|
|
FeelGoodNow.com is currently in early beta. Our site will be growing and changing frequently. We welcome your 
Background |
Risk factors |
Causes |
Signs and symptoms |
Diagnosis |
Complications |
Treatment |
Integrative therapies |
Prevention |
Author information |
Bibliography
Skin Cancer
Skin cancer is the abnormal growth of skin cells. It most often develops on skin exposed to the sun, but can also occur on areas that are not ordinarily exposed to sunlight. Skin cancer is generally divided into two stages, local (where the cancer affects only the skin) and metastatic (where cancer has spread beyond the skin).More than one million new cases of skin cancer will be diagnosed in the United States this year. One in five Americans will develop some form of skin cancer during their lifetime.
The skin consists of three layers including the epidermis, dermis, and the subcutaneous layer. The epidermis is the outermost layer and is very thin. It provides a protective layer of skin cells that sheds continually. Squamous cells lie just below the outer surface. Basal cells, which produce new skin cells, are at the bottom of the epidermis. The epidermis also contains cells called melanocytes, which produce melanin, the pigment that gives skin its normal color and causes moles. When exposed to the sun, these cells produce more melanin that helps protect the deeper layers of skin. The extra melanin is what produces the darker color of tanned skin.
There are three major types of skin cancer, including basal cell carcinoma, squamous cell carcinoma, and melanoma. Basal and squamous cell carcinomas are slow growing and generally highly treatable. If all forms of skin cancer are found early and treated appropriately, they are all nearly 100% curable. It is very important to limit or avoid exposure to ultraviolet (UV) radiation and pay close attention to suspicious changes in the skin.
Other less common types of skin cancer include Kaposi's sarcoma, Merkel cell carcinoma, and sebaceous gland carcinoma.
Basal cell carcinoma: Basal cell carcinoma (BCC) is the most common form of cancer, accounting for nearly 90% of all skin cancers. Basal cells are cells that line the deepest layer of the epidermis. An abnormal growth of cells in this deep layer is known as BCC. Although BCC can usually be diagnosed with a simple biopsy, has a low rate of metastasis, and is fairly easy to treat when detected early, 5-10% of BCCs can be logically aggressive and resistant to treatment. BCC may invade bone and cartilage, and if not treated appropriately and early, it may be very difficult to eliminate.
Squamous cell carcinoma: Squamous cell carcinoma (SCC) is the second most common form of skin cancer, with over 200,000 new cases per year estimated in the United States. Squamous cells are cells that compose most of the epidermis. An abnormal growth of squamous cells is known as a SCC. Most SCCs are not life-threatening when identified early and treated appropriately, but SCC may become more difficult to treat, can cause disfigurement, and a small percentage may spread (metastasize) to other organs resulting in death.
Melanoma: Although melanoma is not the most common of the skin cancers, it causes the most deaths. The American Cancer Society estimates that in 2007, there will be 59,940 new cases of melanoma in the United States. Melanoma is a malignant tumor that originates in melanocytes (produce melanin). The majority of melanomas are black or brown, although some melanomas occasionally stop producing pigment and may be skin tone, pink, red, or purple.
Background
Skin cancer is the abnormal growth of skin cells. It most often develops on skin exposed to the sun, but can also occur on areas that are not ordinarily exposed to sunlight. Skin cancer is generally divided into two stages, local (where the cancer affects only the skin) and metastatic (where cancer has spread beyond the skin).More than one million new cases of skin cancer will be diagnosed in the United States this year. One in five Americans will develop some form of skin cancer during their lifetime.
The skin consists of three layers including the epidermis, dermis, and the subcutaneous layer. The epidermis is the outermost layer and is very thin. It provides a protective layer of skin cells that sheds continually. Squamous cells lie just below the outer surface. Basal cells, which produce new skin cells, are at the bottom of the epidermis. The epidermis also contains cells called melanocytes, which produce melanin, the pigment that gives skin its normal color and causes moles. When exposed to the sun, these cells produce more melanin that helps protect the deeper layers of skin. The extra melanin is what produces the darker color of tanned skin.
There are three major types of skin cancer, including basal cell carcinoma, squamous cell carcinoma, and melanoma. Basal and squamous cell carcinomas are slow growing and generally highly treatable. If all forms of skin cancer are found early and treated appropriately, they are all nearly 100% curable. It is very important to limit or avoid exposure to ultraviolet (UV) radiation and pay close attention to suspicious changes in the skin.
Other less common types of skin cancer include Kaposi's sarcoma, Merkel cell carcinoma, and sebaceous gland carcinoma.
Basal cell carcinoma: Basal cell carcinoma (BCC) is the most common form of cancer, accounting for nearly 90% of all skin cancers. Basal cells are cells that line the deepest layer of the epidermis. An abnormal growth of cells in this deep layer is known as BCC. Although BCC can usually be diagnosed with a simple biopsy, has a low rate of metastasis, and is fairly easy to treat when detected early, 5-10% of BCCs can be logically aggressive and resistant to treatment. BCC may invade bone and cartilage, and if not treated appropriately and early, it may be very difficult to eliminate.
Squamous cell carcinoma: Squamous cell carcinoma (SCC) is the second most common form of skin cancer, with over 200,000 new cases per year estimated in the United States. Squamous cells are cells that compose most of the epidermis. An abnormal growth of squamous cells is known as a SCC. Most SCCs are not life-threatening when identified early and treated appropriately, but SCC may become more difficult to treat, can cause disfigurement, and a small percentage may spread (metastasize) to other organs resulting in death.
Melanoma: Although melanoma is not the most common of the skin cancers, it causes the most deaths. The American Cancer Society estimates that in 2007, there will be 59,940 new cases of melanoma in the United States. Melanoma is a malignant tumor that originates in melanocytes (produce melanin). The majority of melanomas are black or brown, although some melanomas occasionally stop producing pigment and may be skin tone, pink, red, or purple.
Risk factors
Age: Older individuals have a higher risk of developing skin cancer, mainly because many skin cancers develop slowly. Damage by other risk factors that occurred during childhood or adolescence may not become apparent until middle age, but skin cancer can occur in all ages. Basal cell and squamous cell carcinomas are increasing rapidly among women younger than 40.Environmental exposure: Exposure to harsh environmental chemicals, including arsenic, cosmetics, and some herbicides increases the risk of skin cancer.
