What is Skin Cancer?
Skin cancer is a change in certain cells of the skin that abnormally creates a malignant tumor. These abnormal cells may spread through the skin to adjacent structures (local invasion), spread to lymph nodes and/or other organs, and continue to grow/spread through a process called metastasis. The skin is the body’s largest organ where cancer most commonly develops. In the hand, squamous cell carcinoma (SCC) is the most common type of skin cancer, followed by basal cell carcinoma (BCC) and melanoma. There are other, less common types of skin cancer, such as Kaposi’s sarcoma, dermatofibrosarcoma protuberans, sweat gland tumors, and Merkel cell carcinoma (MCC).
What are the risk factors?
Squamous cell carcinoma, basal cell carcinoma, and melanoma are all associated with chronic sun exposure, fair or fair skin, and immune suppression. Other factors include exposure to radiation and certain chemicals such as arsenic, unstable scars from trauma such as burns, and certain genetic conditions such as xeroderma pigmentosum and Gorlin syndrome. Premalignant lesions such as actinic keratosis, cutaneous horns, and Bowen’s disease may develop into SCC. Family history and certain types of moles (moles) may also indicate a predisposition for melanoma.
How does it look?
Squamous cell carcinoma (SHC) may appear as small firm nodules on the skin. They are usually brown or tan, and may show crusting, ulceration, or bleeding. The scaly, upper layer can build up forming a horn of skin. Some people don’t think of cancer, they just think it’s an unhealed cut or infection. Some SHKs may appear as large, mushroom-like growths. SCC has the potential to metastasize, especially to lymph nodes.
Basal cell carcinoma is classically defined as a small, well-defined nodule with a translucent, pearly border overlying telangiectasias (abnormal superficial small blood vessels). These, too, can ulcerate and look like a chronic wound. They tend to grow more slowly and tend to metastasize less.
Melanomas usually look like moles or birthmarks, or they can develop from intact skin (DeNovo). Melanoma is suspicious for growth (enlargement, elevation), color or shape differences, irregular borders, and/or lesions greater than 6 mm in diameter. Melanoma (especially Breslow thickness and ulceration determined by pathology examination) has the potential to metastasize to lymph nodes and/or systemic in parallel with prognostic parameters. In other words, the risk of lymph node and distant metastasis is higher in melanoma with >4 mm ulceration.
The presence of the lesion and its changes are usually known by the patient and apply to the physician. Sometimes the doctor he goes to for another reason finds out by chance. A careful history is taken and physical examination (by eye, by hand, dermoscope, etc.) is performed. A biopsy is required to confirm that the lesion is malignant; It can be done by removing only a small part of a large lesion (punch and incisional biopsy) or by cutting out a small lesion completely, the definitive diagnosis is made by the pathologist.
Lymph nodes should also be examined as they are a common site of metastasis, especially for melanoma and squamous cell carcinoma. Other evaluations such as sentinel lymph node biopsy, CT scan and/or PET scan may be needed to check for metastasis, especially in melanoma.
What are the Treatment Options in Skin Cancer?
The standard treatment is surgical removal of the cancerous tissue with adequate solid margins; skin graft or local flap covering of the surgical wound. Depending on the location of the cancer, local amputation can be done from the total finger or phalanx. Sentinel lymph node biopsy should not be ignored in SCC and melanoma. Depending on the pathology examination results, additional interventions such as radiation and/or systemic drug therapy may be required.
The best treatment for skin cancer is prevention. Wear protective clothing and sunscreen and avoid high-risk exposure to other active ingredients. Also, the prognosis is much better with early detection, so check your skin regularly and point out any lesions to your doctor right away.