Meet our Cancer Specialist: Jason T. Wiseman, MD, MSPH | Shyamal Patel, MD
Common and Rare Tumors
The melanoma, sarcoma, and skin cancer program at the Dignity Health – Cancer Institute at St. Joseph’s Hospital and Medical Center is dedicated to the prevention, diagnosis and treatment of all types of skin cancer, including rare skin cancers – such as merkel cell carcinoma, dermatofibrosarcoma protuberans (DFSP) and other rare cutaneous tumors. Our disease-specific, medical and surgical oncologists serve the needs of our patients, as well as participate in important research and clinical trials.
Skin cancer is the most frequently diagnosed cancer in the United States. According to the American Academy of Dermatology, 5.4 million cases of non-melanoma skin cancer occurred in the U.S. in 2012, including basal cell carcinoma and squamous cell carcinoma. In the same year, according to the Centers for Disease Control and Prevention, 67,753 Americans were diagnosed with melanomas of the skin.
Basal Cell Carcinoma (non-melanoma)
The most frequently occurring form of skin cancer, the Skin Cancer Foundation describes basal cell carcinoma as an abnormal growth or lesion that arises in the skin’s basal cells, which line the deepest layer of the epidermis, the outermost layer of the skin. Basal cell carcinoma often look like red patches, pink growths, open sores, shiny bumps or scars and are usually caused by a combination of cumulative and occasional intense sun exposure.
Basal cell carcinoma rarely spreads beyond where it originally appears on the body. Only in exceedingly rare cases can it spread and become life-threatening.
Squamous Cell Carcinoma (non-melanoma)
Squamous cell carcinoma is caused by a growth of abnormal cells arising in the squamous cells, which compose most of the skin’s upper layers (the epidermis). Squamous cell carcinomas often look like warts, open sores, elevated growths with a central depression or scaly red patches. They may bleed or crust over. They can become disfiguring and sometimes deadly.
Squamous cell carcinoma is caused mainly by cumulative effects of ultraviolet (UV) exposure over a lifetime. Daily year-round exposure to the sun’s UV light, more intense exposure in the summer months and the UV light produced by tanning beds all add to the damage that can lead to squamous cell carcinoma.
Warning signs, prevention and treatment information about squamous cell carcinoma can be found at the Skin Cancer Foundation website.
Your muscles, tendons, fatty tissues, and blood vessels, among others, are all known as soft tissues. These soft tissues can develop cancers known as soft-tissue sarcomas that may cause lumps or swelling and can spread if not addressed. Even though they are fairly uncommon, you may be at a higher risk if you’ve been exposed to certain chemicals, have had radiation therapy in the past or have genetic diseases such as neurofibromatosis, retinoblastoma, and more.
Since many soft-tissue sarcomas begin in the extremities (arms or legs) with a bump or lump that increases in size over time – usually weeks or months. You should see a doctor right away if you have any of the following:
- A new lump or a lump that’s growing anywhere on your body
- Abdominal pain that’s increasingly worse
- Blood in your stools or vomit
- Black, tarry stools
Soft-tissue sarcomas can be treated. Depending on the location, type and stage of the cancer, treatments might include radiation therapy, chemotherapy, targeted drug therapies and surgery. To schedule an appointment or to find out more about soft-tissue sarcoma, call the Dignity Health – Cancer Institute at St. Joseph’s at (602) 406-8222.
More information can all be found at the American Cancer Society.
According to the American Cancer Society, melanoma is a cancer that begins in the melanocytes, the pigment-producing cells located in the bottom layer of the epidermis. Most melanoma cells still produce the substance melanin that results in pigment, so melanoma tumors typically are brown or black. Some melanomas, however, don’t produce pigment and can appear pink, tan, or even white.
Melanoma is much less common than basal cell and squamous cell skin cancers, but it is far more dangerous. Like basal cell and squamous cell cancers, melanoma is almost always curable in its early stages. But it is much more likely than basal or squamous cell cancer to spread to other parts of the body if not caught early.
