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Warning Signs of Skin Cancer

After a summer that many people spend outdoors, doctors say it is important to check for changes to your skin that could be signs of skin cancer. Dr. Anna Paré of Dermatology Consultants appeared on Good Day Atlanta to discuss what people should know about skin cancer.

Skin cancer is the most common form of human cancer. It is estimated that over one million new cases occur every year. The annual rates of all skin cancer are increasing, representing growing public concern. According to the American Academy of Dermatology, one of the five Americans will develop some form of skin cancer in their lifetime.

What is the most common warning sign of skin cancer?
The most common sign is a change in or appearance of a new or a non healing growth.
What are the main causes of skin cancer?
Excessive sun exposure is the number one cause of skin cancer. UV rays can alter the genetic material in skin cells, causing mutations. Other sources of UV light, such as tanning booths, sunlamps, and X-Ray can also cause the damaging effects.
What are the types of skin cancer?
The term ‘skin cancer’ refers to three different conditions. From the least to the most dangerous they are: Basal cell carcinoma (BCC), Squamous cell carcinoma (SCC), and Malignant Melanoma (MM). BCC and SCC are the most common forms (BCC represents 80% of all forms of skin cancer), referred often as non melanoma skin cancers. MM is the most serious form of skin cancer because it tends to spread or metastasize.
How are skin cancers diagnosed?
To make a diagnosis, a dermatologist will usually remove all or part of a growth by performing a biopsy. The skin that is removed is than examined by a pathologist and a specific diagnosis, which determines treatment, is made.
What are the methods of treatment?
For the non melanoma skin cancers the common forms of treatment include:

  • Curettage and Desiccation (scooping out the lesion with a curette and cauterizing to control bleeding and kill the remaining cancer cells. Good for small BCCs and SCCs on trunk and extremities)
  • Surgical excision (the lesion is cut out and stitched up)
  • MOHS micrographic surgery (microscopically controlled excision, during which a surgeon removes as little as possible of normal tissue. This method has very high cure rates and is used for large, recurrent tumors or tumors located on the face and scalp)
  • Medical therapy using creams that attack skin cancer cells with 5-fluorouracil or stimulate the immune system with Imiquimod. These are appropriate for small and superficial skin cancers.
  • Radiation therapy
  • Cryosurgery with Liquid Nitrogen
  • Photodynamic therapy with Levulan
Are there any new medical breakthroughs in treatment of skin cancer?
Actually there are. They have to do with treatment of advanced metastatic MM.
What is MM?
Melanoma is a cancer that develops from melanocytes, pigment producing cells. It is the most serious type of skin cancer because it can metastasize and cause serious illness and death. About 50000 new cases of melanoma are diagnosed in the US each year.
How is MM treated?
In general, MM is treated by surgery. They extend of excision is determined by the tumor thickness and may occasionally require removal of nearby lymph nodes. For advanced metastatic disease immunotherapy maybe necessary.
What is the breaking news in the treatment of advanced metastatic MM?
The FDA, on August 17, 2011, has announced the approval of Vemurafenib ( Zelboraf). It is the second therapy to prolong lives of patients of advanced metastatic disease. Clinical trials have shown that Vemurafenib can produce rapid remission patients with stage 3 or 4 unresectable MM. The pill based drug targets a specific gene ( mutation form of BRAF protein) and works by blocking the mutated form of the protein, slowing the tumor growth. The first therapy of that kind, a slow acting immunotherapy drug called ipilimumab ( Yervoy) was approved in March of 2011. For the first time, physicians have two new drugs that can prolong the lives of patients with advanced melanoma.