What is malignant melanoma Expand Melanoma can be a serious disease in which cancer cells form in the skin. However, it does not always form in the skin. These are known as melanocytes (cells that colour the skin). Melanocytes make melanin, the pigment that gives skin its colour. They also form moles and it is known that having moles is a risk factor in melanoma.
Is there a cure for melanoma Expand When caught early, most melanomas can be cured after fairly minor surgery. In 80-90% of cases, melanoma can be removed with no recurrence. However, it can be more serious than the other forms of skin cancer, because it may spread (metastasise) to other parts of the body, for example, liver, lungs, brain etc. There is no doubt that it once melanoma has spread it can be very difficult to treat but a lot of research is being carried out into melanoma.
I don't have a good relationship with my consultant, can I change Expand Yes, you can ask to be referred elsewhere, but it is worth thinking about the travel if you are feeling ill. Most consultants understand your fears and will do their best to help you.
My melanoma is very thin and I've been told I'm stage 2, am I going to be ok Expand Keep all your medical appointments and be vigilant with your checks. We speak to many patients who have been at stage 2 for years - caught early enough melanoma can be treated successfully.
If my GP says everything is fine and I'm still not happy, what can I do Expand Ask your GP to refer you to a dermatologist. You know your skin better than anyone, and the skin of your child or partner. Make sure if you are concerned that your concerns are treated seriously.
What type of cancer is melanoma Expand There are three main types of skin cancer, basal cell carcinoma (BCC) squamous cell carcinoma (SCC), and melanoma. Melanoma is treated differently to other skin cancers.
I used to use sunbeds when I was much younger and I still like to sunbathe. I have been burned several times. Do I need to be worried Expand It is never advisable to use sunbeds or allow yourself to burn in the sun. Being burned can increase the chances of getting melanoma in later years. The thing to do now is realise the potential damage and start making changes. Avoid sunbeds and don't lie in the sun unprotected. Remember to use good quality high factor sunscreen, stay out of the sun when it is at its strongest and protect the delicate skin of children.
What should I look for when checking my skin Expand Unusual moles, any moles or skin lesions that are different to they were last time you checked. Moles that are bleeding, itchy, an odd shape or colour, raised, larger than normal and any skin issue you are not happy about.
What is a squamous cell carcinoma? Expand A squamous cell carcinoma is a type of skin cancer. There are two main types of skin cancer: melanoma and non-melanoma skin cancer. Squamous cell carcinoma (SCC) is a non-melanoma skin cancer (NMSC), and the second most common type of skin cancer in the UK. NMSC accounts for 20% of all cancers and 90% of all skin cancers. SCC accounts for 23% of all NMSC. What causes a squamous cell carcinoma? The most important cause is too much exposure to ultraviolet light from the sun or other sources. This can cause the DNA of skin cells (keratinocytes) in the outer layer of the skin (the epidermis) to change. Sometimes this alteration in DNA allows the skin cells to grow out of control and develop into an SCC. Ultraviolet light damage can cause SCC directly, or sometimes it can induce a scaly area called an actinic keratosis or Bowen’s disease. These can change into SCC if they are not treated. Squamous cell carcinomas can also develop in skin damaged by other forms of radiation, in burns and persistent chronic ulcers and wounds and in old scars. Certain human viral wart viruses can also be a factor. However, SCC itself is not contagious. Who is most likely to have a squamous cell carcinoma? The following groups of people are at greater risk of developing SCC: Immunosuppressed individuals (people with reduced immune systems) either due to medical treatment, such as methotrexate, ciclosporin and azathioprine, or due to diseases which affect immune function, including inherited diseases of the immune system or acquired conditions such as leukaemia or HIV; Patients who have had an organ transplant because of the treatment required to suppress their immune systems to prevent organ rejection People who are more susceptible to sunburn; People who have had significant cumulative ultraviolet light exposure, for example: people who have lived in countries near to the equator, or who have been posted to work in these countries, e.g. military personnel, construction workers; outdoor workers, such as builders, farmers; people of advanced years, who have had a lifetime of frequent sun exposure; People with skin conditions such as albinism and xeroderma pigmentosum that make them more susceptible to SCC. Are squamous cell carcinomas hereditary? No, they are not, but some of the risk factors, such as a tendency to burn in the sun, are inherited. What does a squamous cell carcinoma look like? SCC can vary in their appearance, but most usually appear as a scaly or crusty raised area of skin with a red, inflamed base. SCCs can be sore or tender and they can bleed but this is not always the case. They can appear as an ulcer. SCC can occur on any part of the body, but they are more common on sun exposed sites such as the head, ears, neck and back of the hands. How will my squamous cell carcinoma be diagnosed? If your doctor thinks that the lesion on your skin needs further investigation, you will be referred to a Dermatologist. To confirm the diagnosis, a small piece of the abnormal skin (a biopsy), or the whole area (an excision biopsy), will be removed using a local anaesthetic and sent to a pathologist to be examined under the microscope. The results will usually be available within a week to ten days. Can a squamous cell carcinoma be cured? The vast majority of SCCs are low risk skin cancers and can be cured. A small number can recur locally and/or spread (metastasise) to the lymph nodes or to other parts of the body. How can a squamous cell carcinoma be treated? Surgery is usually the recommended treatment. This involves removing the SCC with a margin of normal skin around it, using a local anaesthetic. The skin is then closed with stitches or sometimes a skin graft is needed. Sometimes other surgical methods are used such as curettage and cautery. This involves scraping the SCC away using local anaesthetic. Radiotherapy can also be used to treat SCC. This involves shining a beam of X-rays onto the skin. Usually several sessions are required. For advanced SCC, a combination of treatments may be used. For SCC that has spread to other parts of the body a combination of surgery, radiotherapy and/or chemotherapy may be used.
