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Skin Cancer Symptoms

A nevus is defined as a benign tumor. Also known as a mole, these nevi commonly appear in children and teenagers. While these moles are generally not dangerous, the presence of 50 or more nevi puts an individual at higher risk for developing melanoma. We have little to no information about the causes of most cancers. However, there is evidence proving that the presence of nevi increased one's risk for melanoma. Additionally, there is evidence pointing to other, distinct risk factors for skin cancer.

  • For example, if an individual has light eyes, hair or skin, he or she is at higher risk for developing melanoma.  There are a few distinct types of nevi, but only one type that measurably increases one's risk of melanoma. This type of nevus is called a dysplastic nevus. Dysplastic nevi are large, strangely-shaped nevi that severely increases one's risk for melanoma.
  • Some people are born with dysplastic nevi at birth. These individuals are said to have "congenital melanocytic nevi." This condition predicts melanoma in some cases, with up to 10% of individuals with congenital melanocytic nevi getting melanoma in their lifetime.
  • Individuals with dysplastic nevi should schedule a skin examination with their doctor. This examination should be repeated every 6 months in order to catch developing skin cancer at an early stage. Doing so presents the best chance of fighting the disease, giving the patient a fighting chance.
  • In some cases, the skin examination will reveal suspicious nevi. In this case, one or more of the moles may be biopsied for medical examination. The sample will then study these samples under a microscope to determine whether there is cancer present in the nevi. 
  • Sun exposure does not only increase one's risk for developing skin cancer, but may also develop new moles. By reducing exposure to the sun, an individual can eliminate more than one risk factor.
  • Dysplastic nevi can be a number of different colors, including red, tan, brown, or pink.  Being aware of suspicious nevi may lead to an earlier diagnosis.
  • A recent study has found that tanning may increase the amount of nevi present in children with light skin. The study was the first to connect tanning exposure to the nevi, showing that tanning can also cause nevi and increase one's risk of melanoma.
Individuals who present one or more risk factors of melanoma or other skin cancers should concern themselves with reducing those risk factors. The presence of dysplastic nevi, or a large number of nevi, can contribute greatly to an individual's risk of melanoma. Whereas most cancers have no known causes, the evidence showing nevi as a cause of skin cancer should open our eyes to the prevention of skin cancer.
Skin Cancer Diagnosis: Self-examinations of the skin are not enough to procure proper skin cancer diagnosis. In order to determine whether a patient has skin cancer, screening and diagnostic tests conducted by doctors are required. Screening Skin cancer screening has not yet been recommended as a routine check up. However, it is important to understand that certain people are at higher risk for skin cancer, including those over 65 and people with abnormal moles (or more than 50 moles), are at greater risk for contracting skin cancer. Cancer screening tests are often used to find cancer early to treat at an earlier stage, increasing the chance of survival. Skin examinations Skin examinations done by the individual or a doctor are the most common screening method used for skin cancer diagnosis. Most melanomas appearing in the skin are visible to the naked eye, and may grow a tumor slowly under the skin, allowing for early detection. This early detection can lead to containment of the cancer before it spreads. Monthly self-examinations of the skin are recommended. If something abnormal is found, a skin check by a doctor will help determine whether the individual needs to seek a biopsy. Biopsy If skin cancer is suspected as a result of a skin examination, a biopsy may be recommended by the doctor. A biopsy is the only way to fully determine whether a skin abnormality is, in fact, cancer.  In a biopsy, the doctor removes suspicious cells or tissues to be examined under a microscope for cancer
Unlike other forms of cancer, the analysis of the suspicious cells or tissue is done by a dermatopathologist, a doctor responsible for studying diseased tissue. There are two types of biopsy that are done for skin cancer diagnosis:
Excisional biopsy: An excisional biopsy is a biopsy characterized by the cutting away of the entire visible abnormal growth. For nonmelanoma skin cancer, this type of biopsy may be the first line of treatment, and the only treatment necessary.  However, melanoma and other serious skin cancers may require additional removal of healthy tissue around the growth.
Incisional biopsy
: An incisional biopsy is characterized by the removal of a sample from the suspicious growth by a doctor, through a needle. The sample is then studied for cancer cells. A proper skin cancer diagnosis is completely dependent on the results of the biopsy. If cancer cells are found, an excisional biopsy may remove the risk of skin cancer. If the biopsy is not sufficient, additional treatment may be required.
After the type of melanoma is determined, a doctor will undergo melanoma staging, effectively determining the degree of severity. There are three factors commonly used in melanoma staging: thickness, penetration, and metastasis.  Depending on the stage, the subsequent treatment will vary. The thickness of the tumor, also known as Breslow's thickness, is measured in millimeters between the upper layer of the skin and the deepest point of the tumor. The thinner the cancer, the easier treatment is. In situ melanoma is confined to the epidermis. Further classification goes as follows:

| thin tumors are between 1 and 2 mm | intermediate tumors are between 2 and 4 mm | thick tumors are over 4 mm thick |

Thin tumors are classified based on Clark's level of invasion, which determines how many layers of skin are penetrated by the cancer.

  • Clark's Level I - exists in the epidermis.

  • Clark's Level II - penetrates the layer under the epidermis, the papillary dermis

  • Clark's Level III - fills the papillary dermis to the reticular dermis

  • Clark's Level IV - fills the reticular dermis and deep dermis

  • Clark's Level V - invades the subcutaneous fat

The 4 stages of melanoma staging are as follows:
Stage I
: Stage I melanoma is characterized by a thin tumor no more than 1 millimeter thick. The epidermis of the skin may also show ulceration. In stage 1a melanoma, the tumor is less than 1.0mm in Breslow's thickness and fits between Clark's Level II and Level III. In stage 1b melanoma, the tumor is between 1-2.0mm in Breslow's thickness and between Clarks Level III and Level IV.
Stage II
: Stage II melanoma is characterized by thicker tumors, ulcerations, and metastasis to the lymph nodes. In stage IIa, the tumor is between 1-2.0mm in Breslow's thickness with ulceration or 2-4.0mm without ulceration. In stage IIb, the tumor is between 2-4.0 in thickness with ulceration, or over 4.0mm without ulceration.  Last, in stage IIc, the tumor is thicker than 4.0mm and displays ulceration. To determine whether a melanoma has spread to the lymph nodes, doctors will likely conduct a sentinel node biopsy. In this type of biopsy, the doctor removes a node near the tumor and studies it for cancer cells.
Stage III
: Stage III melanoma is characterized by metastasis to the local or regional lymph nodes. At this point of the disease, thickness is not used for melanoma staging.
Stage IV
: Stage IV melanoma is characterized by the metastasis of lymph nodes and to the internal organs. This spread often attacks the lungs as well as the liver, brain, and bone.
Melanoma staging is one of the most important steps in the process of diagnosis and treatment, as it detemines the treatment necessary to cure the disease.
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