There will be nearly 11,000 deaths from skin cancer in 2006 — about 8,000 from melanoma and 3,000 from other skin cancers, says the American Cancer Society.
Skin cancer is the most common of all cancers and accounts for almost half of all cancers in the United States. There are two types of skin cancer, nonmelanoma and melanoma.
U.S. doctors find more than 1 million cases of nonmelanoma skin cancer, usually in a patient´s basal cells or squamous cells. Exposing skin — the face, ear, neck, lips, and the backs of the hands — to the sun causes most nonmelanoma skin cancer. While they can grow fast or slow, they rarely spread to other parts of the body.
The second kind, melanoma does spread to other areas of the body making it more dangerous. It accounts for just a small percentage of skin cancer, but it causes most skin cancer deaths. Melanoma is a cancer that begins in the pigment cells that produce the skin coloring (melanin) which helps protect deeper layers of the skin from the sun´s harmful rays. Detected early, melanoma is almost always curable.
Both nonmelanoma and melanoma skin cancers respond to photodynamic therapy (PDT). PDT is a Food and Drug Administration (FDA) approved treatment for skin cancer that combines a light source and a photosensitizing agent (a drug that is activated by light) to destroy cancer cells. It´s sometimes called photoradiation therapy, phototherapy or photochemotherapy and is useful when there are several lesions on the skin or scalp.
A photosensitizing agent, for example fluorouracil, spread on the skin makes PDT work, because the agent collects more readily in cancer cells than in normal cells. Exposing the agent to light makes it react with oxygen to create chemicals that can kill a skin cancer cell. However, the approved light sources can only penetrate a limited depth of tissue; therefore doctors mainly use PDT to treat areas on or just under the skin. It´s less effective for treating large tumors, because the light cannot pass deep into the tumors. Because it´s a localized treatment, doctors don´t use PDT to treat skin cancer that has metastasized.
Doctors sometimes use PDT in precancerous treatments. It usually needs pre-approval by a healthcare provider. Just because the treatment is in the facial area, case managers shouldn´t assume it´s a cosmetic treatment. Check to see the patient´s age, if the patient is over 60 years old, the case is probably not cosmetic. Also, look at the chart to see if there are multiple lesions on the skin or scalp, usually three or more.
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