Skin Cancer

Skin cancer is the abnormal growth of cells in the skin tissues. The major cause of skin cancer is over exposure of your skin to the sun. Not necessarily, the disease develops only on the exposed areas of your skin, since it can occur in other unexposed areas as well.

Medical professionals who diagnose and treat skin cancer include dermatologists, skin care surgeons, radiation oncologists, etc. There are typically three types of skin cancer, squamous cell carcinoma, basal cell carcinoma and melanoma. The first two types of diseases are non-melanoma skin cancer that affects specific areas of your skin and rarely spread to other body parts. On the other hand, melanoma skin cancer is rare that is likely to spread to tissues in other body parts.

When the DNA of skin cells suddenly starts to mutate for unknown reasons, causing normal cells to grow out of control, it results into skin cancer. At first, skin cancer attacks the uppermost crust of the skin, called the epidermis that gradually invades the lower layers of the skin. The presence of ultraviolet rays in the sun is another potential cause of skin cancer. Over exposure to toxic substances and having a weaker immune system are other reasons that should be taken into consideration.

Look out for the signs and symptoms of skin cancer that generally includes:

• Melanoma skin cancer appears in the form of new spots that gradually change its size, shape and colour. This may happen to any existing spot that actually change in appearance over a time period. It should be noted that this type of cancer may occur in any exposed or non-exposed parts of the body.
• Squamous cell carcinoma is a type of skin cancer that initially appears in the form of red, scaly and thick spots that may easily crust, ulcerate and bleed. This type of cancer is mostly noticeable in individuals over 50 years of age who are often exposed to the sun.
• Basal cell carcinoma, on the other hand, grows slowly on the exposed areas of the skin and is usually not so dangerous. Initially, it appears as a lump that turns pale, red and pearly in colour.
• If you notice pink or red, black or brown spots on the skin that grows quickly and eventually begins to crust and bleed, check out with your doctor right away. It signifies you have Nodular melanoma skin cancer.

Adopting significant preventive measures for skin cancer can help keep the disease at bay. For instance, avoid the sun especially during the noon when the intensity of sun rays is very high. Wear sunscreen every time you step into the sun and do not forget to wear it even at home. When going out into the sun, try to wear protective clothing as much as possible.

Be aware of the various sun-sensitizing medications and avoid tanning beds too. Check your skin at repeated intervals and if you notice any changes, report it to the doctor right away.

In case your doctor notices anything suspicious on your skin, he will carry out a thorough skin examination. A preliminary test is done to assess the condition of your skin and whether there are any skin changes that are likely to turn cancerous. Further examinations are required if the doctor needs to investigate more. A sample of your suspicious skin is sent for a lab biopsy.

If skin cancer is diagnosed, your doctor may conduct further tests to evaluate the type and stage of the cancer. This is because basal cell carcinoma rarely spreads to other parts of the skin, while melanoma or squamous cell carcinoma tends to invade other body areas. In that case, additional tests are required for examining samples of your lymph nodes for signs of cancer.

The treatment options for skin cancer vary depending upon the type and stage of the cancer. Non-melanoma skin cancer treatment includes surgeries, radiation therapy, electrosurgery, cryosurgery, etc. On the other hand, treatment options for melanoma include chemotherapy, surgery, immunotherapy, targeted therapy with inhibitors, etc.

Once the doctor decides your treatment option, you should take care of a few things to get ready for skin cancer treatment as specified by your doctor.

Whether you have a surgery or chemotherapy, radio therapy, targeted treatment or any other type of treatments, this is how you prepare:

• Have a clear understanding of about your disease, the causes, and the treatment options. Your doctor tells you about the type and stage of cancer. It is advised to take a second opinion to be sure that you are walking the right path to get cured.
• Plan your recovery ahead of the treatment. Cancer treatments bring lots of stresses and anxieties with it, so you should be prepared beforehand about this new journey.
• Inform your doctor about the medicines you have already been taking and whether you have any other health concerns. Medications like aspirins and blood thinners usually have a greater impact on your health during or after a surgery. In that case, your doctor may suggest you to stop taking these medicines. Also, he may advice you to take some new medications required for the treatment plan for your cancer.
• Bring a friend or relative on the day of the surgery.

The treatment options are classified as follows, which also explain how the skin cancer treatments are performed:

• Moh’s Micrographic surgery- This type of surgery is performed for non-melanoma and malanoma skin cancer. First, the patient is administered local anaesthesia to numb the skin area where the surgery is performed. The surgeon removes samples of the visible tumour with surrounding tissues. After the procedure the patient is released but he has to wait during this period when the doctors freeze, stain and maps the tissues in details under the microscope. If cancerous cells are found on the outer lining of the tissues, the procedure is performed once more for removal of more tumour cells until the disease is removed completely. The best part of the Moh’s surgical procedure is it does not affect any healthy tissues or cells in the surrounding.
• Excisional surgery- Excisional surgery is usually performed for non-melanoma and melanoma skin cancer. The procedure involves using local anaesthesia to numb the skin area for excision. The excision may be small or large, depending upon how far the tumours have spread. After the cancerous tissues are removed from the area, the open wound is stitched closed. Standard excision is the best option to remove squamous cells and basal cells, while a Moh’s surgery is normally done in places like the face to conserve a greater part of the skin.
• - Cryosurgery for basal cell carcinoma is considered very effective. The procedure starts with numbing the skin area with local anaesthesia. Then, liquid nitrogen is sprayed onto the area or a cotton applicator stick is used to smear the area with a type of chemical. The procedure is repeated for the surrounding areas as well. When done, an antibiotic dressing is done for the wound. The purpose of cryosurgery for skin cancer is to destroy pre-cancerous skin lesions.
• Electrosurgery and curettage- The procedure helps to treat the outermost part of the skin for removing basal cell carcinoma and squamous cell carcinoma. During the procedure, the part of the skin is numbed with local anaesthesia.     A spoon like instrument is used to scrape the upper crust of the skin tissues and then eletrosurgery is given by inserting a metal instrument or needle to help control bleeding of the skin. The procedure is repeated if the doctor feels so. Once over, the wounded area is covered with bandage for better protection.
• Radiation therapy- There is no need for anaesthesia or cutting. The patient is asked to lie down on a table and laser beams are directed on the cancerous parts of the skin for several times a week, continuously for 1-4 weeks. The success rate of radiation therapy ranges from 85-95 percent and is best for non-melanoma skin cancer.
• This is yet another treatment given in combination with radiation and targeted therapies to help treat skin cancer. Chemos are given in the form of oral pills or they are injected through an IV channel created in the arm to help reach into the bloodstream. Chemos are particularly used when the cancer has spread to faraway tissues and lymph nodes in the body.

You are usually discharged on the day after the surgery during which your doctor removes the bandage and evaluates the site. You are advised to clean the site with hydrogen peroxide and then apply antibiotics before doing the bandage. The stitches are removed mostly after a week’s time posts any skin cancer surgery.

The recovery of skin cancer treatment varies. Some patients are required to wear bandages for 7 days after the surgery, while for others it may take 2-3 weeks to recover. Follow-up appointments with the doctor are essential to evaluate your skin condition for months and years after the surgery. Sometimes, your doctor may suggest a reconstruction procedure immediately after your surgery to help restore your skin’s appearance.