(also referred to as...) Basal Cell Carcinoma (BCC), Kaposi's Sarcoma, Melanoma, Paget's Disease, Squamous Cell Carcinoma (SCC)
Description With over 60,000 cases per year, skin cancer comprises one third of all cancers in Canada and is the most common form of this disease. This number could be reduced by 75% if more care was taken to protect skin from excess sun exposure during childhood. Ninety three percent of skin cancers are basal cell carcinoma (BCC) or squamous cell carcinoma (SCC). The good news is that most types are curable. Skin cancer is very slow to develop, taking several years, even decades, therefore early detection is very possible. More common forms tend to develop on sun-exposed skin, but skin cancer can occur anywhere on the body. It can affect anyone regardless of skin colour, but there are risk factors that can increase your chance of developing skin cancer. Risk factors include: blond, red or light brown hair; light coloured eyes; freckles easily; large number of moles; family history of skin cancer; long periods of exposure to the sun; shorter periods of intense exposure; tendency to burn; use of tanning devices; and immunological factors. The myth that tanning will protect you from skin cancer is false. Tanning is the skin's response to ultraviolet light to attempt to prevent further injury, but does not give complete protection from ultraviolet radiation.
The more common forms of skin cancer are discussed below.
Basal Cell Carcinoma (BCC)
This type of tumour begins in the innermost cells of the deeper epidermis. It, along with SCC, account for 93% of all skin cancers.
Squamous Cell Carcinoma (SCC)
Squamous cell carcinoma originates in the middle layer of the epidermis. It most often occurs in sun-exposed areas but can occur anywhere on the skin including the tongue and lining of the mouth. Squamous cell carcinoma can develop on what appears to be normal skin, or on sun-damaged skin, particularly actinic keratosis, a wart-like growth on the skin that can become SCC.
Melanoma Melanoma originates in the pigment-producing cells of the skin called melanocytes. It is the most serious form due to its potential to metastasize to other areas of the body. The incidence of this form of skin cancer is doubling every ten years.
Kaposi's Sarcoma This disease originates in blood vessels, usually of the skin, but can occur anywhere. There are two forms of the disease. One type generally affects older people of Jewish or European (particularly Italian) descent. The second type generally affects children and young men of equatorial Africa and people with AIDS.
Paget's Disease This is a rare form of skin cancer that originates in the glands in or under the skin, usually around the nipple.
Symptoms and Signs:
Basal Cell Carcinoma (BCC)
This tumour usually begins as a small, firm, shiny, raised growth on the skin, occasionally with a pearly-white border. Sometimes this tumour grows more flat and resembles a scar. The growth enlarges very slowly. It sometimes ulcerates and forms a scab at the centre. It can alternately bleed and heal, which is a significant sign of this type of cancer (as well as SCC).
Squamous Cell Carcinoma (SCC)
The tumour forms as a red area with a scaly, crusted surface that does not seem to heal. As the tumour progresses, it may become raised and firm or wart-like in appearance. Over time it becomes an open sore and invades underlying tissue. Bowen's disease is a form of SCC that is limited only to the epidermis and appears as a reddish-brown, scaly, crusted, flat area.
Melanoma This can start as a small, new, pigmented growth on normal skin, but can also develop from pre-existing moles. They are often black or a deep blue. An existing mole may change in shape or colour, especially with the spread of red, white, and blue pigmentation in the surrounding area. The mole and surrounding area may also be inflamed.
Kaposi's Sarcoma The first type involves purple or dark brown spots on the toes and legs. The tumour can cover a significant area on the skin and can be flat or slightly raised. It tends to bleed and ulcerate. The second type initially appears as a red, pink, or purple spot. It is round or oval shaped, and can occur anywhere on the body. Within a few months the tumour can appear on several areas of the body and mouth. This type of tumour can also occur on internal organs and lymph nodes and can cause internal bleeding when they ulcerate.
Paget's Disease This form of cancer appears as an inflamed, red area of skin. It is usually located around the nipple, but can also occur in the groin area and around the anus. It may also appear as an oozing, crusting rash.
