Children's Health

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Treatment

There are several types of MEN syndrome, and each type may need different treatment:

• Patients with the MEN1 syndrome are treated for parathyroid, pancreatic, and pituitary tumors.
• Patients with the MEN2A syndrome usually have surgery to remove the thyroid by age 5 or earlier if genetic tests show certain gene changes. The surgery is done to diagnose cancer or to prevent cancer from forming or spreading.
• Infants with the MEN2B syndrome may have the thyroid removed to prevent cancer.
• Patients with Hirschsprung disease and certain gene changes may have the thyroid removed to prevent cancer.
• A clinical trial of targeted therapy with a tyrosine kinase inhibitor for medullary thyroid cancer.

Skin Cancer (Squamous Cell Cancer, Basal Cell Cancer, Melanoma)

Skin cancer is a disease in which malignant (cancer) cells form in the tissues of the skin. The skin is the body's largest organ. It protects against heat, sunlight, injury, and infection. Skin also helps control body temperature and stores water, fat, and vitamin D. The skin has several layers, but the two main layers are the epidermis (upper or outer layer) and the dermis (lower or inner layer). Skin cancer begins in the epidermis, which is made up of three kinds of cells:

• Squamous cells: Thin, flat cells that form the top layer of the epidermis.
• Basal cells: Round cells under the squamous cells.
• Melanocytes: Found in the lower part of the epidermis, these cells make melanin, the pigment that gives skin its natural color. When skin is exposed to the sun, melanocytes make more pigment and cause the skin to darken.

Anatomy of the skin, showing the epidermis, dermis, and subcutaneous tissue. Melanocytes are in the layer of basal cells at the deepest part of the epidermis.

There are three types of skin cancer:

• Squamous cell skin cancer.
• Basal cell skin cancer.
• Melanoma.

Squamous Cell and Basal Cell Skin Cancer

The risk of squamous cell or basal cell cancer is increased by the following:

• Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) over long periods of time.
• Having a fair complexion, which includes the following:
  • Fair skin that freckles and burns easily, does not tan, or tans poorly.
  • Blue or green or other light-colored eyes.
  • Red or blond hair.
• Having actinic keratosis.
• Past treatment with radiation.
• Having a weakened immune system.

Symptoms of squamous cell and basal cell skin cancer include the following:

• A sore that does not heal.
• Areas of the skin that are:
  • Small, raised, smooth, shiny, and waxy.
  • Small, raised, and red or reddish-brown.
  • Flat, rough, red or brown, and scaly.
  • Scaly, bleeding, or crusty.
  • Similar to a scar and firm.

Tests that examine the skin are used to diagnose and stage squamous cell and basal cell skin cancer include the following:

• Skin exam: A doctor or nurse checks the skin for bumps or spots that look abnormal in color, size, shape, or texture.
• Biopsy: All or part of a growth that doesn't look normal is cut from the skin and viewed under a microscope by a pathologist to check for signs of cancer. There are three main types of skin biopsies:
  • Shave biopsy: A sterile razor blade is used to "shave-off" the growth that does not look normal.
  • Punch biopsy: A special instrument called a punch or a trephine is used to remove a circle of tissue from the growth that does not look normal.
  • Excisional biopsy: A scalpel is used to remove the entire growth.