourself to eat when you are nauseated.

      Eat food cold or at room temperature.

      Keep your mouth clean, and brush your teeth after vomiting.

      Have fresh air with a fan or an open window.

      Limit sounds, sights, and smells that make you feel sick.

      When you don't feel like eating your normal foods, try apple or grape juice, weak teas, clear broths, dry toast, cooked cereal, and gelatin desserts. Avoid citrus juices and lemonade.

      Try ginger, such as candied ginger or ginger tea. Real ginger-not ginger flavoring-helps to reduce nausea.

      Eat a light meal or snack before your chemotherapy appointment so that you have something in your stomach.

      If your chemotherapy is the kind that takes several hours rather than a few minutes, bring a light meal or snacks with you. Your treatment center should have a refrigerator and microwave available for your use.

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      Acupuncture 4 years ago

      Some studies have shown that acupuncture is an effective treatment for nausea and vomiting caused by chemotherapy.2 Your doctor may refer you to a qualified acupuncturist.

      You can also try acupressure. Constant pressure on the P6 point is used to prevent or reduce nausea. The P6 point is on the inner side of your arm, in line with your middle finger. It is close to your wrist, one-sixth of the distance between your wrist and elbow. You can press on your arm with a thumb or finger or try wearing wristbands (such as Sea-Bands) that press a plastic disc on the P6 point on each arm.

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      Complementary therapy 4 years ago

      Although drugs are the main way to treat nausea and vomiting, there are other treatments that have been shown to work well.1 They involve the help of a qualified therapist who can teach you to use your mind and body to control nausea and vomiting. These techniques help stop anticipatory nausea and vomiting. They work by relaxing you, distracting your attention, helping you feel in control, and making you feel less helpless. These treatments include:

      Biofeedback . Biofeedback uses the mind to control a body function that the body normally regulates on its own, such as skin temperature, muscle tension, or heart rate.

      Guided imagery . This is a series of thoughts and suggestions that direct your imagination toward a relaxed, focused state. This technique can help you mentally block the nausea and vomiting.

      Distraction . For example, kids getting chemotherapy may use a video game to help keep their mind off what is happening. This may also help mentally block the nausea and vomiting.

      Progressive muscle relaxation . This is a technique in which you learn to relax by tensing and then releasing different groups of muscles, one at a time.

      Self-hypnosis . A therapist can teach you to hypnotize yourself. Some people are able to learn from books.

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      Medical marijuana 4 years ago

      Marijuana, either in its natural form or as a synthetic drug, has been shown to ease the nausea and vomiting caused by chemotherapy. Although it worked better than many of the antinausea drugs available in the past, it doesn't seem to work as well as other medicines available today. And marijuana can cause unpleasant side effects including dry mouth, low blood pressure, and dizziness, especially in older people or people who haven't used it before. Also, the legality of marijuana for medical use is still a question in many countries.

      Some doctors still use the synthetic form of marijuana to treat nausea and vomiting. These drugs have not been shown to work as well as other drugs now available, but they may be helpful for certain people

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      Antinausea drugs 4 years ago

      Antinausea drugs are usually taken on a regular daily schedule for as long as chemotherapy lasts. Sometimes you may be asked to take the antinausea drug "only as needed." You may be given more than one kind of antinausea drug. Drugs to relieve your nausea include ondansetron (Zofran) and lorazepam (Ativan).

      Antinausea drugs can be given as pills you swallow, as an IV, or as shots. Some drugs are available as suppositories, as capsules that melt in your mouth, or as a patch that is taped to your skin.

      Be sure to follow your doctor's instructions for taking your antinausea medicines and to report back about how well they are working.

      If you have nausea and vomiting after chemotherapy in spite of taking antinausea drugs, tell your doctor immediately. A different antinausea drug may be the answer. Or your chemotherapy drug may need to be changed.

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      How can I control Nausea And Vomiting 4 years ago

      The best way to control nausea and vomiting is to begin treatment for it before you start chemotherapy. Talk to your doctor about your treatment plan. Find out if the cancer drug you'll receive is likely to make you sick. Ask your doctor what medicines are available to prevent nausea and vomiting. Talk about your concerns, no matter how small. The more you know about your treatment, the more you will feel in control and the easier it will be to talk about it with your doctors and nurses.

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      Importance of controlling Nausea and vomiting 4 years ago

      People who feel good are better able to fight their cancer and have happier lives. Your body needs to be able to rest, to refuel, and to cope with the stresses of cancer and its treatment.

      If untreated, nausea and vomiting can make you feel:

      Depressed.

      Unable to cope.

      Tired.

      Stressed.

      Unable to sleep.

      Worried.

      Angry.

      Uninterested in food.

      Dehydrated.

      Controlling your nausea and vomiting can help you to:

      Be active.

      Sleep.

      Cope better with your cancer and its treatment.

      Enjoy family and friends.

      Eat with pleasure

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      What causes Nausea And vomiting? 4 years ago

      Researchers do not know exactly why some chemotherapy drugs cause nausea and vomiting. They believe there are several ways that this can happen. Some drugs may affect the parts of your spinal cord or nervous system that trigger nausea and vomiting. Some drugs may cause nausea and vomiting by irritating the lining of your digestive system. Sometimes, if you had nausea when you had chemotherapy before, your brain remembers this and expects nausea when you have chemotherapy again.

      Chemotherapy drugs are ranked according to how often they cause nausea and vomiting. Some cause very little of those side effects. Also, some people are more likely than others to get sick. Your doctor will consider many things about you, your treatment, and your cancer to decide if you are likely to feel sick.

      Whether you have nausea and vomiting may depend on:

      What types of chemotherapy drugs you get. Some of these drugs are more likely to cause nausea and vomiting than others.

      How large a dose you get. Higher doses are more likely to cause nausea and vomiting.

      When and how often you get chemotherapy. If the time between treatments is short, your body has less time to recover from the nausea and vomiting before you get your next dose.

      How the drugs are given. A drug that is given through your vein (IV) may cause nausea and vomiting sooner than a pill that is swallowed, because your body will absorb the IV drug faster.