Causes: The main cause of skin cancer is over-exposure to the sun (especially resulting in sunburn) over the course of several years. Merely one sunburn can increase your risk of developing skin cancer by 50%. It is also important to note that most people receive approximately 86% of their lifetime exposure to the sun before they reach 18 years of age. Some sources also believe that lack of sun exposure can lead to skin cancer (see "Vitamin D" under Remedies-Vitamins, below). UVB rays are the portion of the light spectrum that are thought to be particularly dangerous. UVB is absorbed by DNA and other biological macromolecules causing a variety of reactions that may lead to genetic mutations. If these mutations persist, their cumulated effect may result in cancer many years down the road. Most UVB rays entering Earth's atmosphere are blocked by the ozone layer. As the ozone layer depletes and holes are formed, an increased amount of UVB passes onto the earth and into your skin. Some scientists believe that UVA may play a role in the development of melanomas. Paget's Disease of the nipple often originates from an existing cancer of breast milk ducts.
What to Expect:
Basal Cell Carcinoma (BCC)
This form usually invades and destroys adjacent tissue but does not often metastasize. However, if the tumour is near the eyes, mouth, bone, or brain, serious consequences can occur as a result of invasion. Early treatment can limit the extent of damage that may occur.
Squamous Cell Carcinoma (SCC)
This form usually only affects adjacent tissue, but has the potential to metastasize and can be fatal.
Melanoma The course of this disease is variable, and is dependent upon the strength of the body's immune system. This form of skin cancer readily metastasizes. The less it invades the skin, the better the cure rate. If melanoma penetrates into deeper layers, it is more likely to spread via lymph nodes and blood vessels, causing death within a few months to a few years.
Kaposi's Sarcoma The first type tends to be limited to the skin and grows very slowly. Metastasis is rare. The second type grows much more quickly and tends to involve internal organs as well.
Remedies
Conventional Approaches Generally, skin cancers are treated by surgery, electrodessication (burning), cryosurgery (freezing), or radiation. Both basal cell and squamous cell carcinomas can be removed by scraping and burning the growth with an electric needle, or by cutting it out (under local anesthesia). If the growths are scar-like or recurrent, then a microscopically controlled surgery called Moh's surgery may be required. Actinic keratosis is often treated with liquid nitrogen. Melanomas can be surgically removed and, if it has not spread, the cure rate is very high. However, you are at an increased risk of developing another melanoma. Regular skin examinations are recommended to detect any new growths early on. The first type of Kaposi's sarcoma, if not occurring with any other symptoms, may not require treatment. However, the spot can be removed with liquid nitrogen or scraped and burned with an electric needle. Treatment is not often successful with the second type, and it does not tend to prolong the life of people with AIDS.
Amino Acids Some studies suggest that arginine may display anti-tumour activity, due to its role in activating certain components of the immune system. L-arginine is found in brown rice, carob, coconut, dairy products, gelatin, meat, oatmeal, oats, nuts, raisins, sesame seeds, soy, sunflower seeds, wheat germ, whole wheat, and all protein-rich foods. L-arginine is available as part of a multi-amino acid complex and in protein powder supplements. Depending on the country in which you live, arginine may also be available as an isolated supplement in capsule or tablet form. You may require a prescription. NOTE: Supplementation should be avoided in pregnant or lactating women.
Antioxidants Green tea is known to enhance the immune system and prevent many forms of cancer. It contains phenols that reduce the potential for cancer to metastasize. Green tea is non-toxic and inexpensive. Place 2 teaspoons of green tea leaves in one cup hot (not boiling) water and steep for 3 to 4 minutes. The longer the infusion, the more bitter green tea becomes. Boiling water destroys some of the beneficial elements of green tea. Allow the water to stop boiling before adding the leaves. Use a ceramic, glass, or earthenware mug. Drink 1 to 2 cups daily. If supplementing, take 250mg green tea extract daily. If choosing standardized extracts, look for preparations that contain 97% polyphenols. There are also several skin care products that are now available with green tea extract. It is still unclear as to what extent these topical applications of green tea protect the skin. Melatonin has been shown to be protective against the DNA damage that can lead to cancer. It may be available in supplement form in various doses. Many government bodies currently ban this compound.
