Skin Cancers

The skin like other organs in the body can be affected by cancer. Skin cancer is an abnormal and uncontrolled growth of skin cells that can be divided into three types:

Squamous cell carcinoma.
Basal cell carcinoma.
Malignant melanoma.

Squamous cell carcinoma:

This type of cancer originates from the squamous cells present in the epidermis which is the outer most layer of the skin (see the skin). Too much exposure to ultraviolet light of sun is the most common cause and that’s why it is more common on areas that are exposed to sun light.

Certain factors increase the risk of squamous skin cancer which may include:

Sunlight exposure for a long time.
People with fair skin are more affected than people with dark skin because they have less melanin pigment which protects the skin from sunlight.
People who have been exposed to x-rays for a prolonged time.
Burns, ulcers and old scars on the skin.
Exposure to chemical substances such as arsenic.
Old age people.
Genetic disorders eg, Xeroderma pigmentosum.
People with suppressed or low immunity.

Squamous cell carcinoma can appear on any area of the body but it mostly appear on sun exposed areas such as the head and neck including the ears and lips, back of the hands.

Symptoms and signs:

In early stages the skin change may include a skin bump that may be pink or red in color with a rough or scaly surface.
A change in a pre existing lesion is a warning sign.
Actinic Keratosis is a precancerous skin lesion that may change to squamous cell cancer, changes in Actinic Keratosis may be a warning sign for developing squamous cell carcinoma, and these changes may include: increase in size, increase in redness, bleeding, thickening or pain.
This type of cancer has the ability to spread to the deeper layers of the skin and may also spread to other areas of the body as well.

Diagnosis:

Diagnosis is usually made by examining the lesion and confirmed by taking a skin biopsy, there are many types of biopsies and the patient is given local anesthesia before taking the biopsy to numb the skin.

Treatment:

The earlier the diagnosis is, the better is the cure rate. Factors that determine the treatment options are: tumor size, the location of tumor and whether or not the tumor has spread.

Cutting the tumor out (excision) after giving local anesthesia and then the wound is closed with stitches.
Curettage and electrodessication in which the cancer cells are scrapped away with a curette and the remaining is destroyed with an electrical current that generates heat. This type of treatment is used for small squamous cell carcinoma.
Cryotherapy: this method freezes the tumor cells using liquid nitrogen leading to their destruction.
Advanced surgery called Mohs surgery in which the surgeon after removing each piece of skin, examines it under a microscope to check if there is any cancer cells left behind, if tumor cells are still present another piece is removed until the skin sample is free from cancer cells. This type of surgery is mostly used for tumors on the face such as the ears or for difficult or recurring tumors.
Actinic keratosis and some cases of Bowen’s disease which is the earliest form of squamous cell cancer can be treated with 5-fluorouracil containing lotion or imiquimod.
Radiotherapy: this method may be used when the tumor is large, in places where it is difficult to remove or to relieve symptoms when the tumor has spread to other parts of the body. Radiotherapy maybe used alone or in combination with surgery.
Chemotherapy: this method is used in cases where there is spread of the tumor to other body parts. In advanced cases, chemotherapy is added to surgery or radiation.
Photodynamic laser therapy: may be used in Bowen’s disease.

Prevention:

As sun exposure is the most important factor, protecting the skin by wearing protective clothes which include hats, long sleeve clothes and UV protective glasses and try to stay out of the sun during peak sunny hours from 10am-4pm.
Using sunscreens with a sun protective factor (SPF) of at least 15. For children and persons with fair skin use sun protective factor of 30.
Regular checking of the skin for any lesion that recently appeared, changes in an existing lesion that may be suspicious include: growing, any change in appearance, bleeding, pain, itching, inflammation or a lesion that never heals completely.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.