What is a basal cell carcinoma? Expand A basal cell carcinoma (BCC) is a type of skin cancer. There are two main types of skin cancer: melanoma and non-melanoma skin cancer. BCC is a non-melanoma skin cancer, and is the most common type (greater than 80%) of all skin cancer in the UK. BCCs are sometimes referred to as ‘rodent ulcers’. What causes basal cell carcinoma? The commonest cause is exposure to ultraviolet (UV) light from the sun or from sunbeds. BCCs can occur anywhere on the body, but are most common on areas that are exposed to the sun such as your face, head, neck and ears. It is also possible for a BCC to develop in a longstanding scar. BCCs are not infectious. BCCs mainly affect fair skinned adults, but other skin types are also at risk. Those with the highest risk of developing a basal cell carcinoma are: People with pale skin who burn easily and rarely tan (generally with light coloured or red hair, although some may have dark hair but still have fair skin). Those who have had a lot of exposure to the sun, such as people with outdoor hobbies or outdoor workers, and people who have lived in sunny climates. People who have used sun beds or have regularly sunbathed. People who have previously had a basal cell carcinoma. Are basal cell carcinomas hereditary? Apart from a rare familial condition called Gorlin’s syndrome, BCCs are not hereditary. However some of the things that increase the risk of getting one (e.g. a fair skin, a tendency to burn rather than tan, and freckling) do run in families. What does a basal cell carcinoma look like? BCCs can vary greatly in their appearance, but people often first become aware of them as a scab that bleeds and does not heal completely or a new lump on the skin. Some BCCs are superficial and look like a scaly red flat mark on the skin. Others form a lump and have a pearl-like rim surrounding a central crater and there may be small red blood vessels present across the surface. If left untreated, BCCs can eventually cause an ulcer; hence the name “rodent ulcer”. Most BCCs are painless, although sometimes they can be itchy or bleed if caught. How will my basal cell carcinoma be diagnosed? Sometimes the diagnosis is clear from the clinical appearance. A skin biopsy can be performed under local anaesthetic to confirm the diagnosis. Can basal cell carcinomas be cured? Yes, BCCs can be cured in almost every case, although treatment can be more complicated if the BCC has been neglected for a long time, or if it occurs in an awkward place, such as close to the eye or on the nose or ear. BCCs rarely spread to other parts of the body. Therefore, although it is a type of skin cancer it is almost never a danger to life. How can a basal cell carcinoma be treated? The commonest treatment for BCC is surgery. Usually, this means cutting away the BCC, along with some clear skin around it, using local anaesthetic injection to numb the skin. The skin can usually be closed with a few stitches, but sometimes a skin graft is needed. Other types of treatment include: Mohs micrographic surgery. This surgical procedure is used to treat more complex BCCs such as those present at difficult anatomical sites or recurrent BCCs. The procedure involves excision of the affected skin and examination of the skin removed under the microscope straight away to see if all of the BCC has been removed. If any residual BCC is left at the edge of the excision further skin is excised from that area and examined under the microscope and this process is continued until all of the BCC is removed. The site is then often closed with a skin graft. This is a time consuming process and is only undertaken when simple surgery may not be suitable. Radiotherapy - shining X-rays onto the area containing the BCC. Vismodegib – this is a type of chemotherapy that has recently become available for the treatment of very complex BCCs, e.g. locally advanced BCCs or the very rare BCC that has spread to other parts of the body. Superficial BCCs: - Curettage and cautery - the skin is numbed with local anaesthetic and the BCC is scraped away (curettage) and then the skin surface is sealed by heat (cautery). - Cryotherapy - freezing the BCC with liquid nitrogen. - Creams - these can be applied to the skin. The two most commonly used are 5-fluorouracil (5-FU) and imiquimod. - Photodynamic therapy - a special cream is applied to the BCC which is taken up by the cells that are then destroyed by exposure to a specific wavelength of light. This treatment is only available in certain dermatology departments (see Patient Information Leaflet on Photodynamic Therapy). Surgical excision is the preferred treatment, but the choice of other treatments depends on the site and size of the BCC, the condition of the surrounding skin and number of BCC to be treated (some people have multiple ) as well as the overall state of health of each person to be treated.