      Individual differences. Not every person reacts the same to the same medicine.

      The antinausea medicine you are taking. If it isn't working for you, you may need to try a different one.

      You may feel sick shortly after your chemotherapy treatment begins. Or you may not feel sick until a day or two later. You may not feel sick at all. As soon as you start to feel sick, tell your doctor.

      Many people start feeling sick before a treatment session even begins. This is called anticipatory nausea and vomiting. Any little thing-the smell of an alcohol swab, the sight of a nurse's uniform, the sounds of the treatment room-may trigger nausea. This usually doesn't happen until after the third or fourth treatment session. Learning how to control anticipatory nausea and vomiting is important, because it can make nausea and vomiting more severe when the chemotherapy actually starts.

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      Cancer: Controlling Nausea and Vomiting From Chemotherapy 4 years ago

      Of all the side effects of chemotherapy, nausea and vomiting are two of the most distressing. But in many cases, nausea and vomiting can be controlled and even prevented.

      Key points

      Nausea and vomiting can be controlled and even prevented. The best treatment plan is one set up by you and your health care team, based on your particular needs and feelings. You are the authority on how well you feel and how much nausea you have.

      Today’s antinausea drugs are very good at preventing and controlling nausea and vomiting. Your doctor should be able to find one that works for you.

      Prevent nausea. When you or your doctor foresee that a treatment will make you very sick, it's best that you take antinausea medicine beforehand.

      There are several other ways to get relief and make yourself feel better before and after your chemotherapy treatments.

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      Other Treatments 4 years ago

      Clinical trials are currently studying many other treatments. These include new forms of chemotherapy and immunotherapy, such as monoclonal antibodies and vaccines. Your doctor may recommend that you join a clinical trial if one is available in your area.

      Complementary therapies

      People sometimes use complementary therapies along with medical treatment to help relieve symptoms and side effects of cancer treatments. Some of the complementary therapies that may be helpful include:

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      Note: Some citations in the text of this section are followed by a level of evidence. The PDQ editorial boards use a formal ranking system to help the reader judge the strength of evidence linked to the reported results of a therapeutic strategy. (Refer to the PDQ summary on Levels of Evidence for more information.) There is a wide range of treatment approaches, including excision, radiation therapy, cryosurgery, electrodesiccation and curettage, photodynamic or laser-beam light exposure, and...

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      Acupuncture, to relieve pain.

      Meditation or yoga, to relieve stress.

      Massage and biofeedback, to reduce pain and ease tension.

      Breathing exercises for relaxation.

      Mind-body treatments like the ones listed above may help you feel better. They can make it easier to cope with cancer treatments. They also may reduce chronic low back pain, joint pain, headaches, and pain from treatments.

      Before you try a complementary therapy, talk to your doctor about the possible value and potential side effects. Let your doctor know if you are already using any such therapies. Complementary therapies are not meant to take the place of standard medical treatment, but they may improve your quality of life and help you deal with the stress and side effects of cancer treatment.

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      Surgery 4 years ago

      Surgery is the most common treatment for melanoma and is done to remove the primary melanoma. Sometimes lymph nodes may be removed at the same time to check them for cancer. Surgery also may be done to remove lymph nodes that have cancer or to remove tumors that may have spread to other parts of the body.

      Surgery Choices

      The most common types of surgery used to treat melanoma include:

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      Local excision. This surgery takes out the melanoma and a little of the tissue around it.

      Wide local excision. This surgery removes more of the tissue around the melanoma. Lymph nodes may also be removed during this surgery.

      Lymph node dissection (lymphadenectomy). This is surgery to remove lymph nodes to see if they have cancer cells. Or this may be done to remove lymph nodes that are cancerous.

      Sentinel lymph node biopsy. This surgery removes the first lymph node that the cancer may have spread to from the tumor. If this lymph node does not have any cancer cells, then you may not need to have more lymph nodes removed.

      What To Think About

      After removal of a primary melanoma, you may need a skingraft or other reconstructive surgery for cosmetic reasons or to restore function. This is most likely if the melanoma was large or was a late-stage tumor.

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      Medications for melanoma 4 years ago

      Medicines for melanoma include chemotherapy with a single medicine or several medicines. Medicines for treatment may include immunotherapy or even a combination of chemotherapy and immunotherapy.

      Medication Choices

      Medicine for melanoma that has metastasized may include:

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      Chemotherapy with medicines such as dacarbazine or temozolomide.

      Immunotherapy with interferon or interleukin-2.

      What To Think About

      Chemotherapy used to treat melanoma may be given as an outpatient treatment, but sometimes people need a short hospital stay.

      Medicines used for chemotherapy may be taken by mouth or injected into your bloodstream so they can travel throughout your body. If the melanoma is on an arm or leg, chemotherapy medicines may added to a warm solution that is injected into the bloodstream of that limb. The flow of blood to and from that limb is stopped for a short time so the medicine can go right to the tumor. This is called hyperthermic isolated limb perfusion.

      Medicines being studied in clinical trials include combinations of chemotherapy, vaccines, and immunotherapies. Clinical trials are also looking at targeted therapy with the monoclonal antibody ipilimumab and a medicine called PLX4032.

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      Home Treatment 4 years ago

      Home treatment can help you manage the side effects that may occur from your treatment. Some treatments for melanoma, such as taking interferon or having chemotherapy, can have serious side effects. If your doctor gives you instructions or medicines to treat these side effects, be sure to follow them. In general, healthy habits such as eating a balanced diet and getting enough sleep and exercise may help control your symptoms.

      Home treatment for nausea or vomiting includes watching for and treating early signs of dehydration, such as having a dry mouth or feeling lightheaded when you stand up. Eating smaller meals may help. So can a little bit of ginger candy or ginger tea.

      Home treatment for diarrhea includes resting your stomach and watching for signs of dehydration. Check with your doctor before using any nonprescription medicines for your diarrhea.

      Home treatment for constipation includes gentle exercise along with adequate intake of fluids and a diet that is high in fruits, vegetables, and fiber. Check with your doctor before using a laxative for your constipation.

