How Skin Cancer DevelopsOctober 22, 2017
Skin cancer is an insidious disease; it is estimated that 2 out of every 3 Australians will be diagnosed with skin cancer by the time they are 70 (http://www.cancer.org.au/about-cancer/types-of-cancer/skin-cancer.html). Depending on the type of skin cancer, it can be caused by repeated episodes of sunburn prior to the age of 18; it can be caused by repeated sun damage, and UV tanning beds. The propensity to develop malignant melanomas can be genetic, and not all skin cancers appear in sun exposed areas.
Viruses can also enter into the body’s cells, causing damage to the DNA, which in later years can cause mutations in the cell in its replication. This leads to abnormal cell growth, or cancer. Stress reduces the body’s ability to remove cancerous cells via the immune system, so ensuring that a reduced stress lifestyle, with plenty of sleep, exercise and a healthy diet will assist in preventing the development of cancer.
Skin Cancer Can Develop in Children
A rare type of lesion, that has histologic overlaps with malignant melanoma is the spitz nevus. It is more common in juvenile populations, and has shown family history of previous skin cancer diagnoses. Spitz nevus can metastasize into malignant melanoma post-puberty due to hormonal changes, therefore any lesion of this type should be treated with caution.
It is important to ensure that children are protected from sun damage, and given a diet rich in fruit and vegetables, and have plenty of sleep and are also regularly checked for odd freckles and moles. If there has been a family history of skin cancer, it is also important that children are checked also.
Fair Skinned People Most Susceptible to Skin Cancers
There are six skin phototypes, with types I & II most susceptible to developing skin lesions. People with more pigmentation in their skin are less likely to develop skin cancers; and those who are light skinned and burn easily have a higher risk of skin cancer. There is a particularly virulent type of skin cancer that dark skinned people can get, and it can appear in places that have not had any sun exposure. Acral lentiginous melanoma affects people of African origin, and people who have particularly strong skin pigmentation should still take precautions against sun damage ( http://www.skincancer.org/prevention/are-you-at-risk/skin-types-and-at-risk-groups#panel1-6).
Regular Skin Inspections are Necessary to Prevent Skin Cancer Developing
When a melanoma is detected in its earliest stages, it has a near 100 percent cure rate. If it is unnoticed and grows to a depth of more than 4 millimeters, the cure rate drops to less than fifty percent (https://www.skincheckwa.com.au/education/check-your-skin-and-moles). It is recommended that adults check their skin every three months for changes in freckles and moles, and report anything of concern or note changes to their doctor.
A doctor can then perform a thorough skin check, and if moles are of a potential concern, a needle or puncture biopsy can be performed. When pathology is performed on the sample, abnormal cellular activity can be determined, and recommendations for treatment can be given in order to resolve the lesion.
How to Note Changes in Potential Skin Cancers
When you are performing a self-check; ensure that you are in a well lit area with a full length mirror. Abnormal lesions can appear on genital areas and also on the underside of the foot, so ensure that you use mirrors to check these. If you note any of the following concerns, make an appointment to see your primary care physician (from https://www.skincheckwa.com.au/education/check-your-skin-and-moles)
- A: Asymmetry of the mole; a normal mole will have a similar top or bottom, or both sides. Any irregularities are a sign of abnormal cell development.
- B: Borders that irregular, ragged or notched, and have changed since the last time you inspected them need to be reported to your doctor
- C: Colours that are unusual or uneven include pink, grey, white or blue. Normal colours are black, tan and brown. If a mole changes colour it is suspect and should be reported to the doctor.
- D: Diameters that become larger than the surrounding moles, or that change significantly indicate a potential skin cancer.
Other types of problems include spots that are growing, sores that don’t heal or that are itching and bleeding, these need to be reported to the doctor a a biopsy needs to be potentially carried out on the suspected lesion.
Other Potential Signs of Skin Cancer
Other types of cancerous lesions can appear as strange growths on the skin, and these can include the following symptoms:
Nodular melanomas can be firm to the touch, look different to regular melanomas, are rounded and can be firm to the touch, after a period of time they crust over and bleed. Basal cell carcinomas appear as scaly lesions on the skin that refuse to heal.
Squamous cell carcinomas are thickened red scaly spots that refuse to heal and often bleed. They most often appear in people over the age of fifty.
How Skin Cancer is Treated
The treatment for skin cancer is dependent on the type of skin cancer, the size and location of it and whether it has spread to other parts of the body. Options to eradicate skin cancer lesions include (https://www.cancercouncil.com.au/64447/cancer-prevention/sun-protection/tips-for-being-be-sunsmart/treatment-for-skin-cancer/):
- Surgical removal of the lesion and the surrounding tissue
- Curettage (scraping and burning)
- Cryotherapy with liquid nitrogen
- Radiation therapy
- Photodynamic therapy (using a light source and special cream to eradicate cancerous cells)
- Imiquimod – a cream that boosts the body’s immune system to destroy cancerous cells
- Chemotherapy using drugs, pills or injections
Skin cancer is a treatable condition, with many people having had them detected, treated and removed, and gone on to live happy and satisfying lives. Inspecting your skin regularly, and taking responsibility for your health is imperative. Prevention ensures that your health stays intact and that you get to have the best quality of life.
Skin cancer is not the terrifying, dreadful thing that it once was, as there are many highly successful treatment options, and due to many ongoing education campaigns, people are now more aware of the importance of skin protection, avoiding tanning, and having regular skin checkups.
At Ubuntu Medical, we also have a Skin Cancer Clinic.