Skin Cancer

Read articles about skin cancers, diagnosis, symptoms, management, and treatment.

Nicotinamide: An Update and Review of Safety & Differences from Niacin

Oral nicotinamide is an affordable over-the-counter supplement with demonstrated benefit in the treatment of a range of skin conditions, most notably AK and NMSC.

Imiquimod 5% Cream (Aldara®) in the Treatment of Basal Cell Carcinoma

Skin cancer, the most common human cancer, is now a global epidemic. The most prevalent form of nonmelanoma skin cancer is basal cell carcinoma (BCC), the incidence of which continues to increase prompting development of new treatment modalities designed to add or complement current therapies.

Sirolimus: A Therapeutic Advance for Dermatologic Disease

Sirolimus, also known as rapamycin (SRL, Rapamune®), was approved in 1999 by the US Food and Drug Administration to prevent graft rejection in renal transplantation. This articles reviews Sirolimus, its pharmacokinetics, mechanism of action, and indication.

Management of Non-melanoma Skin Cancers in Canada

A summary of the most comprehensive and up to date guideline for treating non-melanoma skin cancer in Canada. Background, primary prevention, actinic keratosis, managing basal cell carcinoma, and squamous cell carcinoma, are covered.

Non-Invasive Gene Expression Testing to Rule Out Melanoma

The Pigmented Lesion Assay (PLA) is a gene expression test that helps rule out melanoma and has the potential to reduce the need for surgical biopsies of atypical pigmented skin lesions.

Actinic Keratosis – Treatment

Actinic keratosis is a common skin condition and one that has the potential to become skin cancer. This article focuses on the available treatments: Topical drug therapy, surgical or chemical treatments, and photodynamic therapy.

Squamous Cell Carcinoma in Organ Transplant Recipients: Approach to Management

Skin cancer, particularly squamous cell carcinoma (SCC), continues to be a significant cause of morbidity and even mortality in organ transplant recipients (OTRs). As the number of organ transplant patients continues to increase, dermatologists will be faced with the challenge of diagnosing and managing their skin cancers.

Cutaneous Side-effects of EGFR Inhibitors and Their Management

Epidermal growth factor receptor (EGFR) inhibitors are an increasingly important treatment option for metastasized cancer in patients. We present an overview of the various cutaneous side-effects associated with EGFR inhibition and discuss their respective therapeutic options.

Basal Cell Carcinoma – Treatment

Basal Cell Carcinoma (BCC) is the most common skin cancer. This article focuses on the treatment options available, and the advantages and disadvantages of each.

Cutaneous Reactions to Anticancer Agents Targeting the Epidermal Growth Factor Receptor: A Dermatology-Oncology Perspective

The epidermal growth factor receptor (EGFR) is often overexpressed or dysregulated in solid tumors. Targeting the EGFR-mediated signaling pathway has become routine practice in the treatment of lung, pancreatic, head and neck, and colon carcinomas.

Ingenol Mebutate: An Introduction

The incidence of nonmelanoma skin cancer continues to increase. This article discusses ingenol mebutate, its history, mechanism of action, and recent trial evidence for this emerging therapy are discussed.

Update on Immunotherapeutics in the Management of Metastatic Melanoma

There are many new immunotherapeutics that have been approved or are in clinical and pre-clinical trials to expand our arsenal in the treatment of melanoma and other previously difficult to treat malignancies.

The Multifunctional Value of Sunscreen-containing Cosmetics

Cosmetic products containing ultraviolet light filtering agents are rapidly being developed and entering the marketplace. This article reviews formulary attributes, effective photoprotection, adherence, and behavior modification.

Systemic Retinoids: Chemoprevention of Skin Cancer in Transplant Recipients

Solid organ transplant recipients have an increased incidence of skin cancer, resulting in significant morbidity and mortality post-transplantation. This article studies systemic retinoids, and other chemopreventative agents for high risk patients.

Mohs Surgery: The Gold Standard Treatment for BCC and SCC

Why is Mohs Surgery considered the world's gold standard treatment for BCC and SCCs? Dr. Bryce Cowan explains the types of cancers that are typically treated with Mohs surgery, and why the procedure has such as high cure rate.

Therapeutic Advances in Cutaneous T-Cell Lymphoma

A variety of novel therapeutic modalities have recently become available for patients with cutaneous T cell lymphoma (CTCL). Here, we offer a brief overview of these agents and discuss their place in the spectrum of current therapies for CTCL.

Nivolumab for Metastatic Melanoma

Melanoma is an aggressive skin cancer with a generally poor prognosis at Stage III-IV disease. Discussion centres around clinical trial data from phase I-III studies of Nivolumab (Opdivo®), a human monoclonal antibody which prevents immune inhibition by interacting with PD-1 on tumor cells.

Mohs surgery in Canada, Numbers and Facts

In Canada, there are only a very limited number of qualified Mohs surgeons at this stage, but that number is growing. The health care system in Canada is run at the provincial level, and currently there are only a limited number of facilities where Mohs surgeons can practice at.

Concerns about Cancer Recurrence after Mohs Surgery

If a patient has skin cancer removed with Mohs Surgery, will they see another cancer, or a recurrence of the same cancer again? Unfortunately, the answer is that yes it's highly likely.