Fair skin: The less pigment (melanin) the skin contains, the less protection from damaging UV radiation. People with blond or red hair, or light-colored eyes will freckle or sunburn more easily. These individuals are much more likely to develop skin cancer than a person with darker features.
Family history: Having a parent or a sibling who has developed skin cancer increases the risk of developing skin cancer. Some families are affected by a condition called familial atypical multiple mole melanoma (FAMMM) syndrome. The hallmarks of FAMMM include a history of melanoma in one or more close relatives and having more than 50 moles, some of which are atypical. Because people with this syndrome have an extremely high risk of developing melanoma, frequent screening for signs of skin cancer is crucial.
Fragile skin: If the skin is burned, injured, or weakened by treatments for other skin conditions, it is more susceptible to sun damage and skin cancer development.
Moles: Having lots of moles or abnormal moles (called dysplastic nevi) increases the risk of developing skin cancer. The abnormal moles are irregular and generally larger than normal moles, and are more likely than others to become cancerous.
Personal history: If an individual has developed skin cancer in the past, their risk for developing the disease again is increased. Even basal cell and squamous cell carcinomas that have been successfully removed can recur in the same spot, often within two to three years.
Precancerous skin lesions: Skin lesions known as actinic keratoses can increase the risk of developing skin cancer. These precancerous skin growths typically appear as rough, scaly patches that range in color from brown to dark pink. Actinic keratoses are most common on the face, lower arms and hands of fair-skinned people whose skin has been sun damaged.
Sun Exposure: Individuals who spend a considerable amount of time in the sun can develop skin cancer, especially if the skin isn't protected by sunscreen or clothing. Tanning is the skin's injury response to excessive UV radiation, and increases the risk of skin cancer.
Sunburn: Sunburn is the body's attempt to heal itself from the sun's damaging rays. Every time an individual gets sunburned, there is an increased risk of damaging skin cells and developing skin cancer. One or more severe, blistering sunburns can increase the risk of skin cancer as an adult.
Sunny or high-altitude climates: Individuals living in sunny, warm climates are exposed to more sunlight than those in colder climates. Higher elevations make UV rays stronger, and may also increase the risk of developing skin cancer.
Weak immune system: Individuals with weakened immunities are at a greater risk for developing skin cancer. This includes people living with HIV/AIDS, leukemia, and those taking immunosuppressant drugs after an organ transplant.
Causes
Damage in the epidermis to the normal DNA of skin cells may result in new cells growing out of control, and eventually forming an accumulation of cancer cells.UV light: Much of the damage to DNA in skin cells results from ultraviolet (UV) radiation found in sunlight and in commercial tanning lamps and beds. UV light is divided into three wavelength bands, including ultraviolet A (UVA), ultraviolet B (UVB), and ultraviolet C (UVC). Only UVA and UVB rays reach the earth. UVC radiation is completely absorbed by the atmospheric ozone. UVA and UVB rays play a role in the formation of skin cancer by causing changes in skin cell DNA, including the development of oncogenes, which are types of genes that can turn a normal cell into a malignant one. UVA penetrates the skin more deeply than UVB.
Tanning beds deliver high doses of UVA, which makes them especially dangerous. UVA puts an individual at greater risk of skin cancer than spending long hours in the sun because of the deep penetration of the rays.
Other factors: Heredity, exposure to toxic chemicals, and radiation treatments may also cause skin cancers.
Signs and symptoms
Skin cancer develops primarily on areas of sun-exposed skin, including the scalp, face, lips, ears, neck, chest, arms, hands, and on the legs in women. It also can form on areas not receiving as much light such as the palms, spaces between the toes, and the genital area.A cancerous skin lesion can appear suddenly or develop slowly, it depends on the type of cancer.
Basal Cell Carcinoma: Basal cell carcinoma may appear as a flat, scaly red patch, a pearly or waxy bump on the face, ears, or neck (bumps may bleed or develop a crust), a patch with large blood vessels (may look like a birthmark), or a brown or black raised bump.
Squamous Cell Carcinoma: Squamous cell carcinoma may appear as a flat, scaly red patch (may look similar to a skin rash), a small, smooth, shiny, or waxy bump, a firm, red nodule on the face, lips, ears, neck, hands or arms, or a red or brown, scaly skin patch.
Malignant Melanoma: Although it can occur anywhere on the body, melanoma appears most often on the upper back or face in both men and women. Malignant melanoma may appear as a new mole, a mole that has gotten larger, a mole that changes color or shape, a mole that bleeds, a mole that itches or causes pain, or a mole with an uneven border or shape. Warning signs of melanoma include a large brownish spot with darker speckles located anywhere on the body, a simple mole located anywhere on the body that changes color, size, feel or that bleeds, or a small lesion with an irregular border and red, white, blue, or blue-black spots on the trunk or limbs. Other signs include shiny, firm, dome-shaped bumps located anywhere on the body and dark lesions on the palms, soles, fingertips and toes, or on mucous membranes lining the mouth, nose, vagina and anus.
Superficial spreading melanoma: This type of melanoma is the most common type, accounting for about 70% of all cases. Superficial spreading melanoma travels along the top layer of the skin for a fairly long time before penetrating more deeply. It is most common in younger people. The melanoma appears as a flat or slightly raised discolored patch that has irregular borders and is somewhat geometrical in form, with various colors (tan, brown, black, red, blue or white) in it. The melanoma can be found almost anywhere on the body, but is most likely to occur on the trunk in men, the legs in women, and the upper back in both. Other forms of melanoma include lentigo maligna, acral lentiginous melanoma, and nodular melanoma.
Kaposi's sarcoma: Kaposi's sarcoma is a rare form of skin cancer that develops in the skin's blood vessels and causes red or purple patches on the skin or mucous membranes. Like melanoma, it's a serious form of skin cancer. This form of skin cancer is mainly seen in people with weakened immune systems, such as people with AIDS or taking medications that suppress their immunity (immunosuppressive medications in transplant patients).
Merkel cell carcinoma: Merkel cell carcinoma is a rare cancer that appears as firm, shiny nodules occurring on or just beneath the skin and in hair follicles. The nodules may be red, pink, or blue and can vary in size from a quarter of an inch to more than two inches. Merkel cell carcinoma is usually found on sun-exposed areas of the head, neck, arms, and legs. Unlike basal and squamous cell carcinomas, merkel cell carcinoma grows rapidly and often spreads to other parts of the body.
