Skin CancerFor three decades, Ray Parish has been an avid cyclist.“I ride about four to five times a week, and I average roughly 150 miles a week. Sometimes when I'm feelingreally energetic, I can get into 250 miles a week.” Ray, PatientThat adds up to lots of time outdoors. So, when a fellow cyclist and dermatologist suggested Ray start gettingroutine skin checks, he agreed.“There was one thing on the side of my neck that she had taken pictures of and measured. She took one look atit and she says, We're going to biopsy it."Ray, PatientA Biopsy, a test in which a sample of skin is removed and analyzed under a microscope, showed it was skin cancer.Skin cancer often forms in areas exposed to sunlight but can occur anywhere on the body. It begins in the epidermis,the outer layer of the skin.There are several different types of Skin cancer. Cancer that forms in the cells in the top layer of the epidermis iscalled Squamous Cell Carcinoma. Cancer that forms in the lower part of the epidermis is known as basal cellcarcinoma. These two types are sometimes called Nonmelanoma skin cancers. They’re typically curable, withtreatment depending on the size, location and type of cancer. Treatment methods include: Electrodessication andCurettage, or EDC for short, which involves removing the surface of the cancer with a scraping instrument, andthen applying an electric needle to the base of the cancer. Cryotherapy, in which the growth is frozen with liquidnitrogen. Topical creams and ointments applied to the skin, Laser therapy, which uses an intense beam of light andPhotodynamic Therapy, which combines topical drugs with light.Or doctors may use a procedure called an Excision, in which the skin is numbed, and the cancer surgically removedalong with some healthy skin around it. A more precise type of surgery, known as Mohs surgery, involves removinglayers of tissue one by one and examining them under a microscope. This allows the doctor to remove all the cancer,and as little healthy tissue as possible.“Mohs micrographic surgery has the highest cure rate for skin cancer.” Terry Cronin, MD, DermatologistMelanoma is a less common but more serious type of skin cancer. It forms in Melanocytes, the cells that give skin itscolor.“If you can get a melanoma early when it's shallow, you really are going to have a great prognosis. But if it'signored or not recognized, it can spread to your lymph nodes, and metastasize throughout your body.” TerryCronin, MD, DermatologistDoctors assign melanoma a stage based on three pieces of information: T stands for the tumor… its location,Page 1 of 2This program is for informational purposes only. Publisher disclaims all guarantees regarding the accuracy, completeness,or suitability of this video for medical decision making. For all health related issues please contact your healthcare provider.HCON1003498 EN SkinCancer.pdf© The Wellness NetworkSkin Cancersize, and how much it has grown. N refers to whether it has spread to nearby lymph nodes. And M indicateswhether the Melanoma has metastasized or spread to other parts of the body. For each of these categories,doctors give a number ranging from 0 to 4. The higher the number, the more advanced the cancer is.“If you catch the melanoma early and it's just a T1, N0, M0, meaning no nodes, no metastasis, then surgeryusually is enough to take care of it.” Terry Cronin, MD, DermatologistThat was the case for Ray. His melanoma was detected early, and his doctor treated it successfully with surgery.“He said the prognosis was good.”Ray, PatientWhen cancer has spread to the lymph nodes, doctors typically remove them as well as the tumor. Othertreatments may be used along with surgery or by themselves if the cancer can’t be removed surgically. Theseinclude: Immunotherapy, which uses the body’s immune system to fight the cancer; Targeted therapy, whichtargets substances that help cancer cells grow and spread; Radiation, which uses highenergy xrays to destroycancer cells; And chemotherapy, which kills cancer cells throughout the body.“All right, now I’m feeling your skin.”Once you’ve had skin cancer, it may come back after treatment and you’re at increased risk of additional skincancers, so followup visits with your doctor are crucial. It’s also important to perform selfexams at home.“You shouldn’t be embarrassed to show your dermatologist anything. It’s important that you do.” TerryCronin, MD, DermatologistHaving melanoma hasn’t stopped Ray from enjoying his favorite outdoor activities. But he’s now careful toprotect his skin.“Instead of wearing shorts when I go fishing, I'll wear a long sleeve shirt. I will use a sunscreen. And a hat.It's your life you're playing with.”Ray, PatientPage 2 of 2This program is for informational purposes only. Publisher disclaims all guarantees regarding the accuracy, completeness,or suitability of this video for medical decision making. For all health related issues please contact your healthcare provider.HCON1003498 EN SkinCancer.pdf© The Wellness Network