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Table of Contents > Conditions > Skin Cancer
Skin Cancer
Also Listed As:  Cancer, Skin
 
Signs and Symptoms
What Causes It?
Who's Most At Risk?
What to Expect at Your Provider's Office
Treatment Options
Prevention
Treatment Plan
Drug Therapies
Surgical and Other Procedures
Complementary and Alternative Therapies
Prognosis/Possible Complications
Following Up
Supporting Research

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 Symptoms

Skin 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 Office

Your 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.


Treatment Options
Prevention

Skin 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 Plan

The primary goals of treatment are to remove the cancerous growth(s) and stop the spread of the disease.


Drug Therapies

Melanoma 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 Therapies

Eating 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.


Nutrition

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.


Herbs

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

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 andany current symptoms.


Acupuncture

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

Massage is generally not recommended for those who have been diagnosed with skin cancer.


Prognosis/Possible Complications

Prognosis 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 Up

See your provider regularly for screenings to check for a recurrence of skin cancer.


Supporting Research

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Alimi D, Rubino C, Leandri EP, Brule SF. Analgesic effects of auricular acupuncture for cancer pain [letter]. J Pain Symptom Manage. 2000;19(2):81-82.

Bain C, Green A, Siskind V, Alexander J, Harvey P. Diet and melanoma: an exploratory case-control study. Ann Epidemiol. 1993;3:235-238.

Beers MH, Berkow R, eds. The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck & Co.; 1999:842-849.

Birt DF, Pelling JC, Nair S, Lepley D. Diet intervention for modifying cancer risk. Prog Clin Bio Res. 1996;395:223-234.

Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, Mass: Integrative Medicine Communications; 1998:107,169-170,491.

Boik J. Cancer & Natural Medicine: A Texbook of Basic Science and Clinical Research. Princeton, Minn: Oregon Medical Press; 1996:64, 66,67,76.

Brinker F. The Hoxsey treatment: cancer quackery or effective physiological adjuvant? J Naturopathic Med. 1996;6(1):9-23.

Combs GF Jr, Clark LC, Turnbull BW. Reduction of cancer risk with an oral supplement of selenium. Biomed Environ Sci. 1997;10(2-3):227-234.

Eisenberg D. Alternative therapies for cutaneous disorders. Arch Dermatol. 1997;133(3):379-380.

Ezzo J, Berman B, Hadhazy VA, Jadad AR, Lao L, Singh BB. Is acupuncture effective for the treatment of chronic pain? A systematic review. Pain. 2000;86:217-225.

Ferrini RL, Hill LM. American College of Preventive Medicine practice policy statement: screening for skin cancer. Am J Prev Med. 1998;14:80-86.

Filshie J, Penn K, Ashley S, Davis CL. Acupuncture for the relief of cancer-related breathlessness. Palliat Med. 1998;10:145-150.

Frieling UM, Schaumberg DA, Kupper TS, Muntwyler J, Hennekens CH. A randomized, 12-year primary-prevention trial of beta carotene supplementation for nonmelanoma skin cancer in the Physicians' Health Study. Arch Dermatol. 2000;136(2):179-184.

Gensler HL. Prevention of photoimmunosuppression and photocarcinogenesis by topical nicotinamide. Nutr Cancer. 1997;29(2):157-162.

Greenberg ER, Baron JA, Stukel TA, et al. A clinical trial of beta carotene to prevent basal-cell and squamous-cell cancers of the skin. The Skin Cancer Prevention Study Group. N Engl J Med. 1990;323(12):825-827,789-795.

Hildenbrand GLG, Hildenbrand LC, Bradford K, Cavin SW. Five-year survival rates of melanoma patients treated by diet therapy after the manner of Gerson: a retrospective review. Altern Ther Health Med. 1995;1(4):29-37.

Katiyar SK, Ahmad N, Mukhtar H. Green tea and skin. Arch Dermatol. 2000;136(8):989-94.

Kirkpatrick CS, White E, Lee JA. Case-control study of malignant melanoma in Washington State. II. Diet, alcohol, and obesity. Am J Epidemiol. 1994;139:869-880.

Kune GA, Bannerman S, Field B, et al. Diet, alcohol, smoking, serum beta-carotene, and vitamin A in male nonmelanocytic skin cancer patients and controls. Nutr Cancer. 1992;18:237-244.

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Leffell DJ. The scientific basis of skin cancer. J Am Acad Dermatol. 2000;42(1Pt 2):18-22.

Maa SH, Gauthier D, Turner M. Acupressure as an adjunct to a pulmonary rehabilitation program. J Cardiopulm Rehabil. 1997;17(4):268-276.

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Monique RTM, et al. A systematic review of treatment modalities for primary basal cell carcinoma. Arch Derm. 1999;135:1177-1183.

Moon TE, Levine N, Cartmel B, et al. Effect of retinol in preventing squamous cell skin cancer in moderate-risk subjects: a randomized, double-blind, controlled trial. Cancer Epidemiol Biomarkers Prev. 1997;6(11):949-956.

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Review Date: August 1999
Reviewed By: Participants in the review process include: Jacqueline A. Hart, MD, Department of Internal Medicine, Newton-Wellesley Hospital, Harvard University and Senior Medical Editor Integrative Medicine, Boston, MA; Marcellus Walker, MD, LAc, (Acupuncture section October 2001) St. Vincent's Catholic Medical Center, New York, NY; Leonard Wisneski, MD, FACP, George Washington University, Rockville, MD; Ira Zunin, MD, MPH, MBA, (Acupuncture section October 2001) President and Chairman, Hawaii State Consortium for Integrative Medicine, Honolulu, HI.

Copyright © 2004 A.D.A.M., Inc

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.

 
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