Sebaceous gland carcinoma: Sebaceous gland carcinoma is an uncommon and aggressive form of skin cancer. This form of skin cancer originates in the oil producing glands in the skin. It usually appears as hard, painless nodules that can develop anywhere, but occurs most on the eyelids where they're frequently mistaken for benign conditions.
Precancerous skin lesions: Precancerous skin lesions, including actinic keratosis, can also develop into squamous cell skin cancer. Actinic keratoses appear as rough, scaly, brown or dark-pink patches. They're most commonly found on the face, ears, lower arms and hands of fair-skinned people whose skin has been damaged by the sun. Other precancerous skin lesions include actinic cheilitis (in the lips), arsenical keratosis (exposure to arsenic), Bowen's Disease (superficial SCC that hasn't spread), and leukoplakia (disease of the mucous membrane).
Diagnosis
Most doctors recommend a checkup for skin cancer when a new skin growth, a bothersome change in the skin, a change in the appearance or texture of a mole, or a sore that doesn't heal in two weeks appears.Biopsy: If the doctor suspects skin cancer, a small sample of the skin (biopsy) will be removed and analyzed. A biopsy can usually be done in a doctor's office using local anesthetic.
Squamous cell carcinoma: A biopsy is often the only test needed to determine if the individual has squamous cell carcinoma. This cancer doesn't spread, and larger growths may require further testing.
Basal cell carcinoma: Nodular basal cell carcinoma is the most common type of skin cancer. This tumor usually resembles a smooth, round, waxy pimple, pale yellow or pearl gray, and may vary in size from a few millimeters to one centimeter. The skin covering the nodule is usually so thin that the slightest injury will cause it to bleed. These tumors are often depressed in the middle and display ulcerations. As the tumor grows, it destroys healthy structures in its path, including nerves, muscles, and blood vessels. Large tumors are easily diagnosed, but smaller ones are often difficult to tell from benign skin conditions, such as warts, seborrheic keratoses, moles, psoriasis, or fever sores. Other types of basal cell carcinomas include superficial, sclerosing, pigmented fibroepithelioma, basosquamous carcinoma, and basal cell nevus syndrome.
Melanoma: Moles, brown spots, and growths on the skin are usually harmless, but may increase the risk of developing melanoma, especially if there are more than 100 moles on the body. Diagnosis of melanoma will need to be made when moles appear to be asymmetric (if a line is drawn through the mole and the two halves don't match), have uneven borders, variety of colors (shades of brown, tan, or black), are large in size, or are changing. The type of melanoma will also be determined.
Once the type of melanoma has been established, the next step is to classify the disease as to its degree of severity. Melanoma, like other cancers, is classified in stages, and the stage will determine the treatment. Early melanomas (Stages I and II) are localized, and advanced melanomas (Stages III and IV) have spread to other parts of the body, or metastasized. There are also degrees within stages.
Breslow's thickness: The most important factor in staging a melanoma is the thickness of the tumor, known as Breslow's thickness, and the appearance of microscopic ulcerations (sores). Breslow's thickness measures in millimeters the distance between the upper layer of the epidermis and the deepest point of the tumor's penetration. The thinner the melanoma, the better the chance of a cure. Breslow's thickness diagnoses include: in situ melanoma confined to the epidermis, very thin tumors of less than 1.0 millimeter, thin tumors of 1.01=2.0 mm, intermediate tumors of 2.0-4.0 mm, and thick melanomas of 4.00 mm or more. The presence of microscopic ulcerations moves the tumor into a later stage.
Clark's level of invasion: Very thin tumors are classified according to Clark's level of invasion, which describes the number of layers of skin penetrated by the tumor. Clark's level I signifies the melanoma occupies only the epidermis. Clark's level II means that the melanoma penetrates to the layer immediately under the epidermis, the papillary dermis, Clark's level III means that the melanoma fills the papillary dermis and may touch the next layer known as reticular dermis, and Clark's level IV is when the melanoma penetrates into the reticular or deep dermis. Clark's level V melanoma invades the subcutaneous fat.
Stage I: This category is subdivided according to the thickness of the primary (original) tumor. In Stage 1a, the tumor is less than 1.0 mm in Breslow's thickness without ulceration and is in Clark's level II or III. In Stage Ib, the tumor is less than 1.0 mm in Breslow's thickness with ulceration and/or Clark's level III or IV, or it is 1.01 - 2.0 mm in thickness without ulceration.
Stage II: This category is also subdivided according to gradations in thickness and/or depth and the presence or absence of ulceration. In Stage IIa, the tumor is 1.01 - 2.0 mm in Breslow's thickness with ulceration, or is 2.01-4.0 mm in thickness without ulceration. In Stage IIb, the tumor is 2.01-4.0 mm in Breslow's thickness with ulceration, or is greater than 4.0 mm in thickness without ulceration. In Stage I?c, the tumor is greater than 4.0 mm in Breslow's thickness with ulceration.
Stage III: When a melanoma is in Stage III or greater, the tumor has either spread to the lymph nodes or to the skin between the primary tumor and the nearby lymph nodes. This can be determined by examining a biopsy of the node nearest the tumor, known as the sentinel node. Such a biopsy is now frequently done when a tumor is more than 1 mm in thickness, or when a thinner melanoma shows evidence of ulceration. In Stage III, the metastasis (spreading) is to the skin or underlying tissue (subcutaneous) for a distance of more than 2 centimeters (1 cm equals 0.4 inch) from the primary tumor, but not beyond the regional lymph nodes. These metastases are microscopic.
Stage IV: Stage IV melanoma has metastasized to lymph nodes far away from the primary tumor or to internal organs, most often the lung followed in descending order of frequency by the liver, brain, bone, and gastrointestinal tract.
Complications
Scarring: Some complications of skin cancer can be scars and disfigurement, but it is not usually life-threatening.Metastasis: Once a melanoma is diagnosed past Stage III, metastasis may be found increasing the complications for the patient and treatment involved.
Recurrent skin cancer: Once there has been a diagnosis of skin cancer, a second tumor may be more likely.
