Skin Cancer is cancer that arises from the skin. It originates from the cells of the epidermis (superficial layer of the skin) usually it doesn’t metastasize, and rarely become life-threatening.
Basal cell skin cancer and Squamous cell skin cancer, along with a number of less common skin cancers, are known as nonmelanoma skin cancer (NMSC) and are usually curable.
Malignant melanoma though aggressive is less frequent skin cancer.
Types of Skin Cancer
There are three main types of skin cancer:
- Basal-cell skin cancer (Basal-Cell Carcinoma): Basal-Cell Carcinomas are present on sun-exposed areas of the skin, especially the face. It rarely metastasizes and rarely causes death. It is easily treated with surgery or radiation. It often appears as a painless raised area of skin or may present as a raised area with an ulcer.
- Squamous-cell skin cancer (Squamous-Cell Carcinoma): Less common than BCC, it metastasizes but at a low rate. It usually presents as a hard lump with a scaly top but may also form an ulcer.
- Malignant melanoma: Melanoma is the least frequent of common skin cancer. But it is aggressive and frequently metastasizes. Signs include a mole that has changed in size, shape, color, irregular edges, and is itchy or bleeds. ABCDE rule to watch out for melanoma. If a mole has:
- Asymmetrical shape: Shape of one half does not match the other
- Border irregularities: Edges are ragged
- Color that isn’t consistent
- Diameter larger than 6 mm
- Evolving size or shape: Any new spot or mole that is changing its color, shape or size.
- Kaposi's sarcoma: This cancer is caused by a type of herpes virus, typically in patients with weakened immune systems such as those with AIDS. Presents as skin lesions that are brownish-red to blue in colour and usually found on the legs and feet.
- Less common skin cancer include Merkel cell carcinoma, keratoacanthoma, spindle cell tumors, Paget's disease of the breast, leiomyosarcoma, and angiosarcoma, etc.
Causes of Skin Cancer
- Ultraviolet radiation from sun exposure is the primary cause of skin cancer
- Artificial UV radiation, e.g. tanning beds
- Tobacco Smoking
- HPV infections increase the risk of squamous-cell skin cancer
- Few genetic syndromes including congenital melanocytic nevi syndrome
- Chronic non-healing wounds called Marjolin's ulcers can develop into squamous cell skin cancer.
- Ionizing radiation such as X-rays
- A suppressed immune system from diseases such as HIV/AIDS infection, or from some medications such as prednisone or chemotherapy.
Diagnosis for Skin Cancer
- Skin examination by a dermatologist.
- Skin biopsy is usually used to confirm a suspicion of skin cancer. A small portion of tissue is sent for examination to a pathologist, who examines the tissue and provides a diagnosis based on the microscopic characteristics of the tumor.
- Self-examination is important in the early diagnosis of skin cancer.
- Increasing use of Sunscreen
- Decreasing indoor tanning
- Select clothing, cosmetic products, and contact lenses that offer UV protection.
- Wear sunglasses with total UV protection and a wide-brimmed hat to shade your face and neck.
- Avoid direct sun exposure as much as possible during peak UV radiation hours (between 10:00 AM and 2:00 PM).
- Avoiding the use of tobacco products
- Perform skin self-exams regularly
Treatment of Skin Cancer
Treatment is dependent on:
- A specific type of cancer
- Location of the cancer
- Age of the person
- Whether the cancer is primary or a recurrence.
- The general health of the patient
Nonmelanoma Skin Cancer
It is usually curable. Treatment is generally by surgical removal but may involve radiation therapy or topical medications
- Surgical Excision: Excision of the skin cancer with a margin of normal tissue
- Mohs surgery: It is a technique used to remove cancer with the least amount of surrounding tissue. In this procedure, the edges are checked immediately to see if tumor is found. Thus providing the opportunity to remove the least amount of tissue while ensuring complete removal of cancer and providing cosmetically good results. It is useful for locations where excess skin is limited, such as the face.
- Electrodesiccation and curettage: Physically scraping away the skin cancer cells, followed by electrosurgery
- Topical chemotherapeutic creams
Melanoma skin cancer
It may involve some combination of surgery, chemotherapy, radiation therapy, and targeted therapy. Standