What is Skin Cancer ?
Skin Cancer Definition :
Cancer that forms within the tissues of the skin. There are many types of skin cancer.
Skin cancer that forms in melanocytes (skin cells that create pigment) is termed melanoma. skin cancer that forms within the lower part of the epidermis (the outer layer of the skin) is termed basal cell carcinoma.
Skin cancer that forms in squamous cells (flat cells that form the surface of the skin) is termed squamous cell carcinoma.
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skin cancer that forms in neuroendocrine cells (cells that release hormones in response to signals from the nervous system) is termed neuroendocrine carcinoma of the skin.
Majority of skin cancers cases is diagnosed in older people on parts of the body exposed to the sun or in people who have weakened immune systems.
Types of Skin Cancer
These dry, scaly patches or spots are pre-cancerous growths and can develop into squamous cell carcinoma if left untreated.
⇒ people who get Actinic Keratoses generally have fair skin.
⇒ most people see their 1st Actinic Keratoses once 40 years older as a result of Actinic Keratoses tend to develop after years of sun exposure.
⇒ Actinic Keratoses sometimes form on the skin that gets any sun exposure, like the head, neck, hands, and forearms.
⇒ Because an Actinic Keratoses will get to a type of skin cancer known as squamous cell carcinoma (SCC), treatment is very important.
Basal cell carcinoma
Basal cell carcinoma is the most common type of skin cancer.
⇒ Comprising about 90 % of all cases of skin cancer. most common in the head and neck, basal cell carcinoma is slow-growing cancer that rarely spreads to different parts of the body.
⇒ It always shows on the skin as a raised, pearly or waxy pink bump, usually having a dimple in the middle.
⇒ It can even seem translucent with blood vessels close to the skin’s surface.
Squamous cell carcinoma
Squamous cell carcinoma is more aggressive than basal cell carcinoma.
⇒ It affects the outer layer cell of the epidermis and can spread to different body parts if not treated.
⇒It seems as red, scaly, and rough skin lesions, usually on sun-exposed areas like the hands, head, neck, lips, and ears.
⇒ Similar red patches are also squamous cell carcinoma in place (Bowen’s disease), the earliest form of squamous cell cancer.
It is less common than basal and squamous cell carcinoma.
⇒ Melanoma is far and away the most dangerous, inflicting about 73 % of all skin cancer-related deaths.
⇒ It happens in the melanocytes, or skin cells that create pigment.
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⇒ Knowing the ABCDE warning signs of melanoma can assist you to find an early melanoma.
♦ Asymmetrical shape
♦ Border irregularities
♦ Color that isn’t consistent
♦ Diameter larger than 6 millimeters
♦ Evolving size or shape
Skin Cancer Causes
Ultraviolet (UV) radiation from the sun is the number one reason behind skin cancer, however UV light from tanning beds is just as harmful.
Exposure to sunlight throughout the winter months puts you at the same risk as exposure during the summertime.
High Intense and regular sun exposure causes mostly basal cell and squamous cell skin cancer, whereas occurrences of hard sunburns before age 18, will cause melanoma later in life.
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other less common causes are repeated X-ray exposure, scars from burns or disease and occupational exposure to certain chemicals.
Skin Cancer Symptoms
An uncommon skin growth or sore that does not get away could also be the first indication of a non-melanoma skin cancer.
skin cancer could initially seem as a nodule, rash or irregular patch on the surface of the skin. These spots could also be raised and will ooze or bleed easily.
As cancer grows, the dimensions of the visible skin mass could change and also cancer could grow into inner layers of the skin.
it’s going to be tough to differentiate one kind of skin cancer from another, therefore consult a dermatologist if you notice suspicious or evolving marks on the skin.
Basal cell carcinomas on the head or neck could 1st appear as a light patch of skin or a waxy translucent bump. you’ll see blood vessels or an indentation in the center of the bump.
If the carcinoma develops on the chest, it’s going to look more like a brownish scar or flesh-colored lesion. because cancer develops, it’s going to bleed if injured or ooze and become crusty in some areas.
Squamous cell carcinomas can also develop as a lump on the skin. These firm lumps are generally rough on the surface, in contrast to the smooth and pearly look of a basal cell carcinoma.
If a nodule does not form, cancer could develop more like a reddish, scaly patch. in contrast to a skin rash that goes away with time, these rough, lesion-like patches continue to develop slowly. this kind of cancer is typically found on the head, neck, hands or arms, however, they will also develop in other areas, like the genital region or in scars or skin sores.
The most important warning sign and symptom of Melanoma could be a new spot on the skin or a spot that’s dynamical in size, shape, or color.
Another important sign could be a spot that appears completely different from all of the other spots on your skin (known as the ugly duckling sign).
If you have got one of these warning signs, have your skin checked by a doctor.
The ABCDE rule is another guide to the usual signs of melanoma. be on the lookout and tell your doctor regarding spots that have any of the following features:
A Stands For Asymmetrical shape : One half of a mole or birthmark is not identical to the other.
B Stands For Border irregularities : The edges are abnormal, ragged, notched, or blurred.
C Stands For Color that isn’t consistent : The color isn’t constant everywhere and will include completely different shades of brown or black, or sometimes with patches of pink, red, white, or blue.
