FREE ESSAY ON BRAIN CANCER

BRAIN CANCER

Skin Cancer 
Every hour one American is killed by skin cancer and every thirty seconds one American
gets skin cancer. Cancer is a deadly disease that alters the DNA of a skin cell and
causes it to reproduce at a rapid pace. This overproduction of cells can be harmful and
in many cases deadly. Out of these cancers the most common is Basal cell carcinoma. Many
steps have been made in the treatment of Basal Cell Carcinoma, some have been very
successful and some not. The cells that have the altered DNA are called malignant or
cancerous cells. These cells are found in the outer layers of the skin. The skin's main
job is to protect the body from infections and to insulate the body to keep it at the
proper temperature. The first layer of skin is called the epidermis. This is the layer
that is closest to the surface of the skin. There are three types of cells in this layer.
The first is the squamace. The squamace cells are flat and scaly and are located closest
to the surface of the skin. Second are the basal cells and finally are the melanocytes,
which give the skin its color. The second layer of skin is the dermis, which is much
thicker than the epidermis. This layer contains sweat glands, nerves and blood vessels.
The dermis also contains follicles, which are tiny pockets from which the hair grows. The
most common malignant cells are the basal cells. Cancer in the basal cell is called
nonmelanoma cancer. This means that the cancer did not start in the melanocytes located
in the epidermis. Basal Cell Carcinoma is caused by overexposure to the sun. The sun
gives off ultraviolet rays, which are harmful to the human body. Basal cell carcinoma
will affect body parts such as the eyes, ears and nose. If it is detected before it gets
deep into the skin there will most likely be no problem treating the cancer. A problem
will occur if it isn't detected quickly enough and it has progressed into the deep
portions of the tissue. If Basal cell carcinoma is left untreated it can be very hard to
treat and may even cause death. The common methods of treatment involve the use of Mohs
micrographic surgery, radiation therapy, electrodesiccation and curettage, and simple
excision. Each of these methods is useful in specific clinical situations. Depending on
the case, these methods have cure rates ranging from 85% to 95%. Mohs micrographic
surgery, a newer surgical technique, has the highest cure rate for surgical treatment of
both primary and recurrent tumors. This method uses microscopic control to determine the
extent of tumor invasion. Although Mohs micrographic surgery method is complicated and
requires special training, it has the highest cure rate of all surgical treatments
because the tumor is microscopically outlined until it is completely removed. While other
treatment methods for recurrent basal cell carcinoma have failure rates of about 50%,
cure rates have been reported at 96% when treated by Mohs micrographic surgery. Mohs
micrographic surgery is also indicated for tumors with poorly defined clinical borders,
tumors with diameters larger than two cm, tumors with histopathologic features showing
morpheaform or sclerotic patterns, and tumors arising in regions where maximum
preservation of uninvolved tissue is desirable, such as eyelid, nose and finger. Next
there is a treatment involving simple excision with frozen or permanent sectioning for
margin evaluation. This traditional surgical treatment usually relies on surgical margins
ranging from three to ten millimeters, depending on the diameter of the tumor. Tumor
recurrence is not uncommon because only a small fraction of the total tumor margin is
examined pathologically. Recurrence rate for primary tumors greater than 1.5 cm in
diameter is at least twelve percent within five years. If the primary tumor measures
larger than three cm, the five year recurrence rate is 23.1%. Primary tumors of the ears,
eyes, scalp, and nose have recurrence rates ranging from 12.9% to 25%. Third there is
electrodesiccation and curettage. This method is the most widely employed method for
removing primary basal cell carcinomas. Although it is a quick method for destroying
tumor, adequacy of treatment cannot be assessed immediately since the surgeon cannot
visually detect the depth of microscopic tumor invasion. Tumors with diameters ranging
from two to five mm have a fifteen percent recurrence rate after treatment with
electrodesiccation and curettage. When tumors larger than three cm is treated with
electrodesiccation and curettage, a 50% recurrence rate should be expected within five
years. The fourth type is radiation therapy. Radiation is a logical treatment choice,
particularly for primary lesions requiring difficult or extensive surgery (e.g., eyelids,
nose, and ears). It eliminates the need for skin grafting when surgery would result in an
extensive defect. Cosmetic results are generally good to excellent with a small amount of
hypopigmentation or telangiectasia in the treatment port. Radiation therapy can also be
utilized for lesions that recur after a primary surgical approach. Radiation therapy is
contraindicated for patients with xeroderma pigmentosum, epidermodysplasia verruciformis,
or the basal cell nevus syndrome because it may induce more tumors in the treatment area.