      Home treatment for fatigue includes making sure you get extra rest if you are receiving chemotherapy or radiation therapy. Let your symptoms be your guide. You may be able to stay with your usual routine and just get some extra sleep. Fatigue is often worse at the end of treatment or just after treatment is completed.

      Other issues may include:

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      Hair loss. This can be emotionally distressing. Not all chemotherapy medicines cause hair loss, and some people have only mild thinning that is noticeable only to them. Talk to your doctor about whether hair loss is an expected side effect with the medicines you will receive.

      Sleep problems. If you find you have trouble sleeping, you may sleep more easily if you have a regular bedtime, get some exercise during the day, avoid caffeine late in the day, and try other methods to relieve sleep problems.

      Not all forms of cancer or cancer treatment cause pain. If pain occurs, many treatments are available to relieve it. If your doctor has given you instructions or medicines to treat pain, be sure to follow them. Home treatment may help to reduce pain and improve your physical and mental well-being. Be sure to talk with your doctor about any home treatment you use for pain.

      The diagnosis of melanoma and the need for treatment can be very stressful. You may be able to reduce your stress by expressing your feelings to others. Learning relaxation techniques may also help you reduce your stress.

      Your feelings about your body may change following a diagnosis of melanoma and the need for treatment. Adapting to your body image changes may involve talking openly about your concerns with your partner and discussing your feelings with your doctor. Your doctor may also be able to refer you to groups that can offer additional support and information.

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      Melanoma Treatment 4 years ago

      When melanoma has spread to only one tumor in another location, metastatic melanoma sometimes can be successfully treated with surgery. But metastatic melanoma usually responds poorly to most forms of treatment.

      When successful treatment is not possible, the goal of treatment for metastatic melanoma is to control symptoms, reduce complications, and increase comfort (palliative care).

      Your doctor may recommend that you join a clinical trial if one is available in your area. Clinical trials study other treatments, such as combinations of chemotherapy, vaccines, and immunotherapies. They are also studying targeted therapy with agents such as PLX4032 and ipilimumab.

      Recurrent melanoma

      Melanoma can come back after treatment. This called recurrent melanoma. This kind of melanoma, like metastatic melanoma, usually cannot be cured with treatment. But your medical team will keep you comfortable and help you live as long as possible. Treatments that may help include:

      Surgery to remove any tumors.

      Hyperthermic isolated limb perfusion. If the melanoma is on your arm or leg, chemotherapy medicine may be added to a warm solution and injected into the bloodstream of that limb. The flow of blood to and from that limb is stopped for a short time so the medicine can go right to the tumor.

      Radiation or immunotherapy to relieve symptoms (palliative therapy).

      Medicines injected directly into tumors.

      Lasers to destroy tumors.

      Palliative care may be an important part of your treatment plan.

      What To Think About

      When you first find out that you have cancer, you may feel scared or angry. Or you may feel very calm. It is normal to have a wide range of feelings and for those feelings to change quickly. Some people find that it helps to talk about their feelings with their family and friends.

      If your emotional reaction to cancer interferes with your ability to make decisions about your health, it is important to talk with your doctor. Your cancer treatment center may offer psychological or financial services. You may also contact your local chapter of the American Cancer Society to help you find a support group.

      Palliative care

      Cancer treatment has two main goals: to cure the cancer and to make your quality of life as good as possible. Your quality of life may be improved by having palliative care to manage your symptoms.

      For some people with advanced-stage cancer, a time comes when treatment to cure cancer no longer seems like a good choice. This can be because the side effects, time, and costs of treatment are greater than the promise of cure or relief. But this isn't the end of treatment. You and your doctor can decide when you may be ready for hospice care.

      It can be hard to decide when to stop treatment aimed at prolonging your life and shift the focus to end-of-life care. For more information, see the topics:

      Palliative Care.

      Hospice Care.

      Care at the End of Life.

      For more information about specific treatments, see the following topic

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      Treatment overview 4 years ago

      Surgical removal (excision) of the affected skin is the most effective treatment for melanoma. Excision involves removing the entire melanoma along with a border (margin) of normal-appearing skin. More treatment may be needed based on the stage of the melanoma.

      Initial treatment

      Melanoma may be cured if caught and treated in its early stages when it affects only the skin. If melanoma is confined to the skin (primary melanoma), you will have surgery to remove the affected skin. If the melanoma is thin and has not invaded surrounding tissues, excision may cure the melanoma. In more advanced stages, melanoma may spread, or metastasize, to other organs and bones, requiring additional treatment such as radiation, chemotherapy, or immunotherapy.

      Treatments used for melanoma include:

      Surgery. Your doctor may use one of these surgeries:

      Local excision. This surgery takes out the melanoma and a little of the tissue around it.

      Wide local excision. This surgery removes more of the tissue around the melanoma. Lymph nodes may also be removed during this surgery.

      Lymph node dissection (lymphadenectomy). This is surgery to remove lymph nodes to see if they have cancer cells. Or this may be done to remove lymph nodes that are cancerous.

      Sentinel lymph node biopsy. This surgery removes the first lymph node that the cancer may have spread to from the tumor. If this lymph node does not have any cancer cells, then you may not need to have more lymph nodes removed.

      Chemotherapy.

      Radiation therapy.

      Immunotherapy.

      Side effects of treatment

      The side effects of treatment for melanoma will depend on the type of treatment you have and your age and overall health. The side effects of surgery, chemotherapy, or radiation may be mild enough that you can do things at home to manage them. See the Home Treatment section of this topic for more information.

      Some of the treatment side effects can be avoided. For example, your doctor may prescribe medicines to control nausea and vomiting caused by chemotherapy. Be sure to talk to your doctor about all the side effects that you have.

      Ongoing treatment

      Regular follow-up appointments are important after you have been diagnosed with melanoma. Your doctor will set up a regular schedule of checkups that will happen less often as time goes on.

      Learn to do a skin self-exam and to check for swelling in your lymph nodes, and report any changes to your doctor. It's a good idea to get in the habit of doing this skin and lymph-node check at the same time every month.

      Treatment if the condition gets worse

      Metastatic melanoma

      Swollen or tender lymph nodes may be a sign that the melanoma has spread (metastatic melanoma). Any enlarged regional lymph nodes should be removed and checked for melanoma.

