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Saturday, October 27, 2018


What is skin cancer?

Skin cancer is the most common type of cancer.  The main types of skin cancer are squamous cell carcinoma, basal cell carcinoma, and melanoma. Melanoma is much less common than the other types but much more likely to invade nearby tissue and spread to other parts of the body. Most deaths from skin cancer are caused by melanoma.

Skin cancer is a disease in which malignant (cancer) cells form in the tissues of the skin. The skin is the body’s largest organ. It protects against heat, sunlight, injury, and infection. Skin also helps control body temperature and stores water, fat, and vitamin D. The skin has several layers, but the two main layers are the epidermis (upper or outer layer) and the dermis (lower or inner layer). Skin cancer begins in the epidermis.

Skin cancer can occur anywhere on the body, but it is most common in skin that is often exposed to sunlight, such as the face, neck, and hands.

Risk factors of Skin Cancer

Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer.

Risk factors for basal cell carcinoma and squamous cell carcinoma of the skin include the following:

·         Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) over long periods of time.

·         Having a fair complexion, which includes the following:

                    1-Fair skin that freckles and burns easily, does not tan, or tans poorly.

                     2-Blue, green, or other light-colored eyes.

                      3-Red or blond hair.

Although having a fair complexion is a risk factor for skin cancer, people of all skin colors can get skin cancer.

·         Having a history of sunburns.

·         Having a personal or family history of basal cell carcinoma, squamous cell carcinoma of the skin, actinic keratosis, familial dysplastic nevus syndrome, or unusual moles.

·         Having certain changes in the genes or hereditary syndromes, such as basal cell nevus syndrome, that are linked to skin cancer.

·         Having skin inflammation that has lasted for long periods of time.

·         Having a weakened immune system.

·         Being exposed to arsenic.

·         Past treatment with radiation.

Older age is the main risk factor for most cancers. The chance of getting cancer increases as you get older.

Is it true that only people with light skin get skin cancer?

No. Anyone can get skin cancer. It's more common among people with a light (fair) skin tone, but skin cancer can affect anyone. Skin cancer can affect both men and women. Even teenagers and, rarely, younger children can develop skin cancer.

How can people with dark skin get skin cancer?

Although dark skin does not burn in the sun as easily as fair skin, everyone is at risk for skin cancer. Even people who don't burn are at risk for skin cancer. It doesn't matter whether you consider your skin light, dark, or somewhere in between. You are at risk for skin cancer. Being in the sun can damage your skin. Sunlight causes damage through ultraviolet, or UV rays, (they make up just one part of sunlight). Two parts of UV, UVA and UVB, can both cause damage to skin. Also, the sun isn't the only cause of skin cancer. There are other causes. That's why skin cancer may be found in places on the body never exposed to the sun.

What are some warning signs of skin cancer?

·         Talk with your doctor if you see any changes on your skin that do not go away within one month.

·         Check the skin on all surfaces of your body, even in your mouth.

·         Watch for a new mole or other new growth on your skin.

·         Check for changes in the appearance of an old growth on the skin or scar (especially a burn scar).

·         Watch for a patch of skin that is a different color and becomes darker or changes color.

·         Watch for a sore that does not heal – it may bleed or form a crust.

·         Check your nails for a dark band. Check with your doctor if you see changes, such as if the dark band begins to spread.

When skin cancer is found early, it can be treated more easily.

What does skin cancer look like?

There are many different types of skin cancer (such as melanoma and basal cell skin cancer). Each type looks different. Also, skin cancer in people with dark skin often looks different from skin cancer in people with fair skin. A change on the skin is the most common sign of skin cancer. This may be any new growth on the skin, a sore that doesn't heal, or a change in an old growth.

If you notice a change on your skin, see your doctor. Don't wait until the change looks like the more advanced skin cancers in these photos.

How can I protect myself from skin cancer?

·         Have your doctor check your skin if you are concerned about a change.

·         Your doctor may take a sample of your skin to check for cancer cells.

·         Ask your doctor about your risk of skin cancer.

Some skin conditions and certain medicines (such as some antibiotics or hormones) may make your skin more sensitive to damage from the sun.

Medicines or medical conditions (such as HIV) that suppress the immune system may make you more likely to develop skin cancer.

Having scars or skin ulcers increases your risk.

Exposure to a high level of arsenic (a poison that is sometimes found in well water or pesticides) increases your risk.

Stay out of the sun as much as you can. Whenever possible, avoid exposure to the sun from 10 a.m. to 4 p.m. If you work or play outside, then-

·         Try to wear long sleeves, long pants, and a hat that shades your face, ears, and neck with a brim all around.

·         Use sunscreen with a label that says it is broad spectrum or is at least SPF 15 and can filter both UVA and UVB rays.

·         Wear sunglasses that filter UV to protect your eyes and the skin around your eyes.

If you are concerned about having a low level of vitamin D from not being in the sun, talk with your doctor about supplements.

Don't use tanning beds, tanning booths, or sunlamps.

Sunlight and Skin Cancer

The sun, sunlamps, and tanning booths all give off ultraviolet (UV) radiation. Exposure to UV radiation causes early aging of the skin and skin damage that can lead to skin cancer.