Following treatment for basal cell carcinoma, the patient should be clinically examined
every six months for five years. Thereafter, the patient should be examined for recurrent
tumor or new primary tumors at yearly intervals. It has been prospectively found that 36%
of patients who develop a basal cell carcinoma will develop a second primary basal cell
carcinoma within the next five years. Early diagnosis and treatment of recurrent basal
cell carcinomas or another primary basal cell carcinoma is desirable since the treatment
of the disease in its earliest stages results in less patient morbidity. Carbon dioxide
laser is most frequently applied to the superficial type of basal cell carcinoma. It may
be considered when a bleeding diathesis is present, since bleeding is unusual when this
laser is used. Topical fluorouracil (5-FU) may be helpful in the management of selected
superficial basal cell carcinomas. Careful and prolonged follow-up is required, since
deep follicular portions of the tumor may escape treatment and result in future tumor
recurrence In conclusion Basal Cell Carcinoma has many different treatment that are very
helpful. Some more than others. Instead of going through the hassle of treating Basal
Cell Carcinoma one should prevent it from entering into your system. Basal cell carcinoma
is 100% preventable with the daily use of sunscreen beginning in the childhood years.
Sunscreen prevents the ultraviolet rays from coming in contact with the skin thus
preventing the cancer from entering into you body. 
Bibliography
Works Cited (1) Abide, JM, Nahai F, Bennett RG. The Meaning of Surgical Margins: Plastic
and reconstructive Surgery. : 492-497, 1984. (2) Dabski K, Helm F. Tropical Chemotherapy:
Schwartz RA: Skin Cancer: Recognition and Management. New York, NY: Springer-Verlag,
1988, pp 378-389. (3) Elson, Melvin. Internet Reference.
http://www.colombia.net/consumer/datafile/skincanc.html. (4) Internet Reference.
http://maui.net/~southsky/introto.html (5) Jablonski, Francis. Personal Interview. 10
March 1997 (6) Lippman SM, Shimm DS, Meyskens FL: Nonsurgical treatments for skin cancer:
retinoids and alpha-interferon. Journal of Dermatological Surgery and Oncology: 862-869,
1988. (7) Preston DS, Stern RS: Nonmelanoma cancers of the skin. New England Journal of
Medicine 327(23): 1649-1662, 1992. (8) Thomas RM, Amonette RA: Mohs micrographic surgery.
American Family Physician/GP 37(3): 135-142, 1988. Skin Cancer Jack Ciallella Lab Bio
October 21, 1999 
Bibliography 
Works Cited (1) Abide, JM, Nahai F, Bennett RG. The Meaning of Surgical Margins: Plastic
and reconstructive Surgery. : 492-497, 1984. (2) Dabski K, Helm F. Tropical Chemotherapy:
Schwartz RA: Skin Cancer: Recognition and Management. New York, NY: Springer-Verlag,
1988, pp 378-389. (3) Elson, Melvin. Internet Reference.
http://www.colombia.net/consumer/datafile/skincanc.html. (4) Internet Reference.
http://maui.net/~southsky/introto.html (5) Jablonski, Francis. Personal Interview. 10
March 1997 (6) Lippman SM, Shimm DS, Meyskens FL: Nonsurgical treatments for skin cancer:
retinoids and alpha-interferon. Journal of Dermatological Surgery and Oncology: 862-869,
1988. (7) Preston DS, Stern RS: Nonmelanoma cancers of the skin. New England Journal of
Medicine 327(23): 1649-1662, 1992. (8) Thomas RM, Amonette RA: Mohs micrographic surgery.
American Family Physician/GP 37(3): 135-142, 1988.