Are There Any New Advances in the Treatment of Skin Cancer? Can Melanoma Spread to the Bones and Muscles?

New advances in the treatment of skin cancer include the use of photodynamic therapy in the treatment of various skin cancers such as basal cell carcinoma, squamous cell carcinoma. For melanoma, physicians can now perform sentinel node examination and biopsy to determine the extent of spread before there are any visible signs and symptoms.

Can Arsenicosis Lesions Lead to Skin Cancer?

Chronic arsenic exposure may lead to arsenical keratoses. These lesions are particularly prominent on the palms and soles. The common skin cancers associated with chronic arsenicism are squamous cell and basal cell carcinoma.

Does Skin Cancer Run in the Family? Can Skin Cancer Develop on the Lip?

There are familial cases of skin cancers such as Gorlin syndrome (basal cell naevus syndrome).

If there is a family member with skin cancer, there is a higher risk of skin cancers among first degree relative.

Skin cancers can certainly develop on the lips. The commonest of these is squamous cell cancer.

I Keep on Hearing About Actinic Keratosis. Is This a Form Of Skin Cancer?

Actinic keratoses are the most common precancerous lesions. It is commoner among patients with light skin types. Actinic keratoses are often multiple. They can range from skin colored to reddish brown patch or plaque and they are often better recognized by palpation as a roughening than visualization. There are various ways to treat actinic keratoses such as cryotherapy, 5-fluorouracil etc. Patients have to be follow up for a life time for any new skin lesions and skin cancer surveillance

I have vitiligo in patches on my back and parts of my face. How can I protect these areas that may lack pigments? Also, does having vitiligo mean that I have skin cancer?

Vitiligo areas are areas without pigmentation. Hence, there is a higher risk of sunburn. It is advisable to appear a broad spectrum sunscreen for photoprotection to prevent sun damage and skin cancer.

The aetiology of skin cancers are multifactorial. Having vitiligo does not equate the occurrence of skin cancer.

How would a dermatologist determine melanoma (maligment skin cancer)? Are there specific tests to be performed?

There are some suspicious clinical symptoms and signs of a melanoma such as asymmetry, irregularity of the borders, change in color and increase in size of a pigmented skin lesion. The definitive test is a skin biopsy.

My doctor is treating me for a lesion on my nose. He says it is acarcinoma and I need to have a biopsy. Now what is it and what risks are nvolved in a biopsy?

A skin biopsy is crucial to establish a diagnosis of a skin cancer. In simple term, a skin biopsy involve a surgical excision of a part or the whole tissue sample. It is an outpatient procedure and the patient return for suture removal in 7-14 days kater.

What are the statistics on the recurrence of malignant melanoma? What is the likelyhood of the melanoma returning to the same area of the body as the first time?

The likelihood of the recurrence of a malignant melanoma depends on several factors. For example deeper melanoma are more likely to spread. If the melanoma does spread, it typically spread first to the lymph nodes.

Lately there is lot of talks about the long term effects of sunexposure. What one should be watching for on the skin besides the traditional "ABCDs" of skin cancer.

The ABCD guidelines have been found to be extremely useful for laymen as a form of self monitoring method. A quick revision - A stands for asymmetry, B stands for border irregularity, C stands for color change and D stands for diameter change. If a patient has chronic sun damaged skin, they are at a higher risk of developing skin cancers. The most important thing is to get familiar with your skin. If you noticed any new bumps, bleeding or oozing or change in sensation of the bump, it will be wise to consult a dermatologist.

Would You Please Tell Us Briefly About Kaposi's Sarcoma and Pagets Isease?

Kaposi sarcoma is a uncommon type of cancer. It can be HIV or non HIV related. The dermatologist is often the first physician to nake the diagnosis by performing a simple skin biopsy. The lesions of Kaposi's sarcoma are usually aymptomatic. They can appear anywhere on the skin or in the mouth. The lesion may vary in color from pink to brown. Occasionally, Kaposi's sarcoma can spread to the lymph nodes or internal organs. The treatment involved excision and chemotherapy.

Paget disease of the nipple is an uncommon scaling, red eruption around the nipple. Extramammary Paget's disease,which occur around the anogenital skin, may be associated with a kind of cancer known as adenocarinoma. Again, the dermatologist are often the first to make the diagnosis due to the persistent skin changes and often a skin biopsy will aid to establish the diagnosis. Once diagnosis is made, excision of the involved lesion is often carried out. An extensive screening for internal associated malignancy is also encouraged.

Answers By :

Eileen Tan, MD, MRCP(UK), MMed(Int Medicine)

Dr. Eileen Tan graduated from the National University of Singapore in 1991 and was awarded specialist accreditation in dermatology in 2001. A fellowship in dermatologic surgery, lasers and hair disorders and hair transplantation at the University of British Columbia was concluded in 2002.

Dr. Tan a valued member of the Royal College of Physicians (UK), American Society of Dermatologic Surgery, American Society of Laser Medicine and Surgery, American Academy of Cosmetic Surgery, American Society of Liposuction Surgery and International Society of Hair Restoration and Singapore Dermatological Society of Singapore. She is the first Asian dermatologist to receive the following international awards - American Society of Dermatologic Surgery Preceptorship Award 2002 and the North American Hair Research Society Mentorship Award 2003

Dr. Tan speaks at national and international meetings and has published in both International and local meetings. She is a familiar face on national television, and often featured on radio and in numerous health related publications.

Dr. Tan's practice encompasses general and cosmetic dermatology, with a strong emphasis on hair and nail disorders, hair transplantation and lasers.

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