Skin cancers are generally a result of overexposure to the sun. While skin cancers are the most common form of cancer, many types are both preventable and treatable. Skin cancer is classified into five different types:
- Basal cell carcinoma (BCC) is the most common form and accounts for 75% of all skin cancers. It originates in the basal cells, at the bottom of the epidermis (outer skin layer), and is caused by long-term exposure to sunlight.
- Squamous cell carcinoma (SCC) is the second most common type, accounting for 20% of all skin cancers. It originates in the epidermis, eventually penetrating the underlying tissue if not treated. In a small percentage of cases, this cancer metastasizes, or spreads, to other parts of the body.
- Malignant melanoma (MM) is a form of skin cancer that currently is affecting an increasing number of people. There are more than 40,000 new cases of malignant melanoma annually in the U.S., resulting in more than 7000 deaths. MM is a very serious type of skin cancer, but the cure rate is quite good if it is diagnosed and removed early. MM originates in moles or other growths on normal skin.
- Paget's disease (PD) is a rare type of skin cancer. It generally appears on the nipple, and is associated with an underlying breast cancer. It may also appear in the groin or near the anus, possibly originating in the sweat glands.
- Kaposi's sarcoma (KS) is caused by a virus in the herpes family. An aggressive AIDS-related form affects about one third of AIDS patients. A more slow growing form occurs in elderly men of Italian or Jewish ancestry.
Signs and SymptomsSkin cancer is accompanied by the following signs and symptoms:
- A new skin lesion or open sores that bleed, ooze, or crust, and fail to heal in an expected time frame
- Enlargement of an existing skin lesion
- Change in color of a mole
- Reddish patch or irritated area, frequently occurring on the chest, shoulders, arms, or legs
- Shiny bump that is pearly or translucent
- Poorly defined borders of a skin lesion
What Causes It?The primary cause of skin cancer is exposure to ultraviolet (UV) radiation from the sun. KS, as stated earlier, is caused by a virus, and Paget's disease is related to underlying breast cancer.
Who's Most At Risk?People with the following conditions or characteristics are at risk for developing skin cancer:
- Light skin color
- Spending a lot of time outdoors in work and/or leisure activities
- History of severe sunburn
- Family history of skin cancer
- Large dark-colored birthmark known as congenital melanocytic nevus
- Certain non-cancerous skin conditions, such as actinic keratosis, can predispose a person to skin cancer
- HIV (human immunodeficiency virus) is a risk for KS specifically
What to Expect at Your Provider's OfficeYour healthcare provider will thoroughly examine your skin for new, changed, or unusual moles. This may involve the use of a dermatoscope, which is used for close examination of such skin growths. If any growths appear cancerous, a biopsy will be done. This involves removing a small piece of skin for microscopic examination. A biopsy can confirm whether or not you have skin cancer.
PreventionSkin cancer is a preventable disease. If you are in a high-risk category, take measures to avoid sun exposure and, when in the sun, to protect yourself by covering up, wearing a hat, and applying sunscreen with an SPF of at least 30. It is also wise to have regular skin cancer screenings with your primary healthcare provider or a dermatology specialist.
Treatment PlanThe primary goals of treatment are to remove the cancerous growth(s) and stop the spread of the disease.
Drug TherapiesMelanoma that is deep or has spread, and AIDS-related Kaposi's sarcoma, may be treated with chemotherapy.
Surgical and Other Procedures
- Most skin cancer can be surgically removed
- Where surgery is not possible, cryotherapy (freezing) may be used
- Paget's disease of the nipple usually requires mastectomy (removal of breast tissue)
Complementary and Alternative TherapiesEating certain foods or following therapeutic diets may help prevent skin cancer. While many CAM treatments have not yet undergone rigorous scientific research, studies that have been conducted and clinical experience suggests that these treatments may be useful when applied along with conventional methods for the treatment of skin conditions including skin cancer.
