Diagnosing Skin Cancer

As an individual, one of the ways in managing skin cancer is getting diagnosed at the right time as soon as there are warning signs on the skin. And in diagnosing the skin cancer, a doctor who specializes in skin care (dermatologist) is best need; and they can may choose to diagnose skin cancer in these ways:

• Examination of the Skin: The first stance by the doctor is to examine the skin so as to determine if there are changes that are likely to be cancer. If the examination isn’t confirmed, further testing might take place.
• Skin Biopsy: Whenever doctors notice a part of the skin looking suspicious, they remove a sample of the suspicious-looking skin for lab testing (skin biopsy). This biopsy would help to determine either there is a presence of skin cancer or not; and the type of skin cancer.

Once skin cancer has been found, additional tests would be used to determine the extent (stage) of the skin cancer. Although skin cancer such as basal cell carcinoma rarely spread, skin biopsy that helps to remove the entire growth is usually used as the only test needed to determine its cancer stage. But for large squamous cell carcinoma, merkel cell carcinoma or melanoma, the doctor can recommend further tests to determine the extent of the cancer.

The additional tests might include imaging tests to examine the nearby lymph nodes for signs of cancer or a procedure to remove a nearby lymph node and test it for signs of cancer (sentinel lymph node biopsy).

Just like other major type of cancer, the Roman numeral staging method is usually used to stage the skin cancer. Stage I cancers are small and limited to the area where they began. Stage IV indicates advanced cancer that has spread to other areas of the body.

The skin cancer's stage helps determine which treatment options will be most effective.

Staging

Staging is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting other parts of the body.

Doctors use diagnostic tests to find out the cancer's stage, so staging may not be complete until all the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient's prognosis, which is the chance of recovery.

Staging for Basal Cell and Squamous Cell Carcinoma

Basal cell and squamous cell carcinoma usually do not spread to other parts of the body. On rare occasions, a person’s lymph node(s) may be removed to find out if the cancer has spread, which is called metastasis. Lymph nodes are bean-shaped organs that help fight infection. The doctor may recommend other tests to determine the extent of the disease, including blood tests, chest x-rays and imaging scans of the lymph nodes and nerves, liver, bones, and brain, but this is uncommon.

Staging for Merkel Cell Carcinoma

For Merkel cell carcinoma, the TNM staging system is mostly used, and this is because results found from diagnostic tests and scans are used to answer these questions:

• Tumor (T): How large is the primary tumor? Where is it located?
• Node (N): Has the tumor spread to the lymph nodes? If so, where and how many?
• Metastasis (M): Has the cancer spread to other parts of the body? If so, where and how much?

The results are combined to determine the stage of Merkel cell cancer for each person.

There are 5 stages: stage 0 (zero) and stages I through IV (1 through 4). The stage provides a common way of describing the cancer, so doctors can work together to plan the best treatments.

Stage 0: This is called carcinoma in situ. Cancer cells are found only in the top layers of the skin. The cancer does not involve the lymph nodes, and it has not spread.

Stage I: The primary tumor is 2 centimeters (cm) or smaller at its widest part. The cancer has not spread to the lymph nodes or to other parts of the body.

Stage IIA: The tumor is larger than 2 cm and has not spread to the lymph nodes or other parts of the body.

Stage IIB: The tumor has grown into nearby tissues, such as muscles, cartilage, or bone. It has not spread to the lymph nodes or elsewhere in the body.

Stage III: The cancer has spread to the lymph nodes. The tumor can be any size and may have spread to nearby bone, muscle, connective tissue, or cartilage.

Stage IIIA: The tumor is any size or may have grown into nearby tissues. Biopsy or surgery has found that the cancer has spread to nearby lymph nodes. The cancer has not spread to other parts of the body. Or, there is no sign of a tumor, but cancer was found in a nearby lymph node during an exam or with imaging scans. Its presence was confirmed using a microscope.

Stage IIIB: The tumor is any size or may have grown into nearby tissues. The cancer has spread through the lymphatic system, either to a regional lymph node located near where the cancer started or to a skin site on the way to a lymph node, called “in-transit metastasis.” In-transit metastasis may have reached these other lymph nodes. The lymphatic system is part of the immune system and drains fluid from body tissues through a series of tubes or vessels.

Stage IV: The tumor has spread to distant parts of the body, such as the liver, lung, bone, or brain.

[Next on Skin Cancer: Treatment and Prevention of Skin Cancer]