Skin must be monitored carefully after cancer


May 24, 1994|By Simeon Margolis, M.D. | Simeon Margolis, M.D.,Special to The Sun

Q: When my husband recently had a skin cancer removed from the face, he was told that he was cured and need not worry that the cancer had spread to any other place. I though all cancers could spread, and I am concerned that my husband's doctor just reassured him so that he wouldn't worry. Is there anything further he should be doing?

A: The three common types of skin cancer are basal cell carcinoma, melanoma and squamous cell carcinoma. Melanomas and squamous cell carcinomas DO spread (metastasize) to other body sites. It is more likely that your husband had a basal cell carcinoma because it is by far the most common type of skin cancer. If this is the case, his doctor was not trying to keep your husband from worrying.

Basal cell cancers continue to grow slowly and rarely spread to other sites in the body. More than 90 percent of people are completely cured when the carcinoma is removed surgically or treated with liquid nitrogen, although if left to grow over time, it can invade and destroy nearby tissue. Exposure to the ultraviolet rays of the sun is believed to be the principal cause of basal cell cancers. As a result, they tend to occur most commonly in fair-skinned people who have relatively little melanin to protect them against the sun.

Your husband should take measures to avoid excessive exposure to sunlight, since the presence of one basal cell carcinoma increases the risk that others may develop in the future. He should, for example, avoid direct sunlight during the middle of the day, use protective clothing, such as hats and shirts with long sleeves, apply a sunscreen before going out into the sun and, of course, avoid sunlamps and tanning booths. He should examine the skin regularly for the appearance of new growths and make an appointment with his doctor if any are found. A biopsy is necessary to make the diagnosis. In any case, He should see his physician at least once a year for a full skin exam.

Dr. Margolis is professor of medicine and biological chemistry at the Johns Hopkins School of Medicine.

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