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      Early detection 4 years ago

      Skin self-exam is a good way to detect early skin changes that may point to melanoma. A skin self-exam is used to find suspicious growths that may be cancer or growths that may develop into skin cancer (precancers). Adults should examine their skin once every month. Look for any abnormal skin growth or any change in the color, shape, size, or appearance of a skin growth. Check for any area of injured skin (lesion) that does not heal. Have your spouse or someone such as a close friend help you monitor your skin, especially places that are hard to see such as your scalp and back.

      There are other steps you can take to prevent skin cancer or detect it at an early stage.

      Be aware of the risk of skin cancer and the steps you can take to prevent it, including staying out of the midday sun, wearing protective clothing, and using sunscreen on exposed skin.

      Have your doctor examine any suspicious skin changes. He or she may check your skin once a year. Or your doctor may suggest a skin exam more often, especially if you have:

      Familial atypical mole and melanoma (FAM-M) syndrome, which is an inherited tendency to develop melanoma. Examine your skin every month and be examined by a doctor every 4 to 6 months, preferably by the same doctor each time.

      Increased exposure to ultraviolet (UV) radiation because of your job, hobbies, or outdoor activities.

      Abnormal moles called atypical moles (dysplastic nevi). These moles are not cancerous. But their presence is a warning of an inherited tendency to develop melanoma.

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      Evualation of a skin lesion 4 years ago

      A physical exam of the skin is used to evaluate the skin for melanoma. If melanoma is suspected, a skin biopsy will be done. For this, your doctor will remove a sample of skin tissue and send it to a pathologist to be looked at under a microscope. If the biopsy shows melanoma, the pathologist will measure the thickness of the melanoma to find out how advanced the cancer is.

      Other techniques may include total-body photography to monitor for changes in any mole and to watch for new moles appearing in normal skin. A series of photos of the suspicious lesions may be taken. Then the photos can be used as a baseline to compare with follow-up photos.

      Evaluation of lymph nodes

      Your doctor will do a physical exam that includes checking the lymph nodes to see whether they are larger than normal. This may be followed by a sentinel lymph node biopsy to see whether the melanoma has spread to the lymph system.

      Evaluation for possible metastases (spread of cancer)

      A complete medical history and a physical exam are needed to find out whether the cancer has spread (metastasized) to other parts of the body. Imaging tests, including positron emission tomography (PET scan), computed tomography (CT scan), or magnetic resonance imaging (MRI), may be used to identify metastases in other parts of the body, such as the lungs, brain, liver, or other organs.

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      Later symptoms 4 years ago

      Later signs of melanoma include:

      A break in the skin or bleeding from a mole or other colored skin lesion.

      Pain in a mole or lesion.

      Symptoms of metastatic melanoma may be vague and include:

      Swollen lymph nodes, especially in the armpit or groin.

      A colorless lump or thickening under the skin.

      Unexplained weight loss.

      Gray skin (melanosis).

      Ongoing (chronic) cough.

      Headaches.

      Seizures.

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      Early symptoms 4 years ago

      Early signs

      The most important warning sign for melanoma is any change in size, shape, or color of a mole or other skin growth, such as a birthmark. Watch for changes that occur over a period of weeks to a month. Use the ABCDE rule to evaluate skin changes, and call your health professional if you have any of the following changes.

      A is for asymmetry. One half of the mole or skin growth doesn't match the other half.

      B is for border irregularity. The edges are ragged, notched, or blurred.

      C is for color. The pigmentation is not uniform. Shades of tan, brown, and black are present. Dashes of red, white, and blue add to the mottled appearance. Changes in color distribution, especially the spread of color from the edge of a mole into the surrounding skin, also are an early sign of melanoma.

      D is for diameter. The mole or skin growth is larger than 6 mm (0.25 in.) or about the size of a pencil eraser. Any growth of a mole should be of concern.

      E is for evolution. There is a change in the size, shape, symptoms (such as itching or tenderness), surface (especially bleeding), or color of a mole.

      Signs of melanoma in an existing mole include changes in:

      Elevation, such as thickening or raising of a previously flat mole.

      Surface, such as scaling, erosion, oozing, bleeding, or crusting.

      Surrounding skin, such as redness, swelling, or small new patches of color around a larger lesion (satellite pigmentations).

      Sensation, such as itching, tingling, or burning.

      Consistency, such as softening or small pieces that break off easily (friability).

      Melanoma can develop in an existing mole or other mark on the skin, but it often develops in unmarked skin. Although melanoma can grow anywhere on the body, it often occurs on the upper back of men and women and on the legs in women. Less often, it can grow on the soles, palms, nail beds, or mucous membranes that line body cavities such as the mouth, the rectum, and the vagina. On older people, the face is the most common place for melanoma to grow. And in older men, the most common sites are the neck, scalp, and ears.1

      Many other skin conditions (such as seborrheic keratosis, warts, and basal cell cancer) have features similar to those of melanoma.

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      Melanoma 4 years ago

      There are many risk factors for developing melanoma. The risk factor you can best control to reduce your risk of melanoma is exposure to ultraviolet (UV) radiation from the sun.

      To help prevent skin cancer:

      Protect your skin.

      Stay out of the sun during the midday hours (10 a.m. to 4 p.m.).

      Wear protective clothing. This includes a hat with a brim to shade your ears and neck, a shirt with sleeves to cover your shoulders, and pants. The best fabric for skin protection has a tight weave to keep sunlight out.

      Use a sunscreen every day with an SPF of at least 15. Look for a sunscreen that protects against both types of ultraviolet radiation in the sun's rays-UVA and UVB.

      Use a higher SPF when you are at higher elevations.

      Set a good example for your children by protecting your skin from too much sun.

      Avoid sunbathing and tanning salons. Studies suggest that your risk of melanoma increases by 75% if you start using artificial tanning before you are 30 years old.3

      Examine your skin regularly, and have your doctor check your skin during all other health exams, or at least once a year.

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      Melanoma 4 years ago

      What is melanoma?