Herbs Astragalus is known to boost immunity and fight cancer. An alkaloid extracted from Astragalus oxyphysys called swainsonine has been shown to inhibit the metastasis of melanoma both in vitro and in vivo. It seems to do so by enhancing natural killer cell function. Astragalus can also be used in conjunction with chemotherapy and can act as a protective factor against the side-effects of chemotherapy. To prepare a decoction, add 3 teaspoons to 3 cups water and bring to a boil. Simmer for 30 to 45 minutes. Strain and divide into 3 doses for the day. If supplementing, take 6g three times daily. If using in tincture form, take 20 to 30 drops three times daily. Chaparral has been used for centuries by North American, Pima, and Maricopa Indians for the treatment of a variety of ailments. A group of doctors in Utah during the 1960's tried giving chaparral tea to various patients suffering from melanoma and other cancers. Some patients responded well to the treatment and had a significant decrease in tumour size, while others did not respond at all. Chaparral can be toxic to the liver and kidneys at a high enough dose, however. It also contains a resin that, when in contact with skin, can cause contact dermatitis in some individuals. Avoid if pregnant or lactating. To prepare an infusion, add 1 teaspoon of herb to 1 cup of water. Infuse for 10 minutes and take up to 3 times daily. If using in tincture form, add 10 to 20 drops to 1/4 cup of water. Take 3 times daily. Garlic is known to have anti-tumour promoting activity. Several ingredients of garlic are responsible for this action, in addition to allicin. Studies show that garlic and onion consumption is correlated with a decrease in cancer death rate. Garlic can stimulate growth and proliferation of some beneficial cells in the body used to fight cancer. In vitro studies of melanoma cells show that garlic inhibits cancer cell growth by more than 50%. Aged garlic extract has also demonstrated protective action against radiation damage. Eat 2 to 4 cloves daily. If supplementing, take 600 to 1,200mg once or twice daily Ginseng is found to have many anti-cancer properties. A study of panax ginseng demonstrated its ability to promote differentiation of cancer cells -- to return the aberrant cells back to normal function and appearance. Siberian ginseng can boost immunity and improve resistance to negative effects of both radiation and chemotherapy. It also seems to be non-toxic, and thus, can be used long-term through intensive cancer treatment. Avoid if lactating or pregnant. European mistletoe extract has been used to treat cancer. It has been used in Europe and administered as subcutaneous injections over the course of many months to years. The preparation has been shown to stimulate the immune system, reduce tumour size, and kill cancer cells. It also improves the quality of life and survival. Consult with your naturopath or other health practitioner regarding this particular treatment.
Lifestyle Skin cancer is almost always preventable. Keep babies under one year of age out of direct sunlight. Use a full-spectrum (both UVA and UVB) sunscreen with a sun protection factor (SPF) of at least 15 (although it has been debated that some of the chemicals in sunscreens can cause cancer themselves, or that some exposure to the sun without protection is necessary for the production of vitamin D and its protective effects). Apply the sunscreen 15 to 30 minutes before exposure, and reapply every 2 hours. Further, wear long sleeved shirts, long pants, and a wide brimmed hat when outdoors. Water, sand, cement, and snow can reflect up to 85% of the sun's rays, so be particularly cautious in such environments. Azelaic acid is a substance found in rancid fat. In vitro studies demonstrate that it selectively attacks melanoma cells while leaving normal, healthy skin cells alone. Some doctors report that the use of azelaic acid caused the regression of malignant melanomas. It is thought to do so by interfering with the cancer cell energy supply and with cancer cell DNA. Minimize your exposure to the sun during 10AM and 3PM, as UV rays are highest during this time of day.
