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Skin cancer is the most common type of cancer. There are several forms of skin cancer, which are categorized by the type of cell in which the cancer originates. The most common types of skin cancer are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). The most aggressive types skin cancer are melanoma, which develops in the cells (melanocytes) that produce melanin, and Merkel cell carcinoma, which is rare and usually appears on the face, head or neck as a flesh-colored or bluish-red nodule.
Exposure to ultraviolet light, generally from natural sources like sun exposure or artificial sources like tanning beds, is a common risk factor for all skin cancers. Exposure occurs cumulatively over your lifetime. Other risk factors include:
- Weakened immune system
- Personal history of a prior skin cancer
- Skin cancer in the family
- High mole count or “funny-looking” moles (for melanoma)
Melanoma and other skin cancers are diagnosed by a skin biopsy, in which a dermatopathologist—a pathologist who specializes in evaluating skin—takes a small tissue sample and examines it under a microscope to look for cancer cells. If cancer cells are present, their traits are further described to help determine treatment and prognosis. If there is concern for spread of cancer, it may be necessary to get an additional biopsy from of another part of the body.
One or more of the following tools may be used to aid diagnosis of melanoma and other skin cancer:
- Clinical examination. A physical examination in search of moles, birthmarks or other areas that look abnormal in color, size, shape or texture.
- Blood tests. Measures certain substances in the blood that may indicate the presence of cancer or organ dysfunction.
- Radiographic studies, such as a computed tomography (CT) scan, positron emission tomography (PET)/CT scan, magnetic resonance imaging (MRI) scan or X-ray. Takes pictures of certain body parts to search for abnormalities.
- Sentinel node biopsy. Locates, removes and examines the sentinel lymph node(s), the first lymph node(s) where cancer cells may go when they spread from a primary tumor.
The Indiana University Health Melvin & Bren Simon Cancer Center offers comprehensive diagnostic services, specialty consultations, treatments and clinical trials to people with any stage of melanoma or complicated skin cancer.
Experts from our highly skilled team meet weekly to discuss cases and develop treatment plans. Treatment options for melanoma and other skin cancers are based on current treatment standards and each patient’s needs.
Treatments may include one or more of the following:
- Surgical excision. Removes the cancer and a surrounding border of healthy tissue. This is the most common treatment for melanoma and other advanced skin tumors. In some cases, it is necessary to remove lymph nodes and perform reconstruction at the incision site. A common reconstruction technique is skin grafting, which takes skin from another part of the body and grafts it to the affected area.
- Isolated limb perfusion. Treats an involved arm or leg with heat and chemotherapy that goes directly into the blood vessels.
- Radiotherapy. Uses high-energy beams to destroy cancer cells and reduce the risk of recurrence. It may be used to reduce pain or bleeding in patients with advanced cancer.
- Stereotactic Body Radiation Therapy (SBRT). Administers a large dose of radiation to a tumor without touching healthy tissue.
- Gamma-knife radiosurgery. Uses specialized equipment to deliver a single treatment of high-dose radiation, which is directly aimed at a tumor from many angles, in a single treatment session.
- Systemic therapies. Medicines prescribed to destroy or control cancer cells.
- Chemotherapy. Treatments that attack cancer cells in an effort to destroy them or slow their growth.
- Immunotherapy. Activates the body’s immune system to destroy cancer cells.
- Molecularly targeted therapy. Stops the function of cancer cells by attacking various pathways, such as the signals that direct cell growth.
For patients with squamous cell carcinoma or basal cell carcinoma, the IU Health Melvin & Bren Simon Cancer Center offers Mohs micrographic surgery. This advanced skin cancer treatment uses the precision of a microscope and pathological examination of sampled tissue to remove skin cancer at its roots. This technique removes the diseased tissue, leaving healthy skin intact so that the Mohs surgeon, who is also trained in reconstructive surgery, can repair the wound to minimize scarring. Mohs micrographic surgery has a 99 percent success rate for these types of skin cancer.
Patients in the melanoma program are seen in consultation during a weekly multidisciplinary clinic. This allows specialists from different fields to collaborate on the best course of treatment, and it gives patients access to the most advanced diagnostic and treatment options available. Our research commitment gives patients access to expert doctors and a wide range of treatments, including standard medicines and clinical trial options.
We support and educate patients through the CompleteLife Program, where staff members are available to care for their emotional, mental, social and spiritual needs. We also coordinate the long-term follow-up care required for melanoma and other advanced skin cancers.
The IU Health Simon Cancer Center is at the forefront of cancer care discoveries. Find more information about cancer research and learn if you may be eligible to participate in leading clinical trials that are part of improving cancer diagnosis and treatment.