Skin Cancer Prognosis

Prognosis is the term describing the odds of successful treatment, recovery and survival of an individual affected by a disease. Basal cell carcinoma, squamous cell carcinoma and melanoma prognosis (as well as prognosis for more rare types of skin cancer) depend on a combination of factors.

Skin Cancer Prognosis by Type

Though outcomes vary on a case-by-case basis, skin cancer prognosis follows a general pattern by type:

• Basal cell carcinoma: Generally excellent prognosis
• Squamous cell carcinoma: Excellent prognosis (for small lesions that are found early)
• Melanoma: Excellent to poor based on time of treatment
• Kaposi sarcoma: Generally good (but depends on immune system status for the type associated with AIDS)
• Merkel cell carcinoma: Poor prognosis.

Skin Cancer Staging

Staging is an important part of determining skin cancer prognosis. Skin cancer is usually staged using the American Joint Commission on Cancer (AJCC) TNM staging system. This system accounts for three aspects of the cancer lesion:

• T stands for tumor (the original lesion), which is given a number (0-4) based on the width and depth of the lesion.
• N stands for the lymph nodes (part of the immune system). A number (0-3) is assigned based on the degree to which cancer cells have spread to the lymph nodes.
• M stands for metastasis; in stage 4 skin cancer, cancerous cells have spread to distant body parts, forming secondary tumors in places such as the bones or brain.

For the three most common types of skin cancer (basal cell carcinoma, squamous cell carcinoma and melanoma), lesions that are identified and receive skin cancer treatment in their earliest stages tend to have better prognosis. For example, according to the American Cancer Society (2010), the five-year survival rate for melanoma found in its earliest stage (IA) is 97 percent, while for late-stage (stage IV) melanoma the five-year survival rate is approximately only 40 percent.

Other Factors Affecting Prognosis

Though type and stage are the most significant components determining prognosis, other factors contribute as well:

• Age: Individuals over the age of 70 have a poorer prognosis than younger individuals with skin cancer.
• Lesion location: Some lesions, such as those on the eyelid, are difficult to excise; others, such as those on the nose, present with increased risk of recurrence.
• Overall health: A compromised immune system or co-occurrence of other health problems may negatively affect prognosis.
• Race: Though melanoma rarely occurs in African Americans, it tends to have a higher mortality rate in that group.

Resources

American Cancer Society. (2010). Melanoma skin cancer. Retrieved July 14, 2010, from http://www.cancer.org/acs/groups/cid/documents/webcontent/003120-pdf.pdf

University of Maryland Medical Center. (2009). Skin cancer. Retrieved July 14, 2010, from http://www.umm.edu/altmed/articles/skin-cancer-000029.htm

American Cancer Society. (2010). What are the survival rates for melanoma by stage? Retrieved July 14, 2010, from http://www.cancer.org/Cancer/SkinCancer-Melanoma/DetailedGuide/melanoma-skin-cancer-survival-rates