Skin Cancers

Melanoma occurs in the cells that color the skin. It may appear as a new growth or as a change in the size, shape or color of an existing mole.

Melanoma is the leading cause of skin cancer-related deaths, because it may spread to other areas of the body through the lymph or blood systems. Sixty to seventy percent of melanomas are discovered by the people who have them, so it is important to check the skin for moles that change in shape, size, color, or begin to itch or bleed.

Symptoms

Melanoma often starts as a small, mole-like growth. If you think a mole might be a melanoma, test its ABCDs.

• Asymmetry: One half does not match the other half.
• Border: The edges are irregular, ragged, notched or blurred.
• Color: The color is not the same all over, but may have differing shades of brown or black, sometimes with patches of red, white or blue.
• Diameter: The area is larger than a pencil eraser (or is growing larger).

Risk factors also include being an adult, having a family history, being fair skinned or having sun sensitivity, and having a suppressed immune system.

Treatments

The incidence of melanoma is rising in the United States but with treatment, 5 percent of early malignant melanoma is curable. When discovered early, melanoma may be treated effectively with surgical removal.

St. Luke’s team works to coordinate the full range of support services, including initial oncology consultations, immunotherapy treatment, surgery services, follow-up care, social services and counseling, nutritional counseling, symptom management, home health care, patient and family education and access to other necessary care.

The number of surgical, radiation and medical treatments for melanoma has greatly increased over the past 10 years. Along with surgery and chemotherapy, treatment options also include:

• Immunotherapy, or biological therapy
• Oncolytic viral therapies
• Ipilimumab (ip-ee-LIM-uh-mab)
• High-dose Interleukin-2 (IL-2)
• Interferon
• Sentinel lymph node biopsy (SNLB)
• Radiation therapy
• Promising new treatments and clinical trials.

For additional information on programs, services and locations, download and print the following PDFs:
St. Luke’s Radiation Oncology Program Guide
St. Luke’s Infusion Centers Guide

Basal cell carcinoma starts in the inner-most level of the epidermis and tends to grow slowly. It usually forms on sun-exposed areas and often appears as a small dome-shaped bump. If left untreated, it can invade other areas.

Squamous cell carcinoma develops on skin that has been exposed to the sun for years. It occurs in the skin's upper layers. This may appear as an open sore, an elevated growth with a central depression; or a wart. The site can crust and bleed. If left untreated, this can spread to other areas as well.

Symptoms

Skin cancer can result from damage caused by ultraviolet radiation from the sun or tanning beds. This damage can lead to the uncontrolled growth of abnormal skin cells, causing skin malignancies.

Skin cancers usually appear as changes to your skin, such as new growths or pre-cancerous lesions. While unusual skin growths may not start out as cancer, they could become cancerous over time so it is important to check your skin regularly for any changes. If you know you are at greater risk of developing skin cancer, make sure to get an annual skin evaluation with your primary physician or dermatologist.

Skin cancer prevention guidelines include:

• Limit sun exposure between the hours of 10 am and 4 pm when the sun's rays are the strongest.
• Cover up when in the sun; wear long-sleeved shirts, long pants and a hat that shades your face, neck and ears.
• Use sunscreen that protects against UVA and UVB rays and has a Sun Protection Factor (SPF) of 30 or higher.
• Do not use sunlamps or tanning booths, they are just as harmful as the sun when it comes to skin damage.

Treatments

Your physician may examine your skin to check for signs of skin cancer. If an unusual lesion or mole is found, a skin sample may be taken and sent for laboratory testing to determine if the skin abnormality is cancer, as well as the type of skin cancer.

For skin cancer that is limited to the surface of the skin, a biopsy to surgically remove the entire lesion may be the only treatment needed.

Further diagnostic tests and treatments may be recommended depending on the type and extent of the skin cancer and include:

• Cryosurgery: The freezing of early skin cancers using liquid nitrogen.
• Excisional surgery: Cut out the cancerous tissue and a margin of healthy skin surrounding the tumor.
• Moh's skin-sparing surgery: Tissue is examined layer-by-layer to check for signs of cancer upon surgical removal to spare as much healthy tissue as possible. This usually is recommended for larger, recurring or more difficult-to-treat skin cancers.
• Curettage: Scraping away layers of cancer cells once most of the growth is surgically removed. This is followed by electro-desiccation or cryotherapy to destroy any remaining cancer cells.
• Radiation therapy to remove any cancer that may remain following surgery.
• Laser light therapy
• Chemotherapy
• Immunotherapy or biological therapy

For additional information on programs, services and locations, download and print the following PDFs:
St. Luke’s Radiation Oncology Program Guide
St. Luke’s Infusion Centers Guide