Introduction to Mohs Surgery

Mohs surgery is an advanced technique for removing skin cancers that combines histological analysis under a microscope at real-time with surgical excision.

Metastatic Melanoma: Optimizing Outcomes by Managing Dermatologic Toxicities Associated with Novel Therapies

The last couple of years have seen the beginning of a new era in the treatment of metastatic melanoma. This article focuses on BRAF inhibitors and immune modulators which have demonstrated an overall survival benefit, and the importance of limiting adverse events.

Skin Treatments Introduced in 2015

An overview and update of skin treatments introduced in 2015: Quick overview of drug name, indications and regulatory status. Deoxycholic acid injection, 5-fluorouracil 0.5% + salicylic acid 10% solution, Adapalene 0.3% + benzoyl peroxide 2.5% gel, and more are covered.

Alternatives to Mohs Surgery

In this video Dr. Cowan explains common scenarios where a doctor might not recommend Mohs Micrographic surgery, and might opt for another treatment modality instead.

The Controversy Surrounding Melanoma and Mohs Surgery

Patients often wonder why Mohs is not the standard treatment for invasive melanoma, the most dangerous of skin cancers. Dr. Cowan explains why the use of Mohs surgery is considered controversial for treating invasive melanomas.

Methyl Aminolevulinate-PDT for Actinic Keratoses and Superficial Nonmelanoma Skin Cancers

Methyl aminolevulinate-hydrochloride cream (Metvix® [in Canada] and Metvixia® [in the US], Galderma) in combination with photodynamic therapy (PDT) provides an effective treatment option for actinic keratoses (AKs), superficial basal cell carcinoma (sBCC), and Bowen’s disease (BD).

Immunological Strategies to Fight Skin Cancer

Skin cancer is the most common human cancer, and is currently considered a global epidemic. Recently, there has been a growing interest in immunomodulators, or upregulators of the immune response.

The Recovery Process after Mohs Surgery

Reconstruction surgery is required after any Mohs Surgery procedure. Typically the wounds will take over a year to completely heal after the surgery. 10% per month is a typical rate of healing, with the peak at around 2 months.

Predictive Testing of the Melanocortin 1 Receptor for Skin Cancer and Photoaging

Genetic predisposition to melanoma and nonmelanoma skin cancer extends far beyond the Fitzpatrick phenotype classification scheme. Testing aimed at improving prognostication may serve to limit the influence of certain risk factors.

The Advantages of Mohs Micrographic Surgery

Dr. Cowan explains when Mohs Micrographic Surgery is recommended, from a physician perspective. At the same time, he emphasizes the importance and necessity of patients doing their own research.

Surgical Excision and Histological Analysis in Mohs Surgery

In the third video of the Mohs Surgery series, plastic surgeon Dr. Bryce Cowan explains in further detail the combined process of surgical excision and real-time histological analysis of the excised tissue.

Canadian Skin Management in Oncology (CaSMO) Algorithm for Patients With Oncology Treatment-Related Skin Toxicities

The CaSMO (Canadian Skin Management in Oncology) algorithm focuses on general skincare measures to prevent or reduce the severity of cancer-treatment-related cutaneous toxicities.

Skin Cancer and Genetics

Patients often ask whether they are likely to have skin cancer if their mother or father had this problem. Being a genetic combination of your parents, what you do inherent is the same skin types.

Reducing Skin Malignancy Risk in Organ Transplant Recipients

Skin cancer in organ transplant recipients is a serious problem that manifests as increased squamous cell carcinoma in long-term patients. Education, surveillance, and management of skin cancers in high risk patients are discussed in this article.

Preparing for Mohs Surgery

Patients need to take some important steps prior to surgery to maximize the outcome of their procedure. The first step for a patient is to ensure that their surgeon is a qualified Mohs surgeon...

Imiquimod: An Immune Response Modifier

Imiquimod is an immune response modifier. Studies have shown that it has potent immunomodulatory effects and stimulates human peripheral mononuclear cells to release interferon alpha, sub-types α1,α2, α5, α6, and α8.

Melanoma – Treatment

Melanoma is the rarest of the big 3 skin cancers, but it accounts for the majority of mortality. Discussion is focused on the treatment modalities for melanoma: Surgery, Chemotherapy, Radiation Therapy, Biological Therapy.

Reconstruction Surgery After Mohs Surgery

A very common question from patients concerning Mohs Surgery is “Will I need reconstruction surgery?” Dr. Bryce Cowan explains why reconstruction surgery is necessary to optimize the final outcome, and outlines the process and importance of this with some examples.

Expectations vs True Risks of Surgery

What's the difference between true risks and expectations of surgery? Dr. Cowan explains the difference.

Factors that Affect Cure Rate in Mohs Surgery

Mohs micrographic surgery is often used to treat recurrent skin cancers. In this video, we ask Dr. Bryce Cowan whether previous attempts to remove skin cancer can affect the prognosis of Mohs surgery.

The Use Of Interleukins For Advanced Melanoma

Treatment of metastatic melanoma using traditional chemotherapy regimens has been disappointing. However, recent work with agents that modify the host’s immune system (e.g., interleukins) have provided limited but encouraging results. Interleukins are a group of molecules involved in immune cell signaling.

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