How Is Skin Cancer Diagnosed?

Melanoma may show up as a change in the size, color, texture, or shape of a mole or other darkly pigmented area. Bleeding from a mole that is not the result of a scratch or other injury may also be a warning sign of cancer. Nonmelanoma can be hard to tell from normal skin. The most important warning signs are a new growth, a spot or bump that seems to be growing larger (over a few months or a year or two), oг a sore that does not heal within three months.

When either melanoma or nonmelanoma is suspected, the doctor will take a sample (biopsy) of the abnormal tissue for examination under the microscope.

How Is Skin Cancer Treated?

The first step in treating skin cancer is to stage it, that is, to determine whether and how far it might have spread. Staging a cancer is an important step in choosing the best treatment. It also helps to determine the patient's prognosis (outlook for survival). The most common system for describing skin cancer, assigns five stages: 0, I, II, III, and IV. So, for example, stage 0 means the cancer has not spread beyond the tissue beneath the skin; stage IV means that the cancer has spread to other organs such as the lung, liver, or brain, and is less likely to be curable.

Fortunately, most nonmelanoma can be completely cured by a variety of types of surgery depending on the size of the cancer and where it is. If a squamous cell cancer appears to have a high risk of spreading, surgery may sometimes be followed by radiation, which uses high-energy rays to kill cancer cells, or chemotherapy (kee-mo-THER-a-pee), which uses anticancer drugs that can be injected into a vein in the arm or taken as tablets. For some precancerous conditions, chemotherapy may simply be placed directy on the skin as a cream.

Treatment for melanoma includes surgery and chemotherapy. Radiation therapy is not usually used to treat the original melanoma that developed on the skin.

How Is Skin Cancer Prevented?

A popular anti-skin cancer slogan in Australia states: "Slip on a shirt. Slap on a hat. Slop on some sunscreen. Seek shade." The most important way of lowering the risk of nonmelanoma is to stay out of the sun. Sunscreen does not seem to prevent melanoma. This is especially important in the middle of the day, when sunlight is most intense. Because no one wants to stay indoors all day, children and adults can protect their skin by covering it with clothing and by using a sunscreen. The sunscreen should protect users from both UVA and UVB radiation. It should have a skin protection factor (SPF) of at lease 50 on areas of the skin that are exposed to the sun. Wide-brimmed hats and wrap-around sunglasses with 99 to 100 percent ultraviolet absorption help to protect the eyes. Tanning booths should be avoided.

What Skin Cancer Research Has Been Conducted?

Scientists have made enormous progress in understanding how ultraviolet light damages DNA and how DNA changes cause normal skin cells to become cancerous. In addition, rescarchers have explored ways of treating skin cancers by enlisting the patient's immune system (the body's defenses against tumors and infection) to fight cancer cells.

One possible treatment involves the immune system. The goal of this approach is to recognize and then attack cancerous cells. Other immu-notherapies were anticipated to treat melanoma. As of 2009, much more work remained before therapies could be used by the general public. In June 2008, researchers in Israel announced they had developed a new vaccine that decreases recurrence of melanoma in prior sufferers and increases survival among the current ones. Plans were in place for further tests on this treatment.

Living with Skin Cancer

The most important fact to remember about skin cancer is that most of it is preventable. It is never too late for people to begin to protect their skin. Because a person who has had one skin cancer is at risk for another one, monthly self-examinations should become part of a routine. Cancer is most likely to recur (that is, to come back) in the first five years after treatment. Individuals who love being in the sun must take steps to protect their skin from more exposure. But except for staying out of the sun, almost everyone with skin cancer can go back to the life they had before they got cancer.

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