Skin tumors are the most common malignant tumors in the Western men. They   are  roughly   divided into  melanoma  and  non melanoma  skin  cancer.  More than 1 million new cases of skin cancer are reported each year in the United States . In White men the risk for melanoma  is approximately 1 to 200. For  Non melanoma cancerous skin tumors, the risk  is about 1 to 2!  Only a small part  of  non  melanoma sun-related skin tumors are malignant, but the  trouble and cost of treatment a  considerable  burden on the individual and society.

Pre-malignant skin tumors

Solar  keratosis: This is a common skin tumor expressed a small skin surface, red and rough appearing mostly sun-exposed areas (face, back of hands, scalp).  This benign tumor may transform in  small number of cases to  Squamous cell carcinoma.

Malignant skin tumors

The term “skin cancer” includes two sets of tumors that  are  significantly different from each other. The first type of skin cancer called  Malignant Melanoma.  Melanoma is a particularly malignant tumor originating from the uncontrolled proliferation of melanocytes (cells that produce the melanin). The second type is called non-melanoma skin cancer  and  is  most of  time  -  not  life  threatening.

Non Melanoma Sun Induced Skin Tumors :

The main types  of  tumors  in this group are carcinoma of the calls   in the basal layer of  the skin(Basal cell carcinoma) or carcinoma  of  the  keratinocytes  = Squamous cell carcinoma or  SCC for short.

Basal Cell Carcinoma (BCC)

BCC  is the most common type of skin cancer. Basal cell carcinoma is the most common type of skin cancer, and accounts for about 80 to 90 percent of all skin cancer cases in the United States. Basal cell tumor originates in  the lower layer of the epidermis and  usually appears as a round  lesion  made  of  small shiny little pearls covered with  enlarged capillaries and sometimes an ulcer in the center.  Sometimes the red zone growth looks scaly or covered with shiny skin surface with sharp boundaries.

More than 90 percent of such tumors appear on the face and neck,  on areas exposed to the sun. BCC’s are  more common in people working outdoors than office workers.  This  tumor rarely appears In dark-skinned individuals.  In  the United States where the driver sits on the left side of the car the tumors are more common on the back of the left forearm while  in Australia where the driver sits on the right side of the car and pulls out his right hand through the window, these tumors are more common on the right forearm.  Basal  cell  carcinomas usually appears in people after age 40 and is  growing  slowly.  Although the tumor usually does not send metastases, neglect will  result  in serious distortion of facial skin.

Treatment involves  -   tumor excision – required anyway to prevent the penetration  of  the tumor to deeper  tissues.  If  the treatment is delayed, there   will be need for a  deeper operation and the remaining scar will be bigger.  Approximately 85 percent of cases, insufficient removal of one-time increase and does not appear again.  Approximately 15 percent of the cases required further surgery.  Adam suffered because once a skin tumor carcinoma basket Basel has a 50 percent chance of developing another tumor similar to the following two years – all the people who have skin growth must be checked once a year by a dermatologist.

Squamous Cell Carcinoma, SCC:

This is the second most common type of skin cancer.  In 1994, the annual incidence in the United States ranged from 81-136 cases per 100,000 population for men and 26-59 cases per 100,000 population for women.  Most tumors begin pre-cancerous lesions called  solar keratoses.

These tumors are also particularly exposed body areas like the face back the hands but can occur in less exposed areas like the back.  Carcinoma growth of Thai carcinoma can show Machweiab like carcinoma of the base or covered with Thai thick scrawl.  These tumors are more dangerous Thai carcinoma of the base and may in some cases, to metastasize and cause death.  Particularly dangerous type tumors carcinoma in the lips.  The treatment of these tumors by  be generally surgery under local anesthesia.  When the patient’s tumor metastasis posting will be directed for further treatment by an oncologist.

Malignant melanoma:

Malignant melanoma is the most dangerous  skin cancer.  This increase  that the melanin producing cells.  The most common location of melanoma in women appears both calves and thighs and upper back in men.  Most melanomas appear as points like “brown or black that have changed.  Minority may be missing melanin that is pink or red.  Some of melanoma will begin at last like a malignant change and some appear normal skin.  Number of melanoma revealed each year is much smaller than the number of other skin tumors associated with exposure to the sun, but more people get rid of the melanoma growth than by all other crops together.