Treatment
Treatment for skin cancer and the precancerous skin lesions known as actinic keratoses varies depending on the size, type, depth and location of the lesions. Often the abnormal cells are surgically removed or destroyed with topical medications. Most treatments require only a local anesthetic and can be done in an outpatient setting. Sometimes no treatment is necessary beyond an initial biopsy that removes the entire growth.Freezing: Actinic keratoses and some small, early skin cancers may be destroyed by freezing them with liquid nitrogen (cryosurgery). The dead tissue sloughs off when it thaws. The treatment may leave a small, white scar.
Excisional surgery: Excisional surgery involves cutting out (excising) the cancerous tissue and a surrounding margin of healthy skin. A wide excision removing extra normal skin around the tumor may be recommended in some cases.
Laser therapy: A precise, intense beam of light vaporizes growths, generally with little damage to surrounding tissue, minimal bleeding, swelling, and scarring. This procedure may be used to treat superficial skin cancers or precancerous growths on the lips.
Mohs' surgery: This procedure is used for larger, recurring or difficult-to-treat skin cancers, which may include both basal and squamous cell carcinomas. The skin growth is removed layer by layer, with each examined under a microscope until no abnormal cells remain. This procedure allows cancerous cells to be removed without taking an excessive amount of surrounding healthy skin.
Curettage and electrodesiccation: This procedure involves the scraping away of cancer cell layers using a circular blade (curet), and the electric needle destroys any remaining cancer cells. This simple, quick procedure is common in treating small or thin basal cell cancers, and generally leaves a small, flat, white scar.
Radiation therapy: Radiation may be used to destroy basal and squamous cell carcinomas if surgery isn't an option.
Chemotherapy: Chemotherapy drugs are used to kill cancer cells. For cancers limited to the top layer of skin, creams or lotions containing anti-cancer agents may be applied directly to the skin. Topical drugs can cause severe inflammation and leave scars. Other types of chemotherapy can be used to treat skin cancers that have spread to other parts of the body.
Imiquimod (IMQ) and/or 5-fluorouracil (5FU) are two topical creams for skin cancers. IMQ works by stimulating the body's immune system to destroy cancerous cells (called topical immunotherapy). 5FU works as a topical chemotherapy, preventing rapidly dividing cells from growing. Both creams can cause redness and inflammation, and need to be used for many weeks to be effective. Occasionally, these creams may be used in addition to surgery for maximal success. Topical therapy allows for a low risk of scarring and may be applied at home.
Retinoids: Retinoids, such as tretinoin and isotretinoin, are drugs related to vitamin A and are sometimes used off-label to treat or prevent non-melanoma skin cancer. The retinoids may be taken by mouth or applied to the skin, and their use is being studied in clinical trials for treatment of squamous cell carcinoma. Many side effects exist with these medications, including flu-like symptoms and swelling in the feet and ankles (edema).
Photodynamic therapy: This treatment destroys skin cancer cells with a combination of laser light and drugs that makes cancer cells sensitive to light.
Biological therapy (also called immunotherapy): Interferon and interleukin-2 are currently under investigation to treat melanoma and non-melanoma skin cancers. These immunotherapy drugs stimulate the immune system to fight the cancer. Other medications applied to the skin, such as imiquimod (Aldara®), enhance the immune system's reaction to the presence of skin cancer.
Anti-inflammatory medications: The anti-inflammatory drug diclofenac as a topical cream is used off-label as a treatment in actinic keratinosis. Studies report uses for 60 to 90 days with positive results.
Integrative therapies
Good scientific evidence:Psychotherapy: Psychotherapy is an interactive process between a person and a qualified mental health professional (psychiatrist, psychologist, clinical social worker, licensed counselor, or other trained practitioner). There is good evidence that psychotherapy can enhance cancer patients' quality of life by reducing emotional distress and aiding in coping with the stresses and challenges of cancer. Therapy may be supportive-expressive therapy, cognitive therapy, or group therapy. Studies conflict on whether therapy improves self-esteem, death anxiety, self-satisfaction, etc. While some patients seek psychotherapy in hopes of extending survival, there is no conclusive evidence of effects on medical prognosis.
Unclear or conflicting scientific evidence:
Acupuncture: Acupuncture, or the use of needles to manipulate the "chi" or body energy, originated in China over 5,000 years ago. There has been limited research on acupuncture for cancer pain, and the research that was done was shown to have mixed results. More studies are needed to determine potential benefits. Evidence from several small studies supports the use of acupuncture at a specific point on the wrist (P6), which helps reduce the nausea and vomiting associated with chemotherapy.
Aloe: Transparent gel from the pulp of the meaty leaves of Aloe vera has been used topically for thousands of years to treat wounds, skin infections, burns, and numerous other dermatologic conditions. Preliminary research suggests that aloe may help prevent or aid in the regression of cancerous tumors. Additional research is needed in this area. Caution is advised when taking aloe supplements, as numerous adverse effects including a laxative effect, cramping, dehydration, and drug interactions, are possible. Aloe should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.
American pawpaw: Evidence supporting the use of the American pawpaw (Asimina triloba) tree for the treatment of cancer in humans is largely anecdotal and subjective. Use in humans has reported minimal side effects, and evidence from animal and in vitro studies suggests that American pawpaw extract does have some anticancer activity. Pawpaw standardized extract has been used for 18 months in patients with various forms of cancer. No well-designed studies on the long-term effects of pawpaw extracts have been conducted. Pawpaw should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.
Antineoplastons: Antineoplastons are a group of naturally occurring peptide fractions, which were observed by Stanislaw Burzynski, MD, PhD in the late 1970s and found to be absent in the urine of cancer patients. There is inconclusive scientific evidence regarding the effectiveness of antineoplastons in the treatment of cancer. Several preliminary human studies (case series, phase I/II trials) have examined antineoplaston types A2, A5, A10, AS2-1, and AS2-5 for a variety of cancer types. It remains unclear if antineoplastons are effective, or what doses may be safe. Until better research is available, no clear conclusion can be drawn.
Arabinoxylan: Arabinoxylan is made by altering the outer shell of rice bran using enzymes from Hyphomycetes mycelia mushroom extract. Arabinoxylan has been found to improve immune reactions in diabetes and cancer patients. Arabinoxylan products may contain high calcium and phosphorus levels, which may be harmful for patients with compromised renal (kidney) function.
Aromatherapy: Healing with fragrant oils has been used for thousands of years. Aromatherapy is often used in people with chronic illnesses (frequently in combination with massage), with the intention to improve quality of life or well-being. There is not enough scientific evidence in this area to form a firm conclusion about the effectiveness of aromatherapy. Essential oils are not for internal use.
