What is skin cancer:

Skin cancer, the abnormal growth of skin cells, most often develops on skin exposed to the sun. But this common form of cancer can also occur in areas of your skin that are not normally exposed to sunlight.

What is the risk factor for skin cancer?

Anyone can get skin cancer, but people with certain characteristics are at higher risk:

• A lighter natural skin color.

• Skin that burns frees, reddens easily or becomes painful in the sun.

• Blue or green eyes.

• Blonde or red hair.

• Certain types and a large number of moles.

• Family history of skin cancer.

• Personal history of skin cancer.

• Advanced age. 

Is skin cancer hereditary?

Since most skin cancers are caused by exposure to ultraviolet light, skin cancers are generally not considered hereditary. But the fact that skin cancer is much more common in people with poor pigmentation and that skin color is inherited supports the proposition that genetics is very important. Some very rare genetic syndromes result from several types of melanoma can increase the number of skin cancers in those affected.

What causes skin cancer:

Except in rare cases, most skin cancers arise from ultraviolet light-induced DNA mutations that affect cells of the epidermis. Many of these early cancers appear to be controlled by natural immune surveillance, which when compromised can allow the development of masses of malignant cells that begin to develop into tumors.

What are the different types of skin cancer:

Skin cancer can be divided into two types: non-melanoma and melanoma.

Non-melanoma Skin Cancer

There are two types of non-melanoma skin cancer.

Basal cell carcinoma is a very common cancer in humans. More than 1 million new cases of basal cell carcinoma are diagnosed each year in the US There are several different types of basal cell carcinoma, including the superficial type, the least worrisome variety; the nodular type, the most common; and morphea form, the most difficult to treat because tumors often grow into the surrounding tissue (infiltrate) without a well-defined border.

Squamous cell carcinoma accounts for about 20% of all skin cancers, but it is more common in immunosuppressed people. In most cases, its biological behavior is very similar to that of basal cell carcinoma with a small but significant probability of distant spread.

Melanoma

Melanoma is a cancerous growth of melanocytes and most often develops on the skin. Melanoma can also develop in other parts of the body that contain melanocytes, including the meninges, digestive tract, eyes, and lymph nodes. The following descriptions are limited to melanoma of the skin.

Several types of melanoma can be classified based on their appearance, either visually or microscopically:

Superficial spread: the most commonly seen melanoma. This form can develop in any region of the skin. Lesions are usually elevated around the edges and are brown with hints of pink, white, gray, and blue.

Nodular lesions: they also appear in all regions of the body and are usually black or brown.

Acral lentiginous lesions: characterized by flat, brown, or black tumors that often develop on the hands and feet

Lentigo melanoma - develops on a person's face. Distinguished by its ragged edge and tan-to-brown color.

Most basal cell carcinomas have few or no symptoms. Squamous cell carcinomas can be painful. Both forms of skin cancer can appear as a sore that bleeds, oozes, scabs, or doesn't heal. They start out as a slow-growing lump on the skin that can bleed after minor trauma. Both types of skin cancers can have raised borders and central ulceration.

The signs and symptoms of basal cell carcinomas include:

• The appearance of bright pink, red, pearly, or translucent bump

• Pink skin growths or lesions with raised edges that are crusted in the center

• A 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 spots with ragged edges that can bleed easily

• An open sore that does not go away in weeks.

• A tall growth with a rough surface that is indented in the middle.

• A wart-like growth

When the mole is turning into skin cancer?

An early sign of melanoma is noticing a difference in a mole: asymmetry, irregular border, color changes, increased diameter, or other evolutionary changes can mean that a mole is a melanoma. Moles never develop into squamous cell carcinomas or basal cell carcinomas.

Where does the skin cancer develop:

Skin cancers generally arise on areas of the skin that have been repeatedly exposed to the sun for many years, such as the face and nose, ears, back of the neck, and the bald area of the scalp. Less commonly, these tumors can appear in places with limited sun exposure, such as the back, chest, or extremities. However, skin cancer can occur anywhere on the skin.

How do doctors diagnose skin cancer?

A skin exam by a dermatologist is the way to get a definitive diagnosis of skin cancer. In many cases, appearance alone is sufficient to make the diagnosis.

A skin biopsy is usually used to confirm a suspected skin cancer. This is done by numbing the area below the tumor with a local anesthetic. A small portion of the tumor is cut out and sent for examination by a pathologist, who looks at the tissue under a microscope and makes a diagnosis based on the characteristics of the tumor.

Treatment for skin cancer:

There are several effective ways to treat skin cancer. The choice of therapy depends on the location and size of the tumor, the microscopic characteristics of the cancer, and the general health of the patient.

Topical medications: For superficial basal cell carcinomas, creams, gels, and solutions may be used, including imiquimod (Aldara), which works by stimulating the body's immune system, causing it to produce cancer-fighting interferon, and fluorou racil (5-FU), a chemotherapy drug. Some patients do not experience any side effects from these topical treatments, but others may experience redness, swelling, and irritation. One drawback of topical medications is that there is no tissue available to examine and determine if a tumor has been completely removed.

Destruction by electrodesiccation and curettage (EDC): The tumor area is numbed with a local anesthetic and repeatedly scraped with a sharp instrument (curette) and then cauterized with an electric needle. The advantage of this method is that it is quick, easy, and relatively inexpensive. The disadvantages are that the scar is usually somewhat unsightly and the recurrence rate reaches 15%.

Surgical excision: The area around the tumor is numbed with a local anesthetic. A football-shaped piece of tissue that includes the tumor is then removed, and the edges of the wound are then closed with stitches. For very large tumors, skin grafts or flaps are needed to close the defect. The advantages of this form of treatment are that there is a cure rate greater than 90%, and the surgical specimen can be examined to make sure that the entire tumor has been removed correctly.

Radiation therapy Ten to fifteen treatment sessions deliver a high dose of radiation to the tumor and a small area of surrounding skin. This form of treatment is useful in those who are not candidates for any surgical procedure. The advantage of radiation therapy is that it does not involve any cutting. The downsides to this expensive alternative are that the treated area cannot be tested to make sure that the entire tumor is gone and that the radiation scars look worse over time. This is why it is usually reserved for elderly patients.

What is the prognosis and survival rate for skin cancer?

The prognosis for non-melanoma skin cancer is generally excellent. Both basal cell carcinoma and squamous cell carcinoma are highly curable. There are virtually no deaths from basal cell carcinoma and only rare deaths from squamous cell carcinoma skin cancers, primarily in immunosuppressed individuals. Depending on the treatment method and the location and type of skin cancer, the chance of recurrence of a previously treated skin cancer is as low as 1% to 2% for surgery and as low as 10% to 15% % for destruction by electrodesiccation and curettage.

Prevention of skin cancer:

• Choose the shade, especially between 10 a.m. and 4 p.m.

• Don't get sunburned.

• Avoid tanning and never use UV tanning beds.

• Cover up with clothing, including a wide-brimmed hat and UV-blocking sunglasses.

• Use a broad-spectrum (UVA / UVB) sunscreen with an SPF of 15 or higher every day. For prolonged outdoor activities, use a water-resistant broad-spectrum (UVA / UVB) sunscreen with an SPF of 30 or higher.

• Apply 1 ounce (2 tablespoons) of sunscreen to the entire body 30 minutes before going outside. Re-apply every two hours or after swimming or excessive sweating. 

• Keep newborns out of the sun. Use sunscreen on babies older than six months.

• Examine your skin from head to toe every month.

• See a dermatologist at least once a year for a professional skin exam.