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Skin Cancer

  • Posted on- Jul 13, 2017
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Skin cancer is common and locally destructive cancerous 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 malignant melanoma, the vast majority of skin cancers has less potential to spread to the other parts of the body.
  • It is the most common form of cancer in United States.

Types of skin cancer:

  • Basal cell carcinoma- It is the most common type of skin cancer, it can originate from the skin cells. It is not malignant is nature and can be easily treatable.
  • Squamous cell carcinoma - It is also the second most common type of skin cancer and also originates from the skin cells. Like basal cell carcinoma, it is not malignant in nature and can be easily treatable.
  • Melanoma- This skin cancer originates from the pigment-producing skin cells (melanocytes) but is less common from the first two varieties. But it can be far more dangerous than the other skin cancers. It can grow and spread to other parts.


Symptoms

Symptoms of skin cancer:

Signs and symptoms of basal cell carcinomas include:

  • Appearance of a shiny pink, red, pearly, or translucent bump
  • 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
  • A white, yellow, or waxy area with a poorly defined border that may resemble a scar

Signs and symptoms of squamous cell carcinomas include:

  • 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

Actinic keratoses (AK), also called solar keratoses, are scaly, crusty lesions caused by damage from ultraviolet light, often in the facial area, scalp, and backs of the hands. These are considered precancers because if untreated, up to 10% of actinic keratoses may develop into squamous cell carcinomas.

Diagnosis of skin cancer:

Diagnosis of skin cancer may include:

  • Examination of skin- The doctor may look at the patients' skin to determine whether the skin changes are likely to be skin cancer. Further testing may be needed to confirm that diagnosis.
  • Remove a sample of suspicious skin for testing (skin biopsy)- Doctor may remove the suspicious-looking skin for lab testing. A biopsy can determine whether the patient skin cancer and, if so, what type of skin cancer it is.

As most common skin cancer is not malignant, as it doesn't spreads to other tissues, so biopsy may be the only option of determination of cancer.

But, in case of melanoma skin cancer, certain imaging test may be done such as Chest X-ray, CT scan, MRI imaging and Pet/CT scan to check whether the cancer has spread from skin to spine, chest, lymph nodes and other body organs.

Causes of skin cancer:

  • Basal cell skin cancers arise from DNA mutations in the basaloid cells in the upper layer of the skin.
  • Many of these early cancers seem to be controlled by natural immune surveillance, which when compromised may permit the development of masses of malignant cells that begin to grow into tumours.
  • In squamous cell cancers, the tumours arise from normal squamous cells in the higher layers of the skin of the epidermis.
  • Here, cells are prevented from growing unnaturally, but when certain mutations occur or the immune system is compromised, certain cancer growth can occur.
  • For both the cases, ultraviolet rays may be leading cause of cancer.

Risk factors of skin cancer:

  • Ultraviolet light exposure, either from the sun or from tanning beds. Fair-skinned individuals are more vulnerable. The problem is worse in areas of high elevation or near the equator where sunlight exposure is more intense.
  • A chronically suppressed immune system (immunosuppression) from underlying diseases such as HIV/AIDS infection or cancer, or from some medications such as prednisone or chemotherapy
  • Exposure to ionizing radiation (X-rays) or chemicals known to predispose to cancer such as arsenic
  • Certain types of sexually acquired wart virus infections
  • People who have a history of one skin cancer have a 20% chance of developing a second skin cancer in the next two years.
  • Elderly patients have more skin cancers


Treatment

Treatments of skin cancer:

There are several effective means of treating skin cancer. The choice of therapy depends on the location and size of the tumor, and the general health of the patient.

  • Topical medications: In the case of superficial basal cell carcinomas, some creams, gels, and solutions can be used, including imiquimod (Aldara), which works by stimulating the body's immune system. Side effects are not common but some may experience redness and inflammation.
  • 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 attached with an electric needle.
  • 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.
  • 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.
  • 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.. It is usually served to elderly patients.
  • Other types of treatments for skin cancers include cryosurgery where tissue is destroyed by freezing, photodynamic therapy (PDT) in which medication and blue light is used to destroy the cancerous tissue, laser surgery to vaporize (ablate) the skin's top layer and destroy lesions, and oral medications .

In most cases, Skin cancer patients are left out from the society, due to their appearance from the changing skin, a patient must be always given full support from family, friends and society so that they can recover fast and well.

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