      Melanoma is a kind of skin cancer. It is not as common as other types of skincancer, but it is the most serious.

      Melanoma can affect your skin only, or it may spread to your organs and bones. As with other cancers, treatment for melanoma works best when the cancer is found early.

      This topic is about melanoma that occurs in the skin. It does not cover melanoma that occurs in the eye or in any other part of the body besides the skin.

      What causes melanoma?

      You can get melanoma by spending too much time in the sun. Too much sun exposure causes normal skin cells to become abnormal. These abnormal cells quickly grow out of control and attack the tissues around them.

      Melanoma tends to run in families. Other things in your family background can increase your chances of getting the disease. For example, you may have abnormal, or atypical, moles. Atypical moles may fade into the skin and have a flat part that is level with the skin. They may be smooth or slightly scaly, or they may look rough and "pebbly." Having many atypical moles increases your risk of melanoma. Also, it may be a sign that melanoma runs in your family.

      What are the symptoms?

      The main sign of melanoma is a change in a mole or other skin growth, such as a birthmark. Any change in the shape, size, or color of a mole may be a sign of melanoma.

      Melanoma may grow in a mole or birthmark that you already have. But melanomas may grow in unmarked skin. They can be found anywhere on your body. Most of the time, they are on the upper back in men and women and on the legs of women.

      Melanoma may look like a flat, brown or black mole that has uneven edges. Melanomas usually have an irregular or asymmetrical shape. This means that one half of the mole doesn't match the other half. Melanoma moles or marks may be any size, but they are usually 6 mm (0.25 in.) or larger.

      Unlike a normal mole or mark, a melanoma can:

      Change color, size, or the shape of its border.

      Be lumpy or rounded.

      Become crusty, ooze, or bleed.

      How is melanoma diagnosed?

      Your doctor will check your skin to look for melanoma. If your doctor thinks you have melanoma, he or she will remove a sample of tissue from the area around the melanoma (biopsy). Another doctor, called a pathologist, will look at the tissue to check for cancer cells.

      If your biopsy shows melanoma, you may need to have more tests to find out if it has spread to your lymph nodes.

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      Your feelings 4 years ago

      You may have many different emotions including anger, resentment, guilt, anxiety and fear. These are all normal reactions, and are part of the process many people go through in trying to come to terms with their condition.

      Everyone has their own way of coping with difficult situations. Some people find it helpful to talk to family or friends, while others prefer to seek help from people outside their situation. Some people prefer to keep their feelings to themselves. There is no right or wrong way to cope, but help is there if you need it. Our cancer support specialists can give you information about counselling in your area.

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      Follow-up after treatment for Bowen’s disease 4 years ago

      You may have regular check-ups after treatment. At follow-up appointments, the doctors will check for any further changes that may need to be treated. However, if you notice changes in a patch, or a new patch developing in between appointments, contact your doctor or nurse for advice.

      If you aren’t being seen regularly by a skin specialist, it’s important to keep a close eye on your own skin. Let your GP know if you develop new patches or have any other skin symptoms. Many people with Bowen’s disease are looked after by their GPs when their treatment is over.

      Protecting yourself from the sun is even more important when you’ve had Bowen’s disease. This means wearing clothing that protects you from the sun and using a high-factor sunscreen (SPF 30 or above).

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      Laser treatment 4 years ago

      Laser treatment uses intense light energy to remove tissue. It's sometimes used as a treatment for Bowen's disease of the finger or the genitals. Doctors are carrying out research trials to find out how effective this treatment is in the long term.

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      Surgery 4 years ago

      Surgery may be used for small areas of Bowen’s disease that can be removed under local anaesthetic. But it’s not always the best option for large patches of Bowen’s disease.

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      Photodynamic therapy (PDT) 4 years ago

      Photodynamic therapy is a newer treatment that is used for different conditions. It can be a useful option for people with large areas of Bowen’s disease. It uses laser, or other light sources, combined with a light-sensitive drug (sometimes called a photosensitising agent) to destroy abnormal cells. A photosensitising cream is applied to the affected area. This is usually done 4-6 hours before treatment with the light, which lasts about 20-45 minutes. Afterwards a dressing is put on to cover the area and protect it from light. Usually more than one treatment is needed.

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      Curettage and electrocautery 4 years ago

      Scraping away the affected area (curettage) and using heat or electricity to stop any bleeding (electrocautery) are suitable for small patches of Bowen’s disease. A local anaesthetic is given before the doctor scrapes away the area using a spoon-shaped instrument called a curette.

      An electrically heated loop or needle is then applied to stop the bleeding from the wound (cauterise it) and destroy any remaining abnormal cells. After this treatment a scar may develop.

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      Creams (topical therapy) 4 years ago

      A chemotherapy (anti-cancer treatment) cream called 5-fluorouracil (Efudix®), also known as 5FU, may be used. The cream is applied to the skin regularly over a period of time. It can make the skin in the area red and inflamed before the Bowen’s disease gets better. Usually there are no other side effects.

      A cream called Imiquimod (Aldara®), which works by using the immune system to attack the abnormal cells, can also be used. You will be asked to apply it regularly over a period of time. It will cause some redness and skin irritation before the Bowen’s disease improves.

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      Cryotherapy 4 years ago

      It may be possible to treat the area by freezing it. This is called cryotherapy or cryosurgery. Liquid nitrogen is sprayed on to the affected area to freeze it. At the time, this feels very cold and a bit uncomfortable. Afterwards, you will have a scab, which usually falls off within a few weeks. This removes the affected skin.

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      Bowen's disease- Observation 4 years ago

      Bowen’s disease often grows very slowly, over a period of months or years. So, if you have a thin patch of affected skin which isn't changing, then keeping a close eye on it (observation) may be all that your dermatologist advises. You may have regular check-ups to monitor it carefully.

      This can sometimes be a good option for people who are more likely to have problems with skin healing after treatment.

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      Treatment for Bowen’s disease 4 years ago

      There are a number of different treatments available for Bowen’s disease. Your treatment will depend on where it is on your body, the size, thickness and the number of patches.