Vitamins Studies point to a link between vitamin A deficiency and cancer. It is unclear whether the deficiency promotes cancer, or if the cancer causes the deficiency. Regardless, vitamin A supplementation is beneficial. It has been shown to inhibit tumour promotion and tumour initiation. It also enhances the effect of chemotherapy while protecting from the side-effects of radiation therapy. If using vitamin A for the latter reason, take 50,000 IU per day in divided doses a few days before and during treatment. Several types of skin cancer respond well to topical applications of various vitamin A derivatives. In general, it is a good idea to increase you intake of beta-carotene- and vitamin A-rich foods. Supplement with B complex vitamins, especially if you are undergoing chemotherapy, to counteract the malnutrition that is often brought on by this therapy. B vitamins are also essential for immune and nervous system functioning. Take 50mg daily (100mg is often not fully absorbed by the body). B complex injections may also be considered for better absorption. You must discuss this option with your naturopath or other health practitioner. Some studies indicate that topical applications of a concentrated form of vitamin B6 may help treat melanomas. Ideal sources of B6 include avocados, bananas, beans, blackstrap molasses, brewer's yeast, brown rice, cabbage, chicken, corn, eggs, fish, meat, peas, potatoes, soy, spinach, walnuts, wheat bran, and wheat germ. If supplementing, take 50 to 100mg, in divided doses. Vitamin C has been shown to be selectively toxic to melanoma cells in vitro. It also enhances white blood cell and NK cell activity, both imperative in your body's defense against cancer. Vitamin C is also necessary to convert vitamin D in the body to a useable form (see "Vitamin D" below). Take 10g (10,000mg) daily in divided doses, or to bowel tolerance. Coenzyme Q10 has antioxidant properties and is known to stimulate the immune system. Deficiencies have been associated with the development of cancer. At lower doses, coenzyme Q10 can help patients experience less pain and weight-loss, a decrease in metastasis, and an increase in appetite. At higher doses it may promote tumour remission. Coenzyme Q10 is found in broccoli, meats, peanuts (not a recommended source), salmon sardines, and spinach. If supplementing, take 50 to 300mg daily, in divided doses. Vitamin D is produced in the body when certain wavelengths of sunlight react to specific cells in the skin. It is interesting to note that sulfur dioxide, the main constituent of smog, absorbs those wavelengths of light that trigger vitamin D production in the skin, while allowing the harmful portion of the spectrum through. It seems to be common knowledge that excess sun exposure can cause cancer, but some studies suggest that too little exposure can be harmful as well. This may be due to the protective effects of vitamin D and if you are not receiving enough sunlight, your body may not have adequate supplies of this vitamin. Some studies suggest that brief, regular exposure to sunlight is beneficial in preventing melanoma. Vitamin D has also been shown to suppress the growth of melanoma cells in vitro. It seems to prevent small melanomas from developing in to clinically significant and detectable cases of cancer. Step outside and receive 10 to 15 minutes of sunlight per day, without sunscreen, as it blocks out the part of the spectrum necessary for the production of vitamin D. Very low levels of vitamin E and beta-carotene have been noted in some people with melanoma. Vitamin E may prevent the growth of melanoma, and it can also protect you from the side-effects of chemotherapy. It is best to use selenium in conjunction with vitamin E to enhance its effects. Take 400 to 800 IU daily. Take 200 to 400mcg selenium as a complement. NOTE: Daily selenium intakes greater than 1000mcg can be toxic. Folic acid helps increase the production of white blood cells that are necessary to fight against cancer cells. Take 400mcg daily. In vitro studies suggest that vitamin K is effective in inhibiting tumour colony formation of melanoma cells. Vitamin K has also been shown to enhance the effects of some forms of chemotherapy. Ideal sources of vitamin K include asparagus, avocados, beef, broccoli, cabbage, dark green leafy vegetables, egg yolks, green tea, nuts, oatmeal, rye, seeds, soybeans, turnip greens, wheat, and wheat germ oil. Vitamin K is also found in kelp and alfalfa supplements and is available in some multi-vitamin/mineral preparations. If directly supplementing, take 100 to 300mcg daily in divided doses.
Actions and Remedy Listings
For More Information ... Canadian Dermatology Association
774 Echo Drive, Room 521
Ottawa, Ontario
K1S 5N8 Tel.: 613.730.6262
Toll-free: 1.800.267.3376
Fax: 613.730.8262 Web: www.dermatology.ca
Email: contact.cda@dermatology.ca American Acadamy of Dermatology
930 N. Meacham Road
PO Box 4014
Schaumburg, IL
60168-4014 Tel.: 847.330.0230
Toll-free: 1.888.4620.DERM
Fax: 847.330.0050 Web: www.aad.org
Email: yurbikas@aad.org The book "Cancer Therapy: The Independent Consumer's Guide to Non-Toxic Treatment & Prevention" by Ralph W. Moss (listed in the MBR Resource List) is an excellent resource for information and research done on the properties of various non-toxic treatments for cancer. ISBN 1881025063
See also Cancer, Sunburn
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