Non-melanoma Skin Cancer of the Head and Neck

Skin Cancer, Nonmelanoma
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Sometimes the first sign of melanoma or squamous cell cancer is an enlarged lymph node. Diagnosis is made by clinical exam and a biopsy. Basal cell and squamous cell cancers are staged by size and extent of growth. Basal cell cancers rarely metastasize to lymph nodes, but they can grow quite large and invade local structures.

Squamous cell cancers have a much higher incidence of lymph node involvement in the neck and parotid gland and can spread along nerves. Melanoma is staged based not on size but on how deep it invades the skin layers. Therefore, a superficial or shave biopsy will not provide accurate staging information used to guide treatment.

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Melanomas can have a very unpredictable course and can spread to distant organs. Melanomas with intermediate thickness often require sentinel node biopsy, a surgical procedure performed by a head and neck surgeon, to determine if microscopic spreading to lymph nodes has occurred.

Many early-stage small basal cell cancers or squamous cell cancers can be removed by Mohs surgery, which is a technique that spares normal tissue through repeated intraoperative margin testing, removing only the cancer and leaving adjacent normal tissue.

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Skin cancer is the most common type of cancer in the world. Fortunately, the majority of cancers are not aggressive, and can be treated without the need for major surgery, chemotherapy, or radiation therapy. For these cancers, a multidisciplinary team approach is recommended.

These types of tumors can involve more aggressive surgery with possible evaluation of the lymph nodes, and may require radiation therapy or chemotherapy after surgery. Due to the unique nature of melanoma, we approach these tumors in a separate fashion. At Stanford, all patients with aggressive or rare skin cancers that have a higher risk of treatment failure are discussed at our multidisciplinary High-Risk Non-Melanoma Skin Cancer tumor board.

At this tumor board we have colleagues from dermatology, head and neck surgery, radiation oncology, and medical oncology discuss each patient and review the optimal treatment strategy. With limited resources, many cancer registries do not register all primary NMSCs.

Overview of Non-Melanoma Skin Cancer

In addition, some NMSCs are not registered, especially small BCCs that are treated topically without pathological verification, but also those treated in the private sector. Overall, this leads to under-reporting of the true burden of NMSCs on the health system.

Non-melanoma skin cancer (except cancers of the eyelid and the head and neck)

This data briefing provides recent information on the registered incidence of NMSCs in different cancer registries in the UK and Ireland. Incidence of basal cell carcinomaThere has been a large increase in the incidence of BCCs recorded between and Fig. Some of this increase may be attributable to improved registration.

The incidence rate is higher in males than females.

There is broad variation in incidence rates between registries which is partly, but not entirely, due to different registration policies see above. The increase in incidence of SCCs from to Fig. The incidence rate is higher in males than females, and this gender difference is wider than for BCCs. This may reflect the higher proportion of fair-skinned people in Celtic countries, although it seems unusual this would not also affect the incidence of BCCs.

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You may use the menu to choose a different section to read in this guide. It is not uncommon for individual BCCs to contain a mixture of histologic subtypes, with the most infiltrating component sometimes being present only at the deepest advancing border of the tumor. Search form Search. How common is skin cancer? Adult Treatment. This sequence is typically repeated two or three times. Latest Research.

The higher incidence in Celtic countries may also be due to more complete recording of SCCs, and for Scotland their policy of recording all SCCs per person. The incidence of NMSCs appears to be increasing fairly rapidly and is higher in males than females. For BCCs, it is difficult to separate out the effects of improved registration from true increased incidence.

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This parallels increases in melanoma, and suggests increasing prevalence of historical exposure to UV radiation. There is clear variation in the incidence of NMSCs between cancer registries, and it is unlikely that this can be entirely accounted for by different registration methods.