Art therapy: Art therapy involves the application of a variety of art modalities including drawing, painting, clay, and sculpture. Art therapy enables the expression of inner thoughts or feelings when verbalization is difficult or not possible. Limited evidence suggests that family caregivers of cancer patients may benefit from art therapy to help them cope with the stress of care giving. Possible benefits include reduced stress, lowered anxiety, increased positive emotions, and increased positive communication with cancer patients and healthcare professionals. Art therapy may also reduce pain and other symptoms in cancer patients. More studies are needed to determine how best to use this form of intervention with this population.
Astragalus: Astragalus (Astragalus membranaceus) has been used in Chinese medicine for centuries for its immune enhancing properties. Although early laboratory and animal studies report increased immune cell function and reduced cancer cell growth associated with the use of astragalus, there is no reliable human evidence in these areas. A recent study reports that astragalus-based Chinese herbal medicine may increase effectiveness of platinum-based chemotherapy when combined with chemotherapy. Astragalus is also sometimes used with the intention to reduce side effects of cancer treatments, such as fatigue and weight loss. Due to a lack of well-designed research, a firm conclusion cannot be drawn.
Bee pollen: Bee pollen is considered a highly nutritious food because it contains a balance of vitamins, minerals, proteins, carbohydrates, fats, enzymes, and essential amino acids. Research has found that bee pollen may reduce some adverse effects of cancer treatment, but additional studies are needed before a firm recommendation can be made. Caution is advised when taking bee pollen supplements as allergic reactions may occur in sensitive individuals. Bee pollen should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.
Bitter melon: Bitter melon (Momordica charantia) is used in the traditional Ayurvedic form of medicine from India for lowering blood sugar levels. Research has also found that bitter melon extracts may be beneficial in cancer therapies. MAP30, a protein isolated from bitter melon extract, is reported to possess anti-cancer effects in laboratory studies. Potential anti-cancer effects have not been studied appropriately in humans. Caution is advised when taking bitter melon supplements, as numerous adverse effects including blood sugar lowering and drug interactions are possible. Bitter melon should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.
Black tea: Black tea (Camellia sinensis) is from the same plant as green tea, but processed differently containing more caffeine than green tea. Several studies have explored a possible association between regular consumption of black tea and rates of cancer in populations. This research has yielded conflicting results, with some studies suggesting benefits, and others reporting no effects. Laboratory and animal studies report that components of tea, such as polyphenols have antioxidant properties and effects against tumors. Effects in humans remain unclear, and these components may be more common in green tea rather than in black tea. Some animal and laboratory research suggests that components of black tea may actually be carcinogenic, or cancer causing although effects in humans are not clear. Overall, the relationship of black tea consumption and human cancer remains undetermined.
Bromelain: Bromelain is a sulfur-containing proteolytic digestive enzyme that is extracted from the stem and the fruit of the pineapple plant (Ananas comosus). There is not enough information to recommend for or against the use of bromelain in the treatment of cancer, either alone or in addition to other therapies. Caution is advised when taking bromelain supplements, as numerous adverse effects including blood thinning and drug interactions are possible.
Cat's claw: Originally found in Peru, the use of cat's claw (Uncaria tomentosa) has been said to date back to the Inca civilization, possibly as far back as 2,000 years. Cat's claw has anti-inflammatory properties, and several low-quality studies suggest it may slow tumor growth; however, this research is early and has not identified specific types of cancer that may benefit. A few studies suggest that cat's claw may also boost the immune system. Caution is advised when taking cat's claw supplements, as numerous adverse effects including blood thinning and drug interactions are possible. Cat's claw should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.
Chlorella: Chlorella spp. are single-cellular green algae. Clinical study has examined the effect of chlorella on skin cancer. Additional research is needed in this area.
Copper: Copper is a mineral that occurs naturally in many foods, including vegetables, legumes, nuts, grains and fruits, as well as shellfish, avocado, and beef (organs such as liver). Preliminary research reports that lowering copper levels theoretically may arrest the progression of cancer by inhibiting blood vessel growth (angiogenesis). Copper intake has not been identified as a risk factor for the development or progression of cancer. Copper is potentially unsafe when used orally in higher doses than the recommended dietary allowance (RDA). Copper supplements should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.
Cranberry: Several laboratory studies have reported positive effects of proanthocyanidins, flavonoid components of cranberry (Vaccinium macrocarpon) and other fruits such as blueberries, grape seed, and pomegranate, on health. Based on a small amount of laboratory research, cranberry has been proposed for cancer prevention, but studies are needed in humans before a recommendation can be made.
Echinacea: The evidence from a small number of randomized trials evaluating efficacy of Echinacea in the treatment of radiation-induced leukopenia (decrease in white blood cells) is equivocal. Studies have used the combination product Esberitox®, which includes extracts of Echinacea (Echinacea purpurea and pallida) root, white cedar (Thuja occidentalis) leaf, and wild indigo (Baptisia tinctoria) root.
Essiac®: Essiac® contains a combination of herbs, including burdock root (Arctium lappa), sheep sorrel (Rumex acetosella), slippery elm inner bark (Ulmus fulva), and Turkish rhubarb (Rheum palmatum). The original formula was developed by the Canadian nurse Rene Caisse (1888-1978) and is thought to be effective in cancer therapies, although there is currently no evidence for any type of cancer. Different brands may contain variable ingredients, and the comparative effectiveness of these formulas is not known. None of the individual herbs used in Essiac® have been tested in rigorous human cancer trials, although some components have anti-tumor activity in laboratory studies. Caution is advised when taking Essiac® supplements, as numerous adverse effects, including drug interactions, are possible. Essiac® should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.
Focusing: Focusing (experiential therapy) is a method of psychotherapy that involves being aware of one's feelings surrounding a particular issue and understanding the meaning behind words or images conveyed by those feelings. Early evidence suggests focusing may improve the mood and body attitude of cancer patients. Firm recommendations cannot be made until well-designed clinical trials are available.
Garlic: Preliminary human studies suggest that regular consumption of garlic (Allium sativum, particularly aged garlic) may reduce the risk of developing several types of cancer. Some studies use multi-ingredient products so it is difficult to determine if garlic alone may play a beneficial role. Further well-designed human clinical trials are needed to conclude whether eating garlic or taking garlic supplements may prevent or treat cancer. Caution is advised when taking garlic supplements, as numerous adverse effects, including an increased risk of bleeding and drug interactions, are possible.