In the last 50 years there is a steady increase in the number of cases of melanoma in the Western world. Statistical calculations show that in the 21st century will be the person a chance of 1 to 100 developing melanoma during his life.  Unlike other skin tumors  that  are   affected directly  by the sun the melanoma seems  to be  more related   to  severe  sunburns in childhood and adolescence and less to cumulative sun exposure throughout life.  Statistical work suggests that a person who has severe sunburn on his first 15 years have three times higher  the risk of developing melanoma than those who have not suffered sunburn in childhood.  People are more likely to develop melanoma are fair skin (type I or II) who spend most of the week at work or school room and out over the weekend to suntan on the beach.  History  of  Melanoma  in ones  close family  is  another   significant  risk factor .

How to treat melanoma?

There are two stages of melanoma growth.  First it  spreads laterally and then penetrates deeper into the skin.  Severity is  is directly dependent on the depth of penetration of the skin growth.  If detected  early , when it penetrates only to  the epidermis and the upper part  of the  dermis the melanoma  is  removed  by minor surgery under local anesthesia and prospects for recovery are good.  If the melanoma  penetration   is less  than half a millimeter there is a  98 percent chance that the patient will live 5 years or more.

Grades of  malignant melanoma:

There are two types of malignant melanoma rating:

Clark’s – Melanoma rating according to the different skin layers penetration

Class I-The tumor  penetrates   to epidermis only

Class II-that penetrates the superficial layer of the dermis

Level III-that penetrates to the interface between the epidermis and the dermis

Class IV-that penetrates the dermis

Class V- penetrating the subcutaneous tissue

Prognosis according  to  depth

Class Ia – whose thickness up to 0.75 mm (Clark’s level II) 95% survival

Class  Ib-you rank of 0.76 to 1.5 mm thickness (Clark’s level III) 86% survival

Class IIa-whose thickness of 1.5 to 4 mm (Clark’s level IV) 75% survival

Class IIb-whose thickness over 4 mm (Clark’s level V) 65% survival

Class III-regional lymph nodes or the appearance of up to 5 transit metastases 35% survival

Class IV-presence of distant metastases 5% survival

In the past it was customary to enlarge skin excision for  5 cm  diameter beyond the edge of the melanoma. Today is accepted by most plastic surgeons and dermatologists that it is enough to cut skin away from 1 cm to 3 cm from the edge of the tumor, according to the depth of his penetration. If the melanoma is   diagnosed  after having penetrated the bottom of the dermis or to the subcutaneous  tissue recovery chances are much smaller. In this case there is  a need  to  check if the tumor has spread to regional lymph, more surgery and sometimes even to add chemotherapy or  radiation therapy. The statistics prove that if a tumor depth is  3 mm or more the chance  to survive  for over 5 years is less than 50 percent. From 2003-2007, the median age at diagnosis for melanoma of the skin was 60 years of age^. Approximately 0.8% were diagnosed under age 20; 7.5% between 20 and 34; 11.8% between 35 and 44; 18.7% between 45 and 54; 20.4% between 55 and 64; 17.8% between 65 and 74; 17.0% between 75 and 84; and 6.0% 85+ years of age.

The age-adjusted incidence rate was 20.1 per 100,000 men and women per year. These rates are based on cases diagnosed in 2003-2007 from 17  geographic areas.

US Mortality

From 2003-2007, the median age at death for melanoma of the skin was 68 years of age. Approximately 0.1% died under age 20; 2.7% between 20 and 34; 6.3% between 35 and 44; 14.3% between 45 and 54; 19.6% between 55 and 64; 20.9% between 65 and 74; 24.1% between 75 and 84; and 11.9% 85+ years of age.

The age-adjusted death rate was 2.7 per 100,000 men and women per year. These rates are based on patients who died in 2003-2007 in the US.

Five-year relative survival by race and sex was: 89.0% for white men; 93.7% for white women; 70.0% for black men; 77.9% for black women.

Stage Distribution and 5-year Relative Survival by Stage at Diagnosis for

1999-2006, All Races, Both Sexes