Skin cancer is the most common type of cancer diseases that affect the skin. Skin cancer are cancers that arise from the skin. They are due to the development of abnormal cells that have the ability to invade or spread to other parts of the body. Skin cancer is a common and locally destructive cancerous (malignant) growth of the skin. It originates from the cells that line up along the membrane that separates the superficial layer of skin from the deeper layers. Unlike cutaneous malignant melanoma, the vast majority of these sorts of skin cancers have a limited potential to spread to other parts of the body (metastasize) and become life-threatening. In this article, we will be talking about the types, symptoms, prevention, risk factor and treatment.
There are three major types of skin cancer:
Basal cell carcinoma (the most common)
Squamous cell carcinoma (the second most common), which originate from skin cells, and
Melanoma, which originates from the pigment-producing skin cells (melanocytes) but is less common, though more dangerous, than the first two varieties.
The first two, along with a number of less common skin cancers, are known as non-melanoma skin cancer (NMSC). Basal-cell cancer grows slowly and can damage the tissue around it but is unlikely to spread to distant areas or result in death. It often appears as a painless raised area of skin, that may be shiny with small blood vessel running or may present as a raised area with an ulcer.
Squamous-cell skin cancer is more likely to spread. It usually presents as a hard lump with a scaly top but may also form an ulcer. Melanomas are the most aggressive. Signs include a mole that has changed in size, shape, color, has irregular edges, has more than one color, is itchy or bleeds.
Greater than 90% cases of skin cancer are caused by exposure to ultraviolet radiation from the Sun. Basal cell skin cancers arise from DNA mutations in the basaloid cells in the upper layer of the skin. In squamous cell cancers, the tumors arise from normal squamous cells in the higher layers of the skin of the epidermis. The causes of cancer varies from different types of the cancer. Smoking tobacco is another causes of skin cancer. Chronic non-healing wounds. These are called Marjollin’s ulcer based on their appearance, and can develop into squamous-cell skin cancer. And lastly, the use of many immunosuppressive medications increases the risk of skin cancer.
RISK FACTOR OF RISK CANCER
- Elderly patients have more skin cancers.
- Certain types of sexually acquired wart virus infections
- Ultraviolet light exposure, either from the sun or from tanning beds. Fair-skinned individuals, with hazel or blue eyes, and people with blond or red hair are particularly vulnerable. The problem is worse in areas of high elevation or near the equator where sunlight exposure is more intense.
SIGNS AND SYMPTOMS
The symptoms and signs of skin cancer depends on the types of the skin cancer and the stages.
Basal-cell skin cancer (BCC);
Small blood vessels (called telangiectasia) can be seen within the tumor.
Crusting and bleeding in the center of the tumor frequently develops.
BCC usually presents as a raised, smooth, pearly bump on the sun-exposed skin of the head, neck or shoulder.
Pink skin growths or lesions with raised borders that are crusted in the center.
Raised reddish patch of skin that may crust or itch, but is usually not painful.
Squamouse-cell skin cancer (SCC);
SCC is commonly a red, scaling, thickened patch on sun-exposed skin.
Ulceration and bleeding may occur.
When SCC is not treated, it may develop into a large mass. Squamous-cell is the second most common skin cancer.
Persistent, scaly red patches with irregular borders that may bleed easily.
Open sore that does not go away for weeks.
A raised growth with a rough surface that is indented in the middle.
A wart-like growth.
Most melanoma consist of various colours from shades of brown to black.
A small number of melanoma are pink, red or fleshy in colour; these are called amelanotic melanoma and tend to be more aggressive.
Warning signs of malignant melanoma include change in the size, shape, color or elevation of a mole.
Other signs are the appearance of a new mole during adulthood or pain, itching, ulceration, redness around the site, or bleeding at the site.
A skin examination by a dermatologist is the way to get a definitive diagnosis of skin cancer. In many cases, the appearance alone is sufficient to make the diagnosis.
A skin biopsy is usually used to confirm a suspicion of skin cancer. This is performed by numbing the area under the tumor with a local anesthetic such as lidocaine.
Treatment is dependent on type of cancer, location of the cancer, age of the person, and whether the cancer is primary or a recurrence. Treatment is also determined by the specific type of cancer.
- Surgical excision: The area around the tumor is numbed with a local anesthetic. A football-shaped portion of tissue including the tumor is then removed and then the wound edges are closed with sutures. For very big tumors, skin grafts or flaps are needed to close the defect. The advantages of this form of treatment are that there is a greater than 90% cure rate, the surgical specimen can be examined to be sure that the whole tumor is successfully removed, and the scar produced is usually more cosmetically acceptable than that of the EDC procedure. It is a more complicated procedure and is more expensive than EDC.
- Destruction by electrodessication and curettage (EDC): The tumor area is numbed with a local anesthetic and is repeatedly scraped with a sharp instrument (curette), and the edge is then cauterized with an electric needle. The advantage of this method is that it is fast, easy, and relatively inexpensive. The disadvantages are that the scar is often somewhat unsightly, and the recurrence rate is as high as 15%.
- Mohs micrographic surgery: The site is locally anesthetized and the surgeon removes the visible tumor with a small margin of normal tissue. The tissue is immediately evaluated under a microscope and areas that demonstrate residual microscopic tumor involvement are re-excised and the margins are re-examined. This cycle continues until no further tumor is seen. This more complicated and expensive option is the treatment of choice for tumors where normal tissue preservation is vital, where the tumor margins are poorly defined, in tumors that have been previously treated and have recurred, and in certain high-risk tumors.
- Radiation therapy: Ten to fifteen treatment sessions deliver a high dose of radiation to the tumor and a small surrounding skin area. This form of treatment is useful in those who are not candidates for any surgical procedure. The advantage of radiation therapy is that there is no cutting involved. The disadvantages of this expensive alternative are that the treated area cannot be tested to be sure the whole tumor is gone and radiation scars look worse over time. It is for this reason it is usually reserved for elderly patients.
▪ For low-risk disease, radiation therapy (external beam radio therapy or brachtherapy), topical chemotherapy (imiquidmode or 5-fluorouracil) and cryotherapy (freezing the cancer off) can provide adequate control of the disease; all of them, however, may have lower overall cure rates than certain type of surgery. Other modalities of treatment such as photodynamic therapy, topical chemotherapy, electrodessication and curettage can be found in the discussions of basal-cell carcinoma and squamous-cell carcinoma.
The following are the ways by which skin cancer can be prevented
The risk of developing skin cancer can be reduced through a number of measures including decreasing indoor tanning and mid-day sun exposure, increasing the use of sunscreen, and avoiding the use of tobacco product.
Eating certain foods may decrease the risk of sunburns but this is much less than the protection provided by sunscreen.
Zinc oxide and titanium oxide are often used in sun screen to provide broad protection from UVA and UVB ranges.
Avoiding triggers that cause tumors to develop is another means of preventing skin cancer. And lastly using of creams and soaps that fit the skin.