Ginseng: Several human studies suggest that Asian ginseng (Panax ginseng) may reduce the risk and progression of various organ cancers, especially if ginseng powder or extract is used. Results may have been affected by other lifestyle choices in people who use ginseng, such as exercise or dietary habits. Asian ginseng is also reported to help protect against radiation damage, increase immunity and well-being, and decrease fatigue. Additional trials are necessary before a clear conclusion can be reached. Caution is advised when taking ginseng supplements, as numerous adverse effects including an increased risk of drug interactions are possible. Ginseng should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.
Green tea: Green tea is made from the dried leaves of Camellia sinensis, a perennial evergreen shrub. Green tea has a long history of use in health and longevity, dating back to China approximately 5,000 years ago. Although used for centuries to help prevent diseases, the relationship of green tea consumption and human cancer remains inconclusive. Evidence from well-designed clinical trials is needed before a firm recommendation can be made in this area.
Healing touch (HT): Preliminary data suggests HT may be of benefit in cancer patients for inducing relaxation and improving quality of life. However, due to weaknesses in design and the small number of studies, data are insufficient to make definitive recommendations. Studies with stronger designs are needed.
Hoxsey formula: "Hoxsey formula" is a misleading name, because it is not a single formula, but rather it is a therapeutic regimen consisting of an oral tonic and topical (on the skin) preparations. The tonic is individualized for cancer patients based on general condition, location of cancer, and previous history of treatment. An ingredient that usually remains constant for every patient is potassium iodide. Other ingredients are then added and may include licorice, red clover, burdock, stillingia root, berberis root, pokeroot, cascara, Aromatic USP 14, prickly ash bark, and buckthorn bark. A red paste may be used, which tends to be caustic (irritating), and contains antimony trisulfide, zinc chloride, and bloodroot. A topical yellow powder may be used, and contains arsenic sulfide, talc, sulfur, and a "yellow precipitate." A clear solution may also be administered, and contains trichloroacetic acid. There are no well-designed human studies available evaluating the safety or effectiveness of Hoxsey formula. Caution is advised when taking the Hoxsey formula supplements, as numerous adverse effects including an increased risk of drug interactions are possible. Hoxsey formula should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.
Hydrazine sulfate: Hydrazine is an industrial chemical marketed as having the potential to repress weight loss and cachexia (muscle wasting) associated with cancer, and to improve general appetite status. In large randomized controlled trials, hydrazine has not been found effective for improving appetite, reducing weight loss, or improving survival in adults. The National Cancer Institute (NCI) sponsored studies of hydrazine sulfate that claimed efficacy in improving survival for some patients with advanced cancer. Trial results found that hydrazine sulfate did not prolong survival for cancer patients. The U.S. Food and Drug Administration (FDA) has received requests from individual physicians for approval to use hydrazine sulfate on a case-by-case "compassionate use" basis on the chance that patients with no other available effective therapy might benefit. The overall controversy in the use of hydrazine sulfate is ongoing, and relevance to clinical practice is unknown. The use of hydrazine sulfate needs to be evaluated further before any recommendations can be made. Side effects have been reported, including nausea, vomiting, stomach cramping, and diarrhea.
Lycopene: High levels of lycopene are found in tomatoes and in tomato-based products. Tomatoes are also sources of other nutrients such as vitamin C, folate, and potassium. Several laboratory and human studies examining tomato-based products and blood lycopene levels suggest that lycopene may be associated with a lower risk of developing cancer and may help stimulate the immune system. However, due to a lack of well-designed human research using lycopene supplements, this issue remains unclear.
Maitake mushroom: Maitake is the Japanese name for the edible fungus Grifola frondosa. Maitake has been used traditionally both as a food and for medicinal purposes. Early studies in the laboratory as well as in humans suggest that beta-glucan extracts from maitake may increase the body's ability to fight cancer. These studies have not been well designed, and better research is needed before the use of maitake for cancer can be recommended.
Melatonin: There are several early-phase and controlled human trials of melatonin in patients with various advanced stage malignancies, including brain, breast, colorectal, gastric, liver, lung, pancreatic, and testicular cancer, as well as lymphoma, melanoma, renal cell carcinoma, and soft-tissue sarcoma. Currently, no clear conclusion can be drawn in this area. There is not enough definitive scientific evidence to discern if melatonin is beneficial against any type of cancer, whether it increases (or decreases) the effectiveness of other cancer therapies, or if it safely reduces chemotherapy side effects. Melatonin is not to be used for extended periods of time. Caution is advised when taking melatonin supplements, as numerous adverse effects including drug interactions are possible.
Mistletoe: Mistletoe is one of the most widely used unconventional cancer treatments in Europe. Extracts have been studied for a variety of human cancers including bladder, breast, cervical, CNS, colorectal, head and neck, liver, lung, lymphatic, ovarian, and renal (kidney) cancers as well as melanoma and leukemia. Efficacy has not been conclusively proven for any one condition, and in fact some studies have shown a lack of efficacy in certain preparations for a variety of cancers. Larger, well-designed clinical trials are needed. Caution is advised when taking mistletoe supplements, as numerous adverse effects including nausea, vomiting, and drug interactions are possible. Mistletoe should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.
Moxibustion: Moxibustion is a healing technique employed across the diverse traditions of acupuncture and oriental medicine for over 2,000 years. Moxibustion uses the principle of heat to stimulate circulation and break up congestion or stagnation of blood and chi. Moxibustion is more closely related to acupuncture as it is applied to specific acupuncture points. More studies are needed.
Oleander: Laboratory studies of oleander (Nerium oleander) suggest possible anti-cancer effects, although reliable research in humans is not currently available. There are reports that long-term use of oleander may have positive effects in patients with leiomyosarcoma, Ewing's sarcoma, prostate, or breast cancer. More research is needed.
Omega-3 fatty acids: Omega-3 fatty acids are essential fatty acids found in some plants and fish. There should be a balance of omega-6 and omega-3 fatty acids for health. Randomized controlled trials are necessary before a clear conclusion can be drawn. Caution is advised when taking omega-3 supplements, as numerous adverse effects including an increase in bleeding and drug interactions are possible. Omega-3 supplements should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.
