Ivy Family Health Updates

 
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In this segment Dr. Manjula Jegosothy discusses basal cell and squamous cell carcinoma with Drs. John, Kathryn and Edward Martin.

The two common non-melanoma skin cancers are basal cell carcinoma and squamous cell carcinoma. There may be a genetic predisposition in patients who have these cancers, but they are definitely related to sun exposure. For this reason they are most commonly seen in people with fair skin who have spent a lot of time in the sun. These cancers are highly preventable, especially with use of the newer sunscreens which contain micronized zinc oxide and titanium dioxide.

The mainstay for treatment of skin cancers has been surgical excision. However there are now topical creams which may shrink the cancers, and help eliminate pre-cancerous lesions.

Efudex (5-fluoro-uracil) is a chemotherapy cream which kills the caner cells. It is applied to the skin for varying amounts of time, and with varying dosage schedules depending on the type and location of the tumor. It can be very irritating to the skin, and can create red, scaly lesions where it is applied.

Aldara is one of the newer medications used to treat the skin cancers. It stimulates the immune system to fight the skin cancer. This cream can also make the skin fairly irritated and red. This is usually the first medication used now to treat the basal and squamous cell cancers.

After using the Aldara or Efudex cream, any residual tumor can be surgically excised. The creams should significantly reduce the size of the tumor, which will help with the scarring post operatively.

Basal cell carcinomas are a local tumor 99% of the time, with no evidence of metastasis. Squamous cells cancers however can metastasize.

Patients should go to their dermatologist if they have any of the following for at least one month: a rough red patch on the skin, a non-healing sore, any lesion with discharge which won’t heal. These could all be possible skin cancers.

The most important thing to remember is that these cancers are preventable: stay out of the sun, and use a good sunscreen if you are outside.