D Stands For Diameter larger than 6 millimeters : The Diameter of spot is larger than 6 MM.
E Stands For Evolving size or shape : Change In Shape, Size and color of mole
Diagnosis of Skin Cancer
To diagnose Skin cancer, your doctor may:
Examine your skin: Your doctor could examine your skin to determine whether your skin changes are possible to be skin cancer. more testing could also be required to confirm that diagnosis.
Remove a sample of suspicious skin for testing (skin biopsy): Your doctor could remove the suspicious-looking skin for laboratory testing.
A biopsy will confirm whether you have skin cancer and, if so, what type of skin cancer you have.
Staging Skin Cancer
If your doctor determines you have skin cancer, you’ll have further tests to see the extent (stage) of the skin cancer.
Because superficial skin cancers like basal cell carcinoma rarely spread, a biopsy|diagnostic assay} that removes the complete growth usually is the only test needed to see cancer stage.
however, if you have a large squamous cell carcinoma, Merkel cell carcinoma or melanoma, your doctor could suggest more tests to see the extent of cancer.
Additional tests may include imaging tests to examine the nearby lymph nodes for signs of cancer or a procedure to get rid of it, a close-by lymph node and test it for signs of cancer (sentinel lymph node biopsy).
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Doctors use the Roman numerals I through IV to indicate cancer’s stage. Stage I cancers are tiny and restricted to the area where they began. Stage IV indicates advanced cancer that has spread to different areas of the body.
The Four Stages Of Skin Cancer :
Stage 1 means that the cancer is 2cm across or less and has one or no high-risk features. High-risk features mean cancer:
♦ is more than 2mm thick
♦ has full-grown within the lower dermis
♦ has full-grown into the area around a nerve (perineural invasion)
started on the ear or lip
♦ appearance very abnormal under the magnifier (the cells are poorly differentiated or undifferentiated)
Stage 2 means that the cancer is over 2cm across, or has 2 or more high-risk features.
Stage 3 means that cancer has either:
♦ grown into the bones in the face, like the jaw bone or the bone around the eye
♦ spread to a close-by lymph node (or lymph gland) on the same side of the body (and is less than 3cm)
Stage 4 cancer means that cancer has either:
♦ full-grown into the spine, ribs or lower part of the skull
♦ spread to a lymph node that is over 3cm, or to an internal organ like the lungs
Treatment for Skin Cancer
There are many effective means of treating skin cancer. the selection of therapy depends on the location and size of the tumor, the microscopic characteristics of cancer, and also the general health of the patient.
Topical medications : within the case of superficial basal cell carcinomas, some creams, gels, and solutions are used, together with imiquimod (Aldara), that works by stimulating the body’s system inflicting it to produce interferon that attacks cancer, and fluorouracil (5-FU), a chemotherapy drug.
Some patients don’t experience any side effects of these topical treatments, however, others could have redness, inflammation, and irritation.
A drawback of topical medications is that there’s no tissue available to examine to see if a growth is removed completely.
Destruction by electrodesiccation and curettage (EDC) : The tumor area is numbed with a neighborhood anesthetic and is repeatedly scraped with a pointy instrument (curette), and also the sting is then cauterized with an electrical needle.
The advantage of this technique is that it’s quick, easy, and comparatively inexpensive. The disadvantages are that the scar is usually somewhat ugly, and also the return rate is as high as 15 %.
Surgical excision: the area around the tumor is numbed with a local anesthetic. A football-shaped portion of tissue together with the tumor is then removed and so the wound edges are closed with sutures.
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For very massive tumors, skin grafts or flaps are required to close the defect.
the benefits of this type of treatment are that there is a greater than 90th cure rate, the surgical specimen are often examined to make sure that the complete tumor is successfully removed, and also the scar created is usually more cosmetically acceptable than that of the EDC procedure.
it’s a more complicated procedure and is more expensive than EDC.
Mohs micrographic surgery : the site is locally anesthetized and also the surgeon removes the visible tumor with a little margin of normal tissue.
The tissue is instantly evaluated under a microscope and areas that demonstrate residual microscopic tumor involvement are re-excised and the margins are re-examined.
This cycle continues till no further tumor is seen. This more difficult and expensive choice is the treatment of selection for tumors where normal tissue preservation is important, where the tumor margins are poorly defined, in tumors that are previously treated and have recurred, and in certain high-risk tumors.
Radiation therapy : 10 to fifteen treatment sessions deliver a high dose of radiation to the tumor and a little surrounding skin area.
this type of treatment is beneficial in people who are not candidates for any operation. The advantage of radiation therapy is that there’s no cutting involved.
The drawback of this costly alternative is that the treated area cannot be tested to form sure the complete tumor is gone and radiation scars look worse over time.
it is, for this reason, it is sometimes reserved for older patients.
Photodynamic therapy (PDT) : In this treatments, cancerous tissue is destroyed by freezing, the medication and blue light are used to destroy the cancerous tissue, laser surgery to vaporize (ablate) the skin’s top layer and destroy lesions, and oral medications vismodegib (Erivedge) and sonidegib (Odomzo).
Skin Cancer Foundation