Advances in Diagnosis, Treatment of Skin Cancer

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Key Points

Several ideas could help make the prior authorization system easier on physicians and, ultimately, on patients:

• The otolaryngologist’s role in management of advanced skin cancer continues to evolve, especially with melanoma and advanced BCC, SCC.
• Screen patients for suspicious lesions, even those coming in for other issues.
• Otolaryngologists are now performing sentinel lymph node biopsies.

Risk Factors: Not Just Sun Exposure

The primary risk factor for the development of most skin cancers is sun exposure. “Skin cancer is the end result of a lifetime accumulation of sun,” said Dr. Park. But, sun exposure is not the only risk factor for developing skin cancer. Other risk factors include:

• Immunosuppressive therapies, e.g. transplantation;
• Scars and burns;
• Lymphoma and chronic lymphocytic leukemia;
• HIV;
• Tanning booths; and
• Genetics.

According to the NCCN, the incidence of BCC among organ transplant patients is approximately five- to 10-fold higher than in the general population. The risk of SCC is even higher. Data from transplant registries have reported a five-fold to 113-fold increase in incidence of SCC in transplant recipients compared with the general population.

The use of indoor tanning booths is significantly associated with the development of skin cancer, especially in younger patients. According to Dr. Bradford, the rise in the incidence of melanoma is mostly seen in younger people. There are a number of factors contributing to this, but tanning booths do contribute to the causation, she said.

Having a family history of skin cancer also increases the risk of developing skin cancers, so many clinicians encourage patients to be screened early and often.