Skin Cancer generally

Skin cancer is the most common type of cancer in the Netherlands. This applies to both men and women. Skin cancer is estimated that affects approximately 80,000 people per year. This number is still rising. In many patients with skin cancer, the disease is also caused by excess exposure to ultraviolet radiation (UV radiation in sunlight for example), however, certain genetic physical characteristics, such as, for example, a light-skinned individuals, could contribute to the development of skin cancer. Sometimes it can spread skin cancer. sent off cancer cells via the lymph to the regional lymph nodes and metastases to grow out there. The regional lymph nodes in the neck and ear, the lymph node metastases where a skin tumor in the head and neck area first arrive.

Two types of skin cancer are most common: the basal cell carcinoma (72%) and squamous cell carcinoma (16%). Together they form about 88% of skin tumors.

The melanoma occurs in about 11% of patients with skin cancer before. Rare skin tumors such as Merkel cell carcinoma, Kaposi’s sarcoma, or huidadnexcarcinoom dermatofibrosarcoom occur in about 1% of patients.

basal cell carcinoma

The basal cell carcinoma is the most common form of skin cancer. It can occur anywhere but is most common on the face and on the (bald) head (the sunlit skin). Tumor growth usually begins as a smooth, glassy lump. It grows very slowly. Sometimes appearing therein dilated blood vessels. After a time arises in the middle of an ulcer and surrounded by a rim with a pearl-like luster. It has a crust that is too easy ripping. Sometimes the scab falls off.

The basal cell carcinoma is the least malignant form of skin cancer almost never sows and gives few complaints. Yet it is also important to thoroughly treat a basal cell carcinoma. Nothing is done, then it can grow into deeper skin. It may then affect the tissues under the skin, such as cartilage and bone tissue, or move up to other major organs such as the eye or ear canal.

squamous cell carcinoma

Squamous cell carcinoma is the second most common skin cancer. It arises in the upper layer of the skin: the epidermis. Squamous cell carcinoma can occur anywhere on your body, but especially in places that have been much in the sun, including skin of the skull and neck, face, ears, lips, top hands, lower arms and legs. Usually a squamous cell carcinoma begins as a pale pink, rough lump. Sometimes, with a scaly white spot in the center. The nodule is slowly growing and sometimes hurts. A squamous cell carcinoma may look like a small wound which is slowly increased.

Squamous cell carcinoma often looks different from a basal cell carcinoma. It does not have the pearly shine and dilated blood vessels of the basal cell carcinoma. It often grows faster. A squamous cell carcinoma can metastasize if not treated.

Approximately 10-20% of all squamous cell carcinomas from sows. This is usually done through the lymph nodes near the tumor. Sometimes therefore performed an ultrasound of the neck in order to assess the lymph nodes. However, if necessary, can be taken by a puncture cells from the lymph node by the radiologist for tissue examination, this is relatively rare.


The melanoma is a type of skin cancer that originates in the pigment cells. These pigment cells are also called melanocytes. They are located in the epidermis. Melanomas are becoming more common in the Netherlands. Melanoma literally means black tumor. Often sat there in that place already a birthmark. A melanoma can grow into the deeper layers of the skin and has a strong tendency to metastasize. Melanomas can sit anywhere on the skin, but do have preference for certain places. In women, melanoma often on the legs. In men, especially on the back. But melanoma also occur on the arms, the head and neck region and parts never come into the sun like soles, palms and mucous membranes.

Changes in the skin that may indicate a (starting) melanoma, often occur in existing moles. These changes in a mole its becoming thicker and / or larger, change of color, change of shape or itching. Symptoms that may occur later include pain or bleeding from a mole or a sore or scab on a birthmark. In addition, in a ‘gift’ skin form a melanoma. In the first instance, this melanoma appears to be a new mole. However, these pigment spot continues to grow and will also eventually exhibit the changes that have been mentioned above.

Treatment basal cell carcinoma and squamous cell carcinoma

In most cases, surgery is the treatment of first choice. Often, the surgeon will remove the tumor under local anesthesia (excision). Here he cuts to be with a healthy skin edge (margin) to be sure that he will remove all tumor. With larger tumors and / or tumors with an aggressive growth habit, he will take away more skin. It may be that the surgeon or not the wound edges get together because the wound is too large. A reconstruction may then be necessary to close the wound. This is often done with a skin graft.

In case of skin grafting, the doctor places a piece of skin from another site of the body to the wound. For places in the face it is usually used for this purpose skin of the neck or of the leg. Later can also be a more extensive reconstruction. A pathologist examines the cutting edges of the excised tissue under the microscope. Finds he still tumor cells in the edge of the removed tissue, than is usually found to be a second operation is needed to be sure that the cancer is completely removed.

In some cases, is selected for radiation (radiotherapy). These specific cases, the surgeon discuss with you.

melanoma treatment

Suspected tissue research is needed on a melanoma. Suspected this must place in its entirety, be removed with a 2 mm margin. This surgery is called a diagnostic excision: removal of a piece of tissue in order to diagnose and determine depth growth. Only when the results of the tissue examination is known, the doctor knows which type of melanoma is. Metastases are usually first detected in regional lymph nodes.

In melanoma metastases can also be caused by the formation of so-called satellites, which are small metastases in the surrounding skin (the scar of) the original tumor. After the result of the tissue examination is known to the scar of the previous operation for the security is removed together with a part of the surrounding healthy tissue. It therefore re-removing a piece of tissue called re-excision or excision. The thicker melanoma, the more healthy skin removes the doctor. It may also be necessary to conduct a sentinel node biopsy. Here, the node is removed, which receives from the first tumor as lymph fluid. By examining these can be investigated metastases.