People of all ages and skin tones should limit the amount of time they spend in the sun, especially between mid-morning and late afternoon, and avoid other sources of UV radiation, such as tanning beds. It is important to keep in mind that UV radiation is reflected by sand, water, snow, and ice and can go through windshields and windows. Even though skin cancer is more common among people with a light skin tone, people of all skin tones can develop skin cancer, including those with dark skin.

Follow these tips to protect your skin from sunlight:

·         Wear a hat with a wide brim all around that shades your face, neck, and ears. Baseball caps and some sun visors protect only parts of your skin.

·         Wear sunglasses that block UV radiation to protect the skin around your eyes.

·         Wear long sleeves and long pants. Tightly woven, dark fabrics are best. Some fabrics are rated with an ultraviolet protection factor (UPF). The higher the rating, the greater the protection from sunlight.

·         Use sunscreen products with a sun protection factor (SPF) of at least 15. (Some doctors suggest using a product with an SPF of at least 30.) Apply the product’s recommended amount to uncovered skin 30 minutes before going outside, and apply again every two hours or after swimming or sweating.

Keep in mind that the sun's rays-

·         are strongest between 10:00 a.m. and 4:00 p.m.

·         can go through light clothing, windshields, windows, and clouds

·         are reflected by sand, water, snow, ice, and pavement

Symptoms of Skin Cancer

Not all changes in the skin are a sign of basal cell carcinoma, squamous cell carcinoma of the skin, or actinic keratosis. Check with your doctor if you notice any changes in your skin.

Signs of basal cell carcinoma and squamous cell carcinoma of the skin include the following:

·         A sore that does not heal.

·         Areas of the skin that are:

·         Raised, smooth, shiny, and look pearly.

·         Firm and look like a scar, and may be white, yellow, or waxy.

·         Raised and red or reddish-brown.

·         Scaly, bleeding, or crusty.

Basal cell carcinoma and squamous cell carcinoma of the skin occur most often in areas of the skin exposed to the sun, such as the nose, ears, lower lip, or top of the hands.

Signs of actinic keratosis include the following:

·         A rough, red, pink, or brown, scaly patch on the skin that may be flat or raised.

·         Cracking or peeling of the lower lip that is not helped by lip balm or petroleum jelly.

·         Actinic keratosis occurs most commonly on the face or the top of the hands.

Tests for examining skin cancer

The following tests or procedures, that examine the skin, are used to detect (find) and diagnose basal cell carcinoma and squamous cell carcinoma of the skin-

·         An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.

·         An exam of the skin for bumps or spots that look abnormal in color, size, shape, or texture.

·         All or part of the abnormal-looking growth is cut from the skin and viewed under a microscope by a pathologist to check for signs of cancer.

Prognosis (chance of recovery) and treatment options

The prognosis (chance of recovery) for squamous cell carcinoma of the skin depends mostly on the following:

·         Stage of the cancer.

·         Whether the patient is immunosuppressed.

·         Whether the patient uses tobacco.

·         The patient's general health.

Treatment options for basal cell carcinoma and squamous cell carcinoma of the skin depend on the following:

·         The type of cancer.

·         The stage of the cancer, for squamous cell carcinoma.

·         The size of the tumor and what part of the body it affects.

·         The patient’s general health.

Stages and Treatment of Skin Cancer

After squamous cell cancer of the skin has been diagnosed, tests are done to find out if cancer cells have spread within the skin or to other parts of the body. Cancer may spread from where it began to other parts of the body. There are three ways that cancer spreads in the body. Cancer can spread through tissue, the lymph system, and the blood.

The process used to find out if cancer has spread within the skin or to other parts of the body is called staging. Staging for basal cell carcinoma and squamous cell carcinoma of the skin depends on where the cancer formed. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment for squamous cell carcinoma of the skin.

Basal cell carcinoma of the skin rarely spreads to other parts of the body. Staging tests to check whether basal cell carcinoma of the skin has spread are usually not needed.

The following stages are used for basal cell carcinoma and squamous cell carcinoma of the skin that is on the head or neck but not on the eyelid:

·         Stage 0 (Carcinoma in Situ)

·         Stage I

·         Stage II

·         Stage III

·         Stage IV

The following stages are used for basal cell carcinoma and squamous cell carcinoma of the skin on the eyelid:

·         Stage 0 (Carcinoma in Situ)

·         Stage I

·         Stage II

·         Stage III

·         Stage IV

Treatment depends on the type of skin cancer or other skin condition diagnosed:

·         Basal cell carcinoma

·         Squamous cell carcinoma

·         Actinic keratosis

There are different types of treatment for patients with basal cell carcinoma, squamous cell carcinoma of the skin, and actinic keratosis.

Eight types of standard treatment are used:

·         Surgery

·         Radiation therapy

·         Chemotherapy

·         Photodynamic therapy

·         Immunotherapy

·         Targeted therapy

·         Chemical peel

·         Other drug therapy

New types of treatment are being tested in clinical trials. Patients may want to think about taking part in a clinical trial. Patients can enter clinical trials before, during, or after starting their cancer treatment. Treatment for skin cancer may sometimes cause side effects.

Need of Follow-up tests

Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.

Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.

Basal cell carcinoma and squamous cell carcinoma are likely to recur (come back), usually within 5 years, or new tumors may form. Talk to your doctor about how often you should have your skin checked for signs of cancer.

Source: National Cancer Institute