Prayer: Initial studies in patients with cancer (such as leukemia) report variable effects on disease progression or death rates when intercessory prayer is used. Better quality research is necessary before a firm conclusion can be drawn.
Reishi mushroom: Reishi (Ganoderma lucidum) has been shown to have antineoplastic and immunomodulatory effects in animal studies. One clinical trial and two case reports exist on advanced cancer patients using Ganopoly®, a Ganoderma lucidum polysaccharide extract. Results show improved quality of life and enhanced immune responses, which are typically reduced or damaged in cancer patients receiving chemotherapy and/or radiation therapy. Well-designed long-term studies are needed to confirm these results and potential side effects.
Seaweed: Bladderwrack (Fucus vesiculosus) is a brown seaweed that grows on the northern coasts of the Atlantic and Pacific oceans, and the North and Baltic seas. Bladderwrack appears to suppress the growth of various cancer cells in animal and laboratory studies. Currently, there are no reliable human studies available to support a recommendation for use in cancer. Bladderwrack should not be used if the patient is pregnant or breastfeeding, or has hyperthyroidism (increased thyroid hormone), unless otherwise directed by a doctor.
Shark cartilage: For several decades, shark cartilage has been proposed as a cancer treatment. Studies have shown shark cartilage or the shark cartilage product AE-941 (Neovastat®) to block the growth of new blood vessels, a process called "anti-angiogenesis," which is believed to play a role in controlling growth of some tumors. There have also been several reports of successful treatments of end-stage cancer patients with shark cartilage, but these have not been well-designed or included reliable comparisons to accepted treatments.
Many studies have been supported by shark cartilage product manufacturers, which may influence the results. In the United States, shark cartilage products cannot claim to cure cancer, and the U.S. Food and Drug Administration (FDA) has sent warning letters to companies that promote products in this way. Without further evidence from well-designed human trials, it remains unclear if shark cartilage is of any benefit in cancer and patients are advised to check with their doctor and pharmacist before taking shark cartilage.
Shiitake mushroom: Shiitake (Lentinus edodes) has been taken by mouth for boosting the immune system, decreasing cholesterol levels, and for anti-aging. Lentinan, derived from shiitake, has been injected as an adjunct treatment for cancer and HIV infection. Laboratory, animal, and human studies of lentinan have shown positive results in cancer patients when used in addition to chemotherapy drugs. Further well-designed clinical trials on all types of cancer are required to confirm these results.
Soy: Soy (Glycine max) contains compounds that have been effective against tumors. Genistein, an isoflavone found in soy, has been found in laboratory and animal studies to possess anti-cancer effects, such as blocking new blood vessel growth (anti-angiogenesis), acting as a tyrosine kinase inhibitor (a mechanism of many new cancer treatments), or causing cancer cell death (apoptosis). Until reliable human research is available, it remains unclear if dietary soy or soy isoflavone supplements are beneficial, harmful, or neutral in people with various types of cancer. Caution is advised when taking soy supplements, as numerous adverse effects including an increased risk of drug interactions are possible.
Transcutaneous electrical nerve stimulation (TENS): Transcutaneous electrical nerve stimulation (TENS) is a non-invasive technique in which a low-voltage electrical current is delivered through wires from a small power unit to electrodes located on the skin. Although TENS has been used with some success in pain associated with cancer, there is not enough reliable evidence to draw a firm conclusion in this area.
Thiamin (Vitamin B1): Thiamin deficiency has been observed in some cancer patients, possibly due to increased metabolic needs. It is not clear if lowered levels of thiamin in such patients may actually be beneficial. Currently, it remains unclear if thiamin supplementation plays a role in the management of any particular type(s) of cancer.
Traditional Chinese Medicine (TCM): The ancient Chinese philosophy of Taoism provided the basis for the development of Chinese medical theory. TCM uses over 120 different herbs in cancer treatment, dependent upon the type and cause of the cancer. Studies have reported significant benefits include reducing tumors, reducing treatment side effects, and improved response to treatment. More studies of stronger design are needed before TCM can be recommended with confidence as an adjunct to cancer treatment, although centuries of traditional use in cancer cannot be discounted.
Turmeric: Turmeric (Curcuma longa) is commonly used for its anti-inflammatory properties. Several early animal and laboratory studies report anti-cancer (colon, skin, breast) properties of curcumin. Many mechanisms have been considered, including antioxidant activity, anti-angiogenesis (prevention of new blood vessel growth), and direct effects on cancer cells. Currently, it remains unclear if turmeric or curcumin has a role in preventing or treating human cancers. There are several ongoing studies in this area. Caution is advised when taking turmeric supplements, as numerous adverse effects including an increased risk of bleeding and drug interactions are possible.
Vitamin A: Vitamin A is a fat-soluble vitamin, which is derived from two sources: preformed retinoids and provitamin carotenoids. Retinoids, such as retinal and retinoic acid, are found in animal sources such as livers, kidneys, eggs, and dairy produce. Carotenoids like beta-carotene (which has the highest vitamin A activity) are found in plants such as dark or yellow vegetables and carrots. It is not clear if vitamin A or beta-carotene, taken by mouth or used on the skin with sunscreen, is beneficial in the prevention or treatment of skin cancers or wrinkles. At recommended doses, vitamin A is generally considered non-toxic.
Vitamin C (ascorbic acid): Dietary intake of fruits and vegetables high in vitamin C has been associated with a reduced risk of various types of cancer in population studies (particularly cancers of the mouth, esophagus, stomach, colon, or lung). However, it is not clear that it is specifically the vitamin C in these foods that is beneficial, and vitamin C supplements have not been found to be associated with this protective effect. Experts have recommended increasing dietary consumption of fruits and vegetables high in vitamin C, such as apples, asparagus, berries, broccoli, cabbage, melon (cantaloupe, honeydew, watermelon), cauliflower, citrus fruits (lemons, oranges), fortified breads/grains/cereal, kale, kiwi, potatoes, spinach, and tomatoes. Vitamin C has a long history of adjunctive use in cancer therapy, and although there have not been any definitive studies using intravenous (or oral) vitamin C, there is evidence that it has benefit in some cases. Better-designed studies are needed. Large doses (greater than 2 grams) may cause diarrhea and gastrointestinal upset.
