Moles, Warts & Skin Tags Removal
Skin Cancer: The most common of these cancers include; malignant melanoma,
basal cell carcinoma, and squamous cell carcinoma.
Malignant melanoma: A cancer that arises from melanocytes ( the cell which
produces the melanin – synthesizing ). More common between the ages of 45 and
55.
There is 3 type of melanoma: 1.) superficial spreading melanoma, 2.) nodular
malignant melanoma, and 3.) lentigo malignant melanoma.
Melanoma spreads through the lymphatic and vascular systems and metastasizes to
the regional lymph nodes, skin, liver, lungs, and the CNS ( central nervous system ).
Superficial lesions are usually curable, while deeper lesions tend to metastasize
(transfer of disease from one organ or part of the body to another). Prognosis varies
with tumor thickness. Prognosis is better for a tumor on an extremity (which is
drained by one lymphatic network) than for one on the neck, head, or trunk ( drained
by several networks)
The cause of malignant melanoma is unknown. Risk factors include, a family history
of melanoma, excessive sunlight exposure, skin type ( more common with those who
have blond or red hair, fair skin, and blue eyes), and history of severe sunburns.
Pregnancy may increase risk and exacerbate tumor growth.
Symptoms:
Suspect melanoma when any skin lesion or nevus ( a circumscribed stable
malformation of the skin and occasionally of the oral mucosa) is enlarge, if it changes
color, becomes inflamed and or if it is sore, itches, ulcerates, bleeds, change texture, or
shows signs of surrounding pigment regression.
* Superficial Spreading melanoma: Most common type.
Characteristics; red, white, and blue color over a brown or black background
Irregular, notched margins
Irregular surface
Small, elevated tumor nodules that may ulcerate and bleed.
May have a horizontal growth pattern.
* Nodular malignant melanoma: It usually metastasizes early. Usually grows
vertically and invades the dermis. May be grayish, resembling a blackberry.
Occasionally, it may match the skin color. It may have pigment flecks around the
base, which may be inflamed.
* Lentigo malignant melanoma: Rare type. Usually develops over many years
from a lentigo maligna on an exposed skin surface. The lesion usually looks like a
large ( 2.5 to 6.4 cm ), flat freckle. Color range from, white, slate, tan, brown, and
black. It may have scattered black nodules on the surface and may become
ulcerated.
Diagnostic test: May include: physical examination, skin biopsy, lab studies, CT scan,
X-ray
Treatment:
Wide surgical resection is imperative for malignant melanoma. The extent of resection
depends on the size and location of the primary lesion.
Surgery may also include regional lymphadenectomy.
Chemotherapy with DTIC and cisplatin, and biotherapy with interferons or interleukin
-2 to eliminate or reduce the number of tumor cells, for deep primary lesions.
Radiation therapy is usually reserved for metastatic disease. Prognosis depends on
tumor thickness.
* Call your doctor if you suspect any of the above symptoms promptly.
Basal cell carcinoma: This is a slow growing destructive skin tumor. The exact
cause is unknown, but precipitating factors include prolonged sun exposure, arsenic
ingestion, radiation exposure, burns, and very rare,- vaccinations. It is more common
with those with blond, fair skinned, white males. There is three types of basal cell
carcinoma, 1.) noduloulcerative, 2.) superficial, and 3.) sclerosing basal cell
epitheliomas.
Symptoms:
* Noduloulcerative basal cell epitheliomas – occur most often on the face, particularly
on the forehead, eyelid margins, and nasolabial folds.
Early stage – lesions are usually small, smooth, pinkish translucent papules with
telangiectatic (a vascular lesion formed by dilation of a group of small blood vessels)
vessels on the surface and occasional pigmentation.
Late stage – lesions are enlarged, with depressed centers, firm and elevated borders.
They eventually become ulcerated becoming locally invasive. Ulcerated tumors rarely
metastasize. These occur if late stage lesions are not treated. If left untreated, they
can spread to vital areas and become infected, and invade bone, or cause massive
hemorrhage if they invade large blood vessels.
* Superficial basal cell epitheliomas – occur most often on the chest and back and
appear as oval or irregularly shaped, light pigmented plaques with sharply defined,
slightly elevated thread – like borders. They may be scaly with small atrophic areas in
the center that resemble psoriasis or eczema. Such lesions are usually chronic and
noninvasive.
* Sclerosing basal cell epitheliomas – occur on the head and neck. they appear as
waxy, sclerotic, yellow to white plaques without distinct borders and often resemble
small patches of scleroderma.
Diagnostic test: physical examination, biopsy and family history.
Treatment:
Treatment varies depending on size, location and depth of the lesion.
Treatment may include curettage and electrodesiccation for small lesion.
Chemotherapy with topical 5 – fluorouracil
Surgical excision, irradiation, or Moh’s microsurgery
* Regular follow up with your doctor is important
Call your doctor if you have any of the above symptoms.
Squamous cell carcinoma: The skin cancer is an invasive tumor with metastatic
potential. It may be caused by overexposure to ultraviolet rays, X – ray therapy,
chronic skin irritation and inflammation, ingestion of herbicides containing arsenic, and
exposure to local carcinogens such as tar, and oil. Risk factors include being white
male, and over age 60. Those who work outdoors and are expose to the sun, those
who have a pre malignant lesion. Squamous cell carcinoma commonly develops on
sun damaged areas of the skin.
Symptoms:
A nodule growing on a firm indurated base, there may be some ulceration at the lesion
site ( if carcinoma develops in normal skin )
A pre malignant, preexisting lesion may be inflamed and indurated. Metastasis to
regional lymph nodes may cause pain, malaise, fatigue, weakness, and anorexia
Diagnostic test – Excisional biopsy of the lesion confirms the diagnosis
Treatment:
Depending on the lesion, treatment may consist of wide surgical excision or
electrodesiccation and curettage.
Radiation therapy ( usually used for older or debilitated patients)
Moh’s surgery also may be indicated.
* Regular follow up with your doctor is important
Call your doctor if you have any of the above symptoms.
Cancer treatments seek to destroy malignant cells while sparing normal ones, to
reduce pain, and to induce cure or remission. A single primary treatment or a
combination of treatments may be used. These treatments can provide local and
systemic therapy and offer doctors the advantage of attacking cancer cells with
several mechanisms. They include:
* Chemotherapy – which interrupts malignant cells life cycles, inhibiting or destroying
their ability to divide
* Radiation – which also inhibits cell division by impairing DNA synthesis and causing
cell membrane lysis. Radiation can be used as a primary treatment or as an adjunctive
procedure intended to kill cancer cells that may have survived other treatments.
* Biotherapy ( immunotherapy ), which employs biological response modifiers that
act on malignant cells by inhibiting division and by enhancing the body’s immune
responses to such cells.
* Bone marrow transplantation, which is used to replace or replenish the bone
marrow of patients with leukemia or multiple myeloma
* Surgery, which removes tumors or reduces their size. Surgery enables other
treatments because there are fewer malignant cells to combat.
* Several new cancer treatments are emerging. surgical treatments using lasers and
intraoperative radiation can effectively remove tumors or reduce their size at the time
of initial surgery and staging. Hyperthermia – the use of heat to destroy cancer cells is
being investigated as a single modality and in combination with radiation and
chemotherapy.