      How well the skin is likely to heal afterwards is an important factor when making decisions about treatment. The skin on the lower legs tends to be more fragile (especially in older people) and, as a result, there may be problems with it healing.

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      How Bowen’s disease is diagnosed 4 years ago

      Bowen’s disease is diagnosed by taking a sample of skin (biopsy). You will usually be referred to a dermatologist (specialist in skin diseases) to have this done.

      A local anaesthetic is given to numb the area and a small part of the affected skin is removed. The sample is then sent to the laboratory to be looked at under a microscope.

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      Signs and symptoms of Bowen’s disease 4 years ago

      Bowen’s disease can occur anywhere on the body but it's usually found on the lower legs. To begin with, it often looks like a red, scaly patch, or sometimes like raised spots or warts. The affected skin may become itchy, sore and may bleed. As Bowen’s disease can look like other skin conditions such as eczema or psoriasis, it’s important to get any skin problems checked out by a doctor.

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      Bowen's disease- causes 4 years ago

      Long-term overexposure to the sun is probably the most important risk factor for Bowen’s disease. But it can occur in areas that haven’t been exposed to the sun so this isn’t the only cause.

      Previous radiotherapy in the affected area is another risk factor, as is exposure to a chemical called arsenic, although this is rare.

      People who have to take drugs that lower their immunity (for example, after a kidney transplant) are more at risk of getting Bowen’s disease.

      Occasionally, Bowen’s disease can affect the genital area. This is usually linked with a common type of virus called the human papilloma virus (HPV). There are different types of this virus and some are linked with cancers, such as cervical cancer.

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      Bowen’s disease 4 years ago

      Bowen’s disease looks like a red, scaly patch on the skin. It is caused by the abnormal growth of cells called keratinocytes in the outer layer of the skin (epidermis). These cells don’t spread into the deeper layers of the skin. Bowen’s disease is sometimes called squamous cell carcinoma in-situ.

      Untreated cases of Bowen’s disease may develop into squamous cell cancer in a small number of people (about 3-5 out of every 100 who have it). This is a common, curable type of skin cancer which affects the outermost cells of the skin but can spread to deeper layers of skin.

      If left untreated for a long time, squamous cell cancer can spread to other parts of the body. Bowen’s disease is more common in women and it usually affects people in their 60s and 70s.

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      Research - clinical trials for skin cancer 4 years ago

      Cancer research trials are carried out to try to find new and better treatments for cancer. Trials that are carried out on patients are called clinical trials.

      Clinical trials may be carried out to:

      test new treatments, such as new chemotherapy drugs, gene therapy or cancer vaccines

      look at new combinations of existing treatments, or change the way they are given, to make them more effective or reduce side effects

      compare the effectiveness of drugs used to control symptoms

      find out how cancer treatments work

      find out which treatments are the most cost-effective.

      Trials are the only reliable way to find out if a different type of surgery, chemotherapy, radiotherapy, or other treatment is better than what is already available.

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      Topical immunotherapy for skin cancer 4 years ago

      Immunotherapy is the name given to cancer treatments that use the body's immune system to attack cancer cells.

      An immunotherapy cream called imiquimod (Aldara®) stimulates the immune system and may be used to treat some small, superficial basal cell cancers or Bowen's disease. It’s usually used in areas where surgery may be difficult or for people who have more than one tumour.

      You’ll be given the cream to take home and asked to apply it once a day for a number of weeks. Some redness or crusting of the skin occurs during the treatment, but there should be no permanent scarring. If the skin reaction is very strong, your doctor may give you a steroid cream to use as well.

      Occasionally, the cream may cause shivers and other flu-like symptoms. If this is the case, let your doctor or specialist nurse know as they may advise you to stop using it.

      Your hospital team can give you more detailed instructions on how to use your immunotherapy cream and how to manage any side effects.

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      Topical chemotherapy for skin cancer 4 years ago

      If chemotherapy is given, it’s normally applied directly to the skin cancer as a cream or lotion. This is called topical chemotherapy.

      Usually a drug called 5-fluorouracil (Efudix®), which is commonly known as 5FU, is used. You will be asked to put the cream on at home. Your doctor or specialist nurse will explain how to do this.

      The chemotherapy cream is applied once or twice a day for a number of weeks. If possible, a waterproof dressing should be put over the cream once applied, although it can sometimes be difficult to put a dressing on some areas of the body.

      The treatment should make the skin red and inflamed. Once the area becomes sore and weepy, the treatment will need to be stopped. Your doctor can prescribe a steroid cream to reduce the inflammation if it’s very sore. The skin will take a week or two to heal after treatment finishes.

      Exposure to the sun can make the inflammation worse, so you should protect the area until it has healed. Usually there are no other side effects with this type of chemotherapy.

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      Healing 4 years ago

      After PDT, a crust may form over the treated area. The crust will fall off naturally in a few weeks, leaving the healed, new skin underneath. Usually there’s no scarring and the appearance of the healed skin is very good

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      Side effects of PDT for skin cancer 4 years ago

      Pain

      Before your PDT treatment, your doctor or specialist nurse may advise you to take a couple of paracetamol tablets to prevent any pain. For many people this is all they need, but occasionally a local anaesthetic is given before treatment.

      You may feel a bit of discomfort, like a burning sensation, when you’re having the treatment. A cooling fan can sometimes be used to relieve this.

      At the end of treatment, a steroid cream may be applied to the treated area to stop it becoming painful. You may be given a steroid cream to use when you get home in case the area becomes painful later on.

      Sensitivity to light

      The treated area of skin will be sensitive to daylight and bright, indoor lighting. This effect will probably last for about 24 hours. You will need to keep the treated area of skin covered during this time so that your skin doesn’t burn.

      After that you can wash, bathe or shower as usual, but you’ll still need to treat your skin gently and not rub the area until it’s healed.

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      Photodynamic therapy for skin cancer 4 years ago

      PDT uses light sources combined with a light-sensitive drug (sometimes called a photosensitising agent) to destroy cancer cells. PDT is particularly useful in areas where the skin cancer develops directly over bone, such as in Bowen’s disease on the shins and hands.

