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    Understanding Skin Cancer -- Diagnosis and Treatment

    How Do I Know If I Have Skin Cancer?

    All potentially cancerous skin growths must be biopsied to confirm a cancer diagnosis. Depending on the suspected type of skin cancer, the biopsy techniques vary slightly but crucially.

    Any potential melanoma requires a surgical biopsy, in which the entire growth is removed with a scalpel if possible. A pathologist then studies the sample under a microscope to determine whether cancer cells are present.

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    If melanomais diagnosed, other tests may be ordered to assess the degree of cancer spread (metastasis). They include:

    • Imaging. Your doctor will order one or more tests to look for metastasis. They include CT scan, MRI, PET scan, bone scan, and chest X-ray.
    • Other biopsies. Using a variety of techniques, your doctor may want to get tissue samples from lymph nodes.

    Skin growths that are most likely basal cell carcinoma, squamous cell carcinoma, or other forms of non-melanoma can be biopsied in various ways. Part or all of the growth can be taken with a scalpel for examination under a microscope.

     

    What Are the Treatments for Skin Cancer?

    Most skin cancers are detected and cured before they spread. Melanoma that has spread to other organs presents the greatest treatment challenge.

    Standard treatments for localized basal cell and squamous cell carcinomas are safe and effective and cause few side effects. Small tumors can be surgically excised, removed with skin scraping and electric current cauterization, frozen with liquid nitrogen, or killed with low-dose radiation.

    In rare cases where basal cell or squamous cell carcinoma has begun to spread beyond the local skin site, the primary tumors are first removed surgically. Then patients may be treated with radiation, immunotherapy in the form of interferon, and rarely, chemotherapy. However, responses to this therapy are infrequent and short-lived. Rare patients with advanced squamous cell carcinoma respond well to a combination of retinoic acid (a derivative of vitamin A) and interferon (a type of disease-fighting protein produced in labs for cancer immunotherapy). Retinoic acid may inhibit cancer recurrence in patients who have had tumors removed, but there is a lack of evidence to support either of these treatments. Vismodegib (Erivedge) may be used to treat the rare cases of locally advanced, or metastatic, basal cell carcinoma and has been shown to shrink these tumors. Sonidegib (Odomzo) can be used to treat patients with locally advanced basal cell carcinoma who are not candidates for surgery or radiation. It may also be used if the skin cancer returns after surgery or radiation.

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