Skin cancers are characterized by an uncontrolled and abnormal multiplication of skin tissue (skin tissue). There are two main categories:

• carcinomas (about 90% of cases)
• melanomas (about 10% of cases)

Other types of skin cancers also exist, such as Merkel cell carcinoma, Kaposi sarcoma, and cutaneous lymphoma, but they are much less common, accounting for less than 1% of skin cancers.

The TNM score is a classification system used to assess the stage of a cancer, plan treatment, and predict prognosis.

In melanoma, we look in particular for:

• The T, which describes the size and extent of the tumor
• The N, which indicates whether the cancer has spread to nearby lymph nodes
• The M, which indicates whether the cancer has spread to other parts of the body, called metastases

The Breslow Index is a measure of tumor thickness that is used to assess the severity of melanoma. The Breslow Index is an important element in the classification of melanoma according to the TNM classification system. More specifically, it is used to determine category T, which measures the size and extension of the tumor.

This information can be found on the pathologic report or a consultation report.

NB: On the platform Klineo, it is a simplified version of the TNM stadium. In the search fields, only the first number following the letter must be selected (ex: “Pt1c N0i+ M0” = “T1N0M0”)

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TNM classification table for melanomas

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At the localized stage: The first line of treatment is surgical. Other treatments can also be used (chemotherapy, radiology, etc.).

At the locally advanced/metastatic stage: treatments include surgery, radiation, immunotherapy, and chemotherapy.

Basal cell carcinoma rarely has the ability to metastasize (that is, it is unlikely to give rise to secondary tumors in other parts of the body).

Surgery : Surgery is the main treatment for basal cell carcinomas. Different surgical techniques can be used depending on size, location and medical history (surgical excision, Mohs surgery, curettage, cryosurgery, Curetage-Electrocoagulation...).

Local treatments : Local treatments are possible. Among these treatments:

• ‍Dynamic phototherapy: A cream containing a photosensitive substance, which is particularly well absorbed by cancer cells, is applied to the tumor. It is then exposed to a high-intensity light source, causing the destruction of cancer cells. This treatment can be combined with the application of a cream:imiquimod (ALDARA, ZYCLARA). ‍
• Chemotherapy local in the form of a cream. Example: 5-Fluoro-Uracil (5-FU).

Radiotherapy : Radiotherapy consists in using radiation (we also say rays or radiation) to destroy cancer cells by blocking their ability to multiply. We are talking about a locoregional treatment of cancers. In the case of cutaneous basal cell carcinomas, radiation therapy is offered as the first line treatment when surgery is not possible. Radiation therapy may also be prescribed after surgery, this is called adjuvant therapy.

Chemotherapy : This is a treatment that uses powerful drugs to destroy cancer cells by preventing them from multiplying or spreading in the body. In the case of cutaneous basal cell carcinomas, chemotherapy may be offered in the form of:

• ‍Local chemotherapy in the form of a cream. Example: 5-Fluoro-Uracil (5-FU). ‍
• Intravenous chemotherapy if basal cell carcinoma has invaded neighboring areas or if it has spread. Example: Cisplatin (PLATINOL AQ) alone or combined with Paclitaxel (TAXOL).

Targeted treatment : Targeted therapy is a drug treatment that specifically targets genetic or molecular abnormalities or alterations present in cancer cells or other diseased cells.

Immunotherapy :: Immunotherapy is a treatment that aims to stimulate the body's immune defenses against cancer cells. In the case of cutaneous basal cell carcinomas, the immunotherapy that is often used is Cemiplimab (LIBTAYO).

There are other treatments available via clinical trials. Thanks to Klineo, you can find the clinical trials that are right for you. To do this, it is important to enter the treatments received in order to find relevant clinical trials. This information can be found in the recent consultation report.