Depending on the stage when it’s diagnosed, melanoma can be treated with surgery, radiation therapy, targeted therapy or biologic therapy. If you have been diagnosed with melanoma, call the Dignity Health – Cancer Institute at St. Joseph’s, please call (602) 406-8222 to meet with a skin cancer specialist, and better understand your treatment options.
Warning signs, risk factor and treatment information about melanoma can be found at Skin Cancer Foundation.
According to the International Transplant Skin Cancer Collaborative, organ transplant patients are up to 65 times more likely to develop skin cancer than people without transplants. Our multidisciplinary skin cancer team works closely with the lung transplant group at the Norton Thoracic Institute to educate and treat at risk patients.
For more information about skin cancer or to schedule an appointment at the Dignity Health – Cancer Institute at St. Joseph’s, please call (602) 406-8222.
Merkel Cell Carcinoma (MCC)
A rare and aggressive skin cancer, Merkel cell carcinoma presents a high risk of recurring and spreading (metastasizing) throughout the body. According to Merkelcell.org, Merkel cells are found in the skin where their key function is as touch receptors. Merkel cell carcinoma occurs when an uncontrolled growth of Merkel cells develop in the skin.
Merkel cell carcinoma does not have a distinctive appearance. It usually develops on sun-exposed skin as a painless, firm, flesh-colored red or blue bump. It will grow rapidly and/or break down the overlying skin. Diagnosis usually requires a biopsy. Most common factors for those at risk of developing MCC are:
- Age 65 or older
- Fair skin
- History of extensive sun exposure
- Chronic immune suppression (e.g. kidney or heart transplantation or HIV)
Information, frequently asked questions and treatment information about Merkel cell carcinoma can be found at Merkelcell.org. To schedule an appointment or find out more about our skin cancer program at the Dignity Health – Cancer Institute at St. Joseph’s, call (602) 406-8222.
Dermatofibrosarcoma Protuberans (DFSP)
Dermatofibrosarcoma protuberans (DFSP) is a rare, slow-growing malignant tumor that develops in the deep tissues of the skin and, using a tentacle-type approach, can grow into surrounding fat, muscle and bone. It often presents as a small, firm patch of skin, approximately one to five centimeters in diameter.
Dermatofibrosarcoma Protuberans (DFSP) is not gender specific as to whom it targets; however, it is more common among people age 20 to 50. According to Sarcomahelp.org, there are several variations of DFSP that can be identified under a microscope:
- Bednar tumors (pigmented DFSP) contain dark-colored cells called melanin-containing dendritic cells. Melanin is the substance that gives skin its color. As a result, this type of tumor may contain various colors, including red and brown. Bednar tumors account for approximately 1%-5% of all DFSP cases.
- Myxoid DFSP tumors contain an abnormal type of connective tissue that is called myxiod stroma. This type of tumor is uncommon, presents a diagnostic challenge and is important to recognize in order to prevent both under- and over-treatment.
- Giant cell fibroblastoma, referred to as juvenile DFSP because it typically affects children and adolescents, is characterized by giant cells in the tumor. It appears to be histologically similar to DFSP and in rare instances can be found within the same tumor in conjunction with DFSP, resulting in a hybrid lesion.
- Rarely, the tumors involved in the different types of DFSP can have regions that look familiar to fibrosarcoma, a more aggressive type of soft tissue sarcoma. In these cases, the condition is called Fibrosarcomatous (FS) DFSP. These tumors are more likely to metastasize than tumors in the other types of DFSP.
Treatment options for Dermatofibrosarcoma Protuberans (DFSP) include Mohs Micrographic Surgery, or wide local excisions.
To schedule an appointment or find out more about our skin cancer program at the Dignity Health – Cancer Institute at St. Joseph’s, call (602) 406-8222.