      Before your treatment, the doctor may remove any scabs from the area. A photosensitising cream (for example Metvix®, which contains methyl aminolevulinate) will then be applied to your skin. It will be left on for a specific time period, usually between 3-6 hours, depending on the type of cream that’s used. This is so it can penetrate into the skin.

      After the cream is removed, the doctor shines a special light onto the treatment area. The light treatment usually lasts 8-45 minutes depending on the light source used.

      Afterwards, a dressing is put on to cover the area and protect it from light. You may need to keep the dressing on the treated area for up to 36 hours after your treatment. You will be given instructions about this before you leave hospital.

      Usually only one treatment of PDT is needed, but occasionally two or three further treatments may be given if your skin cancer is thick.

      Your doctor or nurse will be able to give you more detailed information about your specific PDT treatment.

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      Radiotherapy for skin cancer 4 years ago

      Radiotherapy treats cancer by using x-rays to destroy the cancer cells, while doing as little harm as possible to normal cells.

      Radiotherapy works well for skin cancers and is particularly useful in areas where surgery might be difficult or disfiguring (such as the face), and for tumours that have penetrated deeply into the skin. However, its use isn’t recommended for young people as it can cause skin changes, which become more visible over the years.

      The treatment is given in the hospital radiotherapy department. It can be given as a single treatment, but usually several doses are necessary and these are given each day over a period of one or more weeks. Your doctor will discuss your individual treatment plan with you.

      Radiotherapy treatment affects only a small area of skin and will not make you feel unwell. For up to a month after treatment, the treated skin will be red and inflamed. During this time, it will look as though the treatment has made things worse rather than better. This is normal. After a further few weeks the area will dry up and form a crust or scab.

      In time the scab will peel away, leaving healed skin underneath. At first, this new skin will look pinker than the skin around it. This will gradually fade and the treated area will start to look like the skin around it, although it may be slightly paler.

      Radiotherapy to areas that produce hair, such as the head, can make the hair fall out in the treated area. Your hair usually grows back within 6-12 months, depending on the dose of radiotherapy and how many sessions you’ve had. Some people find that the hair loss is permanent. Your clinical oncologist can discuss with you whether your hair is likely to grow back after treatment.

      Radiotherapy doesn’t make you radioactive and it’s perfectly safe for you to be around other people, including children, throughout your treatment.

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      Cryotherapy for skin cancer 4 years ago

      If the cancer is very small and only affecting the surface layers of the skin, it may be possible to remove it by freezing it. This is called cryotherapy or cryosurgery. This treatment is only occasionally used.

      Liquid nitrogen is sprayed on to the cancer to freeze it. It can be a bit painful when the liquid nitrogen is applied - some patients describe the feeling as like a bee sting.

      After the treatment you may feel an aching or throbbing sensation in the area for a minute or two. Within an hour or so the area may blister. This is to be expected and the blister may contain blood. Fluid may need to be drained from the blister using a sterile needle, but the top of the blister should be left intact.

      The treated area needs to be covered with a dressing until a scab forms. About two weeks after the treatment, the scab drops off and the cancer cells should have cleared. You may have a white scar in the area. Occasionally, you may need more than one cryotherapy treatment to get rid of the tumour completely.

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      Your feelings 4 years ago

      You may have many different emotions, including anger, resentment, guilt, anxiety and fear. These are all normal reactions and are part of the process many people go through in trying to come to terms with their condition.

      How you feel about the way you look is an important part of self-esteem, so if your skin graft has affected your appearance even slightly, this can also have an effect on your feelings.

      Everyone has their own way of coping with difficult situations. Adjusting to the news that you have a long-term condition can take time and it’s important that you get the support that you need. Some people find it helpful to talk to family or friends, while others prefer to seek help from people outside their situation. Some people prefer to keep their feelings to themselves. There is no right or wrong way to cope, but help is available if you need it. Our cancer support specialists can give you information about counselling in your area.

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      Complications and side effects of skin grafts 4 years ago

      Sometimes the grafted area may bleed or get infected. This can cause the graft to fail. It's important to contact your doctors if the area becomes painful, red and swollen. You are more likely to have problems with the graft if you smoke.

      Both the grafted and donor areas will develop scars. These should gradually fade. They usually heal well with time, especially if they are on the face. Using a moisturising cream can help keep the skin supple.

      There will be some difference between the grafted skin and the skin surrounding it. This should lessen over time. If you are concerned about the appearance of the area, you could try camouflage make-up. Some hospitals have specialist nurses who can show you the best way to apply this.

      We also have a section on coping with body changes.

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      After the skin graft 4 years ago

      You can usually go home the same day or you may need a short stay in hospital. This depends on where the graft is and how big it is.

      If the grafted area is on your hand, you may have a sling to help keep your arm raised as much as possible. If the graft is on your leg, it's important to keep your leg up when possible. This helps prevent swelling and reduces pain.

      You will need to take things gently for the first two weeks to allow the graft to heal properly. The grafted area will be quite fragile, so it's important not to rub or brush against the graft or the dressing, or to put any pressure on the area.

      Avoid any kind of exercise that might stretch or injure the graft for a few weeks. Start with some gentle exercise and build it up. You might need to take some time off work, depending on where the graft is and the kind of work you do. Your specialist will give you more advice on this.

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      The donor site 4 years ago

      You will also have a dressing on the donor site to protect it from infection. For a partial thickness skin graft, healing will take about two weeks, but the area may remain red for some time after this. With a full thickness graft, the donor area will take about five days to heal.

      The donor area can often feel more uncomfortable than the grafted area, and you may need to take regular painkillers.

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      The grafted area 4 years ago

      Once the skin layer has been removed from the donor site, it is laid over the area where the cancer has been removed. It may be secured in place with stitches. You will have a dressing over the grafted area and this is left in place while the graft heals. The skin graft will connect with the blood supply in the area, which allows it to ‘take’ and survive. This usually takes 5-7 days.

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      How a skin graft is done 4 years ago

      You may have either a general or a local anaesthetic depending on the area being grafted. Your doctors will advise you which is best for you.

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      Skin grafts 4 years ago

      Surgery for all types of skin cancer involves removing the affected area and some of the surrounding, healthy-looking skin.

