Excision of Melanoma, Basal Cell, and Squamous Cell Cancer

Melanoma

Melanoma is a type of skin cancer that begins in cells in the skin called melanocytes. Melanocytes are pigment producing cells in the skin, hair and eye that determines their color. The pigment that melanocytes produce is called melanin.

How do I know if a skin lesion is cancerous?

A thorough and regular self-examination is key to the early detection of skin cancers. Early warning signs of skin cancers include:

  • Growth of new moles
  • Existing moles or lesions that begin to grow larger

Cancerous lesions can be specifically detected using the ABCDE rule, which is:

  • A – Asymmetry
  • B – Border: uneven, notched or scalloped borders
  • C – Color: different shades of a color or different colors
  • D – Diameter: diameter larger than 6 mm
  • E – Evolving: change in size, shape or color, bleed, itch or don’t heal

It is the most common type of skin cancer and is the leading cause of death from skin disease. Melanoma begins on the surface of the skin and can grow down into the skin reaching the blood vessels and spread around the body. It can occur anywhere on the skin, eyes, mouth or the internal organs and the disease affects people of all ages.

Causes of skin cancer

Skin cancer is caused by exposure to large quantities of sun radiation particularly the ultraviolet radiation. This may start a change in skin cells (melanocytes) that eventually turns them into melanoma cells.

Risk factors for developing melanoma

  • Frequent sun exposure
  • Fair sun sensitive skinned people
  • History of sunburns
  • Reduced Immunity
  • Irregularly looking moles that are larger in size
  • Previous history of melanoma
  • Older age
  • Hereditary conditions

Signs and Symptoms of Melanoma

Melanoma is often painless and usually produces the following signs:
The first sign is a change in size, shape and color of an existing mole. It may also appear as a new irregular mole. It may appear black or blue black in color. They are typically located on the back, the shoulders or the back of the legs. They often have an irregular border and uneven colors. Skin may become reddish or swollen and may be painful.

Treatment of Melanoma

Surgical treatment: This is the standard treatment for melanoma. Wide surgical excision is done for removal of the tumor along with surrounding normal skin, depending on the depth of the melanoma.

A sentinel lymph node biopsy may be performed to see if the cancer has spread to the lymph nodes.

Basal Cell Carcinoma

Basal cell carcinoma is the most common form of skin cancer. About 80% of skin cancer cases are found to be basal cell carcinoma. It can look like a small pearly nodule or pinkish patch on the skin. It can also appear as a sore that seems to heal but returns repeatedly or as yellowish waxy scar. It develops as a result of short-term exposure to harmful UV rays on the sun-exposed areas such as the face, ears, scalp, neck and trunk. These cancers grow slowly and rarely spread to other parts of the body.

MelanomaBasal Cell Cancer

Squamous Cell Carcinoma

About 16% of skin cancers are squamous cell carcinoma. Squamous cell carcinoma develops most often in middle-aged and elderly people with fair complexions and people who have had long-term exposure to sun rays. It appears as a crusted or scaly area over the skin. It is most commonly seen on sun-exposed areas of the body.

Causes

Sun exposure is the most common cause of skin cancer. Exposure to the sun’s ultraviolet (UV) rays damages the DNA in the skin cells. When your body fails to repair the damaged DNA which has occurred with chronic sun exposure, cancer develops.

Warning Signs

Sores that do not heal or sores that grow larger and turn into tumors. Sores or tumors in or around the body openings should be watched carefully as these can behave aggressively.

Treatment

Dermatologists diagnose skin cancer by physical observation of the shape, size, color and texture of an affected or suspicious area. They may also order a skin biopsy where a piece of skin from the affected area is removed and observed under a microscope for the presence of cancer cells. They may also perform various tests to exclude other causes for the lesions.

Your dermatologist considers various factors before initiating treatment such as the type, location, severity or aggressiveness of the cancer and the patients’ age and condition. There are several treatment options available to treat skin cancers.

Surgical therapy

  • Curettage and desiccation: Curettage involves scooping out the cancer mass with the help of a spoon–like instrument called a curette. Desiccation is then done by applying an electric current to control the bleeding and kill the remaining cancer cells.
  • Surgical excision: removal of the entire tumor mass.
  • Radiation therapy: This treatment uses high energy radiation to damage the cell’s DNA. It is usually used to treat cancer which has spread to organs and cancer in areas that are difficult to treat surgically.
  • Cryosurgery: In this technique, liquid nitrogen is applied to freeze and kill the abnormal cancer cells.
  • Laser surgery: Cancer cells are destroyed and their growth is arrested using laser beams.
  • Mohs micrographic surgery: Also known as ‘microscopically controlled excision’. In this method the surgeon removes a small piece of the tumor mass and examines it under the microscope during surgery. The procedure of removing and examining continues until the cancerous growth is removed and the skin sample is free of cancer cells. It is preferred for large tumors that recur after previous treatment. This would be done by a specialist in Mohs surgery.