Vitamin E: There is no reliable scientific evidence that vitamin E is effective as a treatment for any specific type of cancer. Caution is merited in people undergoing treatment with chemotherapy or radiation, because it has been proposed that the use of high-dose antioxidants may actually reduce the anti-cancer effects of these therapies. This remains an area of controversy and studies have produced variable results. Patients interested in using high-dose antioxidants such as vitamin E during chemotherapy or radiation should discuss this decision with their medical oncologist or radiation oncologist. Caution is advised when taking vitamin E supplements, as numerous adverse effects including an increased risk of bleeding and drug interactions are possible.
Yoga: Yoga is an ancient system of relaxation, exercise, and healing with origins in Indian philosophy. Several studies in cancer patients report enhanced quality of life, lower sleep disturbance, decreased stress symptoms, and changes in cancer-related immune cells after patients received relaxation, meditation, and gentle yoga therapy. Yoga is not recommended as a sole treatment for cancer, but may be helpful as an adjunct therapy.
Fair negative scientific evidence:
Selenium: Selenium is a trace mineral found in soil, water, and some foods, and it is an essential element in several metabolic pathways. Results from the Nutritional Prevention of Cancer (NPC) trial, conducted among 1,312 Americans over a 13-year period, suggest that selenium supplementation given to individuals at high risk of nonmelanoma skin cancer is ineffective at preventing basal cell carcinoma, and may actually increase the risk of squamous cell carcinoma and total nonmelanoma skin cancer. Therefore, selenium supplementation should be avoided in individuals at risk or with a history of nonmelanoma skin cancer.
Prevention
Protection from the sun and ultraviolet (UV) rays: Avoid the sun between 10 a.m. and 4 p.m., because the sun's rays are strongest during this period. Try to schedule outdoor activities for other times of the day, even during the winter months or when the sky is cloudy. Sunburns and suntans cause skin damage that can increase the risk of developing skin cancer. Sun exposure accumulated over time may also lead to skin cancer. Five or more sunburns double the risk of developing skin cancer in a lifetime.Sunscreen may not filter out all harmful UV radiation, especially the radiation that can lead to melanoma, but they play a major role in an overall sun-protection program. A broad-spectrum sunscreen with a sun protection factor (SPF) of at least 15 is recommended when going outside year-round. For the most protection, apply sunscreen 20 to 30 minutes before sun exposure and reapply it every two hours throughout the day, as well as after swimming or exercising.
In July 2006, the U.S. Food and Drug Administration (FDA) approved a new over-the-counter sunscreen marketed as Anthelios SX®. The new sunscreen offers better protection from UVA rays than traditional broad-spectrum sunscreens, according to the manufacturer. This may help reduce the risk of various types of skin cancer, including melanoma, basal, and squamous cell carcinomas.
It's recommended to wear dark, tightly woven clothing that covers the arms and legs, sunglasses (with UVA and UVB protection), and a broad-brimmed hat, which provides more protection than a baseball cap or visor.
Avoid tanning beds and tan-accelerating agents: Tanning beds emit UVA rays that penetrate deeper into the skin and can cause precancerous skin lesions.
Sun-sensitizing medications: Some common prescription and over-the-counter drugs, including some antibiotics, some cholesterol, high blood pressure and diabetes medications, birth control pills, nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen, and the acne and the chemotherapy agent isotretinoin can make the skin more sensitive to sunlight. Also, some herbal supplements may increase sun sensitivity, such as St. John's wort, commonly used for mild depression. A pharmacist can help determine medications that may cause sun sensitivity.
Regular check-ups: Examining the skin often for new skin growths or changes in existing moles, freckles, bumps and birthmarks is very important in preventing all forms of skin cancer. Healthcare professionals recommend a complete skin exam every year if an individual is older than 40, or more often if they are at high risk of developing skin cancer.
Author information
Natural Standard is an international research collaboration that aggregates and synthesizes data on complementary and alternative therapies. Using a comprehensive methodology and reproducible grading scales, information is created that is evidence-based, consensus-based, and peer-reviewed, tapping into the collective expertise of a multidisciplinary Editorial Board. The mission of this collaboration is to provide objective, reliable information that aids clinicians, patients, and healthcare institutions to make more informed and safer therapeutic decisions. Natural Standard is widely recognized as one of the worlds premier sources of information in this area.Bibliography
American Academy of Dermatology. www.aad.org.
American Academy of Family Physicians. http://familydoctor.org.
American Cancer Society. www.cancer.org.
Fecher LA, Cummings SD, Keefe MJ, et al. Toward a molecular classification of melanoma. J Clin Oncol. 2007 Apr 20;25(12):1606-20. View Abstract
Gimotty PA, Elder DE, Fraker DL, et al. Identification of high-risk patients among those diagnosed with thin cutaneous melanomas. J Clin Oncol. 2007 Mar 20;25(9):1129-34. View Abstract
Markovic SN, Erickson LA, Rao RD, et al. Malignant melanoma in the 21st century, part 2: staging, prognosis, and treatment. Mayo Clin Proc. 2007 Apr;82(4):490-513. View Abstract
National Cancer Institute (NCI). www.cancer.gov.
Natural Standard: The Authority on Integrative Medicine. www.naturalstandard.com. Copyright © 2007.
Satzger I, Schenck F, Thol F, et al. Therapeutic use of erythropoietin in dermatooncology. J Dtsch Dermatol Ges. 2007 Apr;5(4):280-5. View Abstract
Scope A, Benvenuto-Andrade C, Agero AL, et al. Correlation of dermoscopic structures of melanocytic lesions to reflectance confocal microscopy. Arch Dermatol. 2007 Feb;143(2):176-85. View Abstract
Skin Cancer Foundation. www.skincancer.org.
Related Terms
Acral lentiginous melanoma, actinic cheilitis, actinic keratoses, arsenical keratosis, biological therapy, Bowen's Disease, dysplastic nevi, Breslow's thickness, epidermis, familial atypical multiple mole melanoma (FAMMM), immunity, immunotherapy, Kaposi's sarcoma, lentigo maligna, melanin, melanocytes, nodular melanoma, oncogenes, Mohs' surgery, photodynamic therapy, seborrheic keratoses, squamous cells, sunscreen, topical immunotherapy, UV light.
Natural Standard Bottom Line Monograph, Copyright © 2009 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intendedfor informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
Natural Standard's methodology ,
editorial board , and grading scales.
|
A Better Health Solution Acupuncture 614 Wymore Rd Winter Park FL 32789 6784372 |
Search thousands of qualified integrative health professionals.