Children's Health

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Treatment of Squamous Cell and Basal Cell Skin Cancer

Treatment for squamous cell and basal cell cancer is usually surgery to remove the tumor.

Melanoma

Melanoma is the most common skin cancer in children. It occurs more often in children aged 10 to 19 years. Melanoma rates in the United States have slowly increased since 1975.

The risk of melanoma is increased by the following:

• Giant melanocyticnevi (large black spots, which may cover the trunk and thigh).
• Xeroderma pigmentosum.
• Certain disorders of the immune system.
• Werner syndrome.

Risk factors for melanoma in all age groups include:

• 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.
• Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) over long periods of time.
• Having a history of many blistering sunburns as a child.
• Having several large or many small moles.
• Having a family history of unusual moles (atypical nevussyndrome).
• Having a family or personal history of melanoma.

Symptoms of melanoma include the following:

• A mole that:
  • changes in size, shape, or color.
  • has irregular edges or borders.
  • is more than one color.
  • is asymmetrical (if the mole is divided in half, the 2 halves are different in size or shape).
  • itches.
  • oozes, bleeds, or is ulcerated (a hole forms in the skin when the top layer of cells breaks down and the tissue below shows through).
• Change in pigmented (colored) skin.
• Satellite moles (new moles that grow near an existing mole).

Tests that examine the skin are used to diagnose and stage melanoma. They may include:

• Physical exam and history.
• X-ray of the chest.
• CT scan.
• MRI.
• PET scan.

See the General Information section for a description of these tests and procedures.

Other tests and procedures used to diagnose melanoma 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 the abnormal-looking growth is cut from the skin and viewed under a microscope by a pathologist to see if cancer cells are present. There are 4 main types of skin biopsies:
  • Shave biopsy: A sterile razor blade is used to "shave-off" the abnormal-looking growth.
  • Punch biopsy: A special instrument called a punch or a trephine is used to remove a circle of tissue from the abnormal-looking growth.
  • Excisional biopsy: A scalpel is used to remove the entire growth.
  • Wide local excision: A scalpel is used to remove some of the normal tissue around the area where melanoma was found, to check for cancer cells. Skin grafting may be needed to cover the area where tissue was removed.
• Sentinel lymph node biopsy: The removal of the sentinel lymph node during surgery. The sentinel lymph node is the first lymph node to receive lymphatic drainage from a tumor. It is the first lymph node the cancer is likely to spread to from the tumor. A radioactive substance and/or blue dye is injected near the tumor. The substance or dye flows through the lymph ducts to the lymph nodes. The first lymph node to receive the substance or dye is removed. A pathologist views the tissue under a microscope to look for cancer cells. If cancer cells are not found, it may not be necessary to remove more lymph nodes.
• Lymph node dissection: A surgical procedure in which lymph nodes are removed and a sample of tissue is checked under a microscope for signs of cancer. For a regional lymph node dissection, some of the lymph nodes in the tumor area are removed. For a radical lymph node dissection, most or all of the lymph nodes in the tumor area are removed. This procedure is also called a lymphadenectomy.
• FISH (fluorescence in situ hybridization): A laboratory test used to look at genes or chromosomes in cells and tissues. Pieces of DNA that contain a fluorescent dye are made in the laboratory and added to cells or tissues on a glass slide. When these pieces of DNA attach to certain genes or areas of chromosomes on the slide, they light up when viewed under a microscope with a special light. This test is done to tell the difference between melanoma and melanocytic tumors of unknown metastatic potential (MELTUMP).
• Cytogenetic analysis: A laboratory test in which cells in a sample of tissue are viewed under a microscope to look for certain changes in the chromosomes.