      If the area is fairly small, it will be possible to close the wound by bringing the edges of skin together. Larger wounds may need a skin graft to cover the area. Skin grafts are layers of skin taken from another part of the body (the donor site) and placed over the area where the cancer has been removed.

      A partial thickness (or 'split') thickness skin graft is where the epidermis and a part of the dermis layer are used. The skin is usually taken from the thigh, buttock or upper arm. Skin will grow back in these areas.

      A full thickness skin graft is where the epidermis and the full dermis layers are used. In this case, only a small area is taken from the donor site and the skin edges of the donor site are then stitched together to heal. Skin may be taken from the neck, the area behind the ears and the inner side of the upper arm.

      Nowadays, skin grafts are less commonly needed as part of skin cancer treatment. This is because skin cancers are generally picked up and removed at an earlier stage when they are still small. This means the wound is also small so skin grafting isn’t needed. Another reason is that surgeons now use more skin flaps. This is where a portion of nearby skin, its underlying tissue and blood supply is moved to close the area where the cancer was removed. Skin flaps can give a better cosmetic result and heal more quickly.

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      How treatment is planned 4 years ago

      In most hospitals a team of specialists will talk to you about the treatment they feel is best for your situation. This multidisciplinary team (MDT) will include:

      oncologists (chemotherapy, immunotherapy and radiotherapy specialists)

      plastic surgeons

      dermatologists (skin disease specialists)

      pathologists (who advise on the type and extent of the skin cancer by examining tissue under a microscope)

      skin cancer specialist nurses

      counsellors and psychologists.

      The MDT will take a number of factors into account when advising you on the best course of action, including your age, general health, any medication you are taking, the type and size of the cancer, where it is on your body and what the cells look like under a microscope.

      You may be asked if you’d like to take part in a clinical trial.

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      Treatment for skin cancer 4 years ago

      There is a variety of treatments for skin cancer – the options offered to you will depend on several factors including the size of the skin cancer, where it is on your body and your biopsy results.

      Monitoring Your specialist may want to keep an eye on the changes to your skin rather than give treatment immediately.

      Surgery This is an important treatment for many skin cancers. It can be done in a variety of ways.

      Cryotherapy This destroys cancer cells by using liquid nitrogen to freeze them. It’s a very quick way of treating small, low-risk skin cancers such as superficial basal cell carcinomas.

      Radiotherapy This may be used instead of surgery. It can be a very effective treatment for basal and squamous cell carcinomas. Radiotherapy may be given after surgery if there’s a risk that some cancer cells may still be present. Sometimes it’s used for tumours that have grown into the deeper layers of the skin.

      Photodynamic therapy (PDT) PDT uses light sources, combined with a light-sensitive drug (sometimes called a photosensitising agent), to destroy cancer cells.

      Topical chemotherapy A chemotherapy cream containing a drug called 5FU (Efudix®) can be used to treat some early squamous cell carcinomas and superficial basal cell carcinomas.

      Topical immunotherapy A cream called imiquimod (Aldara®) can be used to treat some basal cell carcinomas and squamous cell carcinomas.

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      TNM staging system 4 years ago

      Another staging system known as the TNM system is commonly used. This can give more precise information about the extent of the cancer.

      T describes the size of the tumour.

      N describes whether the cancer has spread to the lymph nodes.

      M describes whether the cancer has spread to another part of the body (secondary or metastatic cancer).

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      Staging of skin cancers 4 years ago

      Knowing the extent of the cancer helps the doctors to decide on the most appropriate treatment. Most people with basal cell cancers do not need to have tests to find the stage of the cancer, as it is very rare for them to spread beyond the initial area of skin. Tests will only be done if the cancer is very large.

      Although it is rare for squamous cell cancers to spread, tests to find the stage may be done because in some people they may spread.

      A commonly used staging system is outlined below:

      Stage 0 is also called carcinoma in situ. Carcinoma in situ means that cancer cells are present, but they are all contained in a small area in the top layer of skin (the epidermis). They have not started to spread or grow into deeper layers of skin. Squamous cell stage 0 is also called Bowen's disease. If it is not treated, it can develop into a squamous cell skin cancer.

      Stage 1 The cancer is less than 2cm across and has not spread

      Stage 2 The cancer is more than 2cm across and has not spread

      Stage 3 The cancer has spread into the tissues under the skin and possibly to nearby lymph nodes

      Stage 4 The cancer has spread to another part of the body. This very rarely occurs with either squamous or basal cell cancers of the skin.

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      Further tests 4 years ago

      If you have a basal cell carcinoma, you probably won’t need any further tests as long as the cancer has been completely removed. This is because basal cell carcinomas almost never spread.

      If you have a squamous cell carcinoma, your doctor may want to examine you all over as well as taking a biopsy. This is to make sure that you don’t need any further treatment, as squamous cell carcinomas can occasionally spread.

      Further tests are particularly important if you’ve had treatment for skin cancer before and it has come back (recurred). During the physical examination, your doctor will probably feel the lymph nodes close to the cancer to see if any of them are enlarged.

      Rarely, your doctor may recommend that you have an operation to sample some of the nearby lymph nodes if they think there’s a risk that the cancer has spread to them. Very occasionally, ultrasound, CT or MRI scans are done if your doctor thinks there’s a possibility that the cancer has begun to spread. These scans are not usually needed when you are first diagnosed. Your doctor will explain these tests to you if necessary.

      It may take 1-2 weeks for the results of your tests to be ready. Waiting for your results can be a difficult time. It may help to talk things over with a relative or close friend. You may want to call our cancer support specialists, or contact other support organisations.

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      Biopsy 4 years ago

      The dermatologist will be able to tell a great deal from a simple examination of the affected area of skin, possibly using an instrument called a dermatoscope. However, it’s not always possible to tell the difference between skin cancers and benign (non-cancerous) conditions by examination alone, so you may be advised to have a tissue sample (biopsy) done.

      This is a quick and simple procedure, which can usually be done in the outpatient department using a local anaesthetic. The doctor will remove all or part of the affected area and send it to the laboratory where it will be examined under a microscope by a pathologist.