Skin Cancer & Screening
Skin cancer is the most common cancer and is increasing at a rapid rate. It happens when normal cells in the skin change to abnormal cells. The cause is complex and involves multiple factors including ultraviolet light exposure (sunlight, tanning beds), genetics and changes in DNA that control cell growth.
Chronic sun exposure and sunburn are major contributing factors to skin cancer. The damaging effects of the sun build up over time so the more you are exposed to the sun (or to tanning beds), the higher your risk of skin cancer.
There are 2 main types of skin cancer, melanoma and non-melanoma (basal cell carcinoma and squamous cell carcinoma). Non-melanoma skin cancer can occur anywhere on the skin but it is often found on the head, face, neck, back of the hands, arms and legs. This is because these body parts are most exposed to sun rays. Most forms of non-melanoma skin cancer can be easily treated because they grow slowly but if not treated, some non-melanoma skin cancers can become large or spread inside the body.
Basal Cell Carcinoma
Basal Cell Carcinoma (BCC) is the most common cancer affecting human beings. It is often painless and slow-growing. The majority of lesions appear on sun-exposed skin and the cancer can present as a longstanding ulcer with a shiny or pink, pearly raised papules which may have a firm, scar-like appearance with no symptoms.
BCC rarely spreads to internal organs but can be dangerous as they can destroy important structures such as the eyelid, nose or lips. Therapy includes surgical excision, photodynamic therapy (PDT) therapy and in some cases, the use of creams to stimulate the immune system so as to destroy or shrink the lesion.
The cure rate is over 95% if diagnosed and treated at an early stage.
Squamous Cell Carcinoma
Squamous Cell Carcinoma (SCC) usually appears in elderly patients due to cumulative chronic sun exposure. It favours sun-exposed skin as well as skin that may have received radiation therapy or skin near a chronic wound such as an ulcer. SCC appears as flat or bumpy growths with a tinge of pink or red. They often have a rough, scaling, dry appearing surface and may be tender to touch. Advanced SCC has the potential of spreading to internal tissues such as lymph nodes, so early diagnosis and treatment is crucial.
Therapy includes surgical excision, radiation therapy and injection of medication into the SCC. The cure rate for early SCC is very high but declines for more advanced lesions.
Malignant Melanoma
Malignant Melanoma is a cancer of the pigment cells (melanocytes) of the skin. It is a very dangerous type of skin cancer and often presents as a dark brown or black skin growth or ulcer. It may look like an ordinary mole but unlike the common mole, it grows more rapidly. Its surface may be thick and irregular with varying shades of colour and features of change over time.
Melanoma may occur spontaneously or arise from a pre-existing “normal” mole. People who are born with large moles (giant congenital nevi) or have a positive family history of melanoma are at increased risk.
Melanoma is more common among caucasians and can occur on any part of the body, including the palms and soles. Excessive exposure to the sun and a history of sunburns are predisposing factors. Melanomas tend to spread (metastasize) to surrounding lymph nodes or other parts of the body, leading to morbidity and mortality. Early detection and treatment of this condition is therefore important.
Diagnosis
Any skin lesion that is progressively enlarging should be examined by a trained doctor. If skin cancer is suspected, Dr Cebi may advise a biopsy to be done under local anaesthetic. Upon confirmation of skin cancer, she can assess and advise on the best option for treatment. The right treatment for you will depend on the type of skin cancer you have, its size and location, as well as your age and other health problems.
Treatment
The most common form of treatment of a malignant skin tumour is excision, which involves removing the entire skin lesion. In some situations, a complete excision may not be feasible therefore, other forms of treatment such as; radiotherapy, photodynamic therapy or topical therapy may be used. If the cancer has spread to involve the lymph nodes or other organs, the patient may need to be managed jointly with an oncologist and/or surgeon.
Follow Up
After the removal of skin cancer, patients will need to follow up regularly and over a number of years. This is to look out for any recurrences of the skin cancer and also gives Dr Cebi a chance to assess whether new skin cancers have developed in other areas.
For more information, visit cansa.org