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33 - Skin cancer other than melanoma

Published online by Cambridge University Press:  23 December 2009

By
Sankha Suvra Mitra
Edited by
Louise Hanna ,
Tom Crosby  and
Fergus Macbeth
Sankha Suvra Mitra
Affiliation:
Consultant, Clinical Oncologist, The Sussex Cancer Centre, Royal Sussex County Hospital, Brighton and Sussex University Hospitals, NHS Trust, Brighton, East Sussex, UK
Louise Hanna
Affiliation:
Velindre Hospital, Cardiff
Tom Crosby
Affiliation:
Velindre Hospital, Cardiff
Fergus Macbeth
Affiliation:
Velindre Hospital, Cardiff
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Summary

Introduction

Skin cancer is a common cancer, and it is often caused by ultraviolet radiation from chronic sun exposure in a fair-skinned population. Basal cell carcinoma is the most frequent variety, and presents as a superficial tumour that very rarely metastasises. Squamous cell carcinoma can spread to regional lymph nodes.

For the management of skin cancer, patients are usually discussed in a multidisciplinary team meeting. Surgical excision is the treatment of choice for the majority of tumours. Non-surgical treatment options include radiotherapy, curettage, imiquimod cream, photodynamic therapy, and topical 5-FU therapy. Radiotherapy is an important treatment option for older patients – it is preferred to surgery for large superficial tumours, multiple tumours, and in areas around the eye, nose, and ear where the cosmetic results may be better. The radiotherapy technique involves treatment with either superficial X-rays or electron therapy. Cure rates are about 95% at 5 years.

The National Institute for Health and Clinical Excellence has recently published service guidance on the care of these patients (NICE, 2006).

Range of tumours

In the differential diagnosis of a skin tumour, the tumour could be benign or malignant, and a malignant tumour could be primary or secondary.

Premaligant conditions

Premalignant conditions include the following (Soutar and Robertson, 2001):

  • Actinic keratosis.

  • Bowen's disease.

  • Erythroplasia of Queyrat.

  • Paget's disease.

Benign tumours

Benign tumours include the following:

  • Benign naevus.

  • Sebaceous cyst.

  • Epidermal cyst.

  • Basal cell papilloma (seborrhoeic keratosis).

  • Vascular angioma.

  • Keratoacanthoma.

  • Dermatofibroma.

Malignant tumours

Primary malignant tumours include:

  • Basal cell carcinoma.

  • […]

Information

Type
Chapter
Information
Practical Clinical Oncology , pp. 382 - 394
Publisher: Cambridge University Press
Print publication year: 2008

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References

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