It is difficult to test the role of nutrients in protecting against various forms of skin cancer. However, a number of scientific studies have investigated the role of such nutrients as antioxidants (including vitamin C, beta-carotene, selenium, and vitamin A), folic acid, fats and proteins specifically, and a variety of whole foods. While results are not absolutely clear, there appears to be some protective effect from antioxidants and from certain foods such as fish, beans, carrots, chard, pumpkin, cabbage, broccoli, and vegetables containing beta-carotene and vitamin C. Lignans, substances found in foods such as soy and flaxseed, may also be beneficial in fighting cancer in general, including the spread of melanoma from one part of the body to another, as demonstrated in animals.
Therapeutic diets may also help with skin cancer. Gerson's diet, which is customized for each patient, is one of these. Although more research is necessary, there are some preliminary reports suggesting that this diet may enhance treatment of melanoma. Common measures in the Gerson's diet include low salt and low fat intake, highly concentrated nutrients given through hourly feedings throughout the day of raw fruit and vegetable juices, and strategies to speed up metabolism (the breakdown and use of food), such as exercise, taking supplements, and restricting calories. Castor oil, administered every other day for several weeks, and coffee enemas given as frequently as every 4 hours over a 24-hour period, are thought to alleviate pain and improve nutritional status.
Naturopathic doctors and botanists recommend a number of herbs and herbal combinations to prevent and treat cancer in general. To identify appropriate herbs to use in your treatment for skin cancer, see a trained herbalist, who will consider your condition and may prescribe herbs to support your care.
Green tea (Camellia sinensis) contains polyphenols, compounds that are potent antioxidants. Antioxidants eliminate free radicals, harmful by-products of cells' metabolism that are thought to play a role in cancer. The main polyphenol in green tea is epigallocatechin gallate (EGCG). Scientific studies suggest that EGCG and green tea polyphenols may prevent the onset and growth of skin tumors.
For Kaposi's sarcoma, some naturopaths recommend a paste made from lemon balm (Melissa officinalis) cream, several drops of Hoxsey-like formula (a mixture of herbs and potassium iodide thought to be effective against cancer), and powdered turmeric applied to lesions twice a day.
An animal study conducted in China investigated the effects of Cordyceps sinensis on natural killer cells (NK). NK are white blood cells that attack cancer and other harmful substances in the body. This study found that Cordyceps sinensis was effective against malignant melanoma by promoting NK activity and inhibiting tumor formation.
Homeopathy is widely used among patients with melanoma, and warrants scientific investigation. An experienced homeopath considers your individual case and recommends treatments that address both your underlying condition and any current symptoms.
While acupuncture is not used as a treatment for cancer itself, evidence suggests it can be a valuable therapy for cancer-related symptoms (particularly nausea and vomiting that often accompanies chemotherapy treatment). There have also been studies indicating that acupuncture may help reduce pain and shortness of breath. Acupressure (pressing on rather than needling acupuncture points) has also proved useful in controlling breathlessness; this is a technique that patients can learn and then use to treat themselves.
Some acupuncturists prefer to work with a patient only after the completion of conventional medical cancer therapy. Others will provide acupuncture and/or herbal therapy during active chemotherapy or radiation. Acupuncturists treat cancer patients based on an individualized assessment of the excesses and deficiencies of qi located in various meridians. In many cases of cancer-related symptoms, a qi deficiency is usually detected in the spleen or kidney meridians.
Massage is generally not recommended for those who have been diagnosed with skin cancer.
Prognosis/Possible ComplicationsPrognosis varies depending on the type of skin cancer, as follows:
- Basal cell carcinoma: generally excellent
- Squamous cell carcinoma: excellent for small lesions removed early and completely
- Malignant melanoma: 5-year survival is almost 100 percent for very superficial lesions removed early; however, thick lesions and melanoma that has spread to other organs have poor prognosis
- Paget's disease: depends on the extent and cell type of the underlying breast cancer
- Kaposi's sarcoma: good for superficial lesions of the slow-growing form in the elderly of Italian or Jewish ancestry; the course of AIDS-related KS depends on the status of the person's immune system
Following UpSee your provider regularly for screenings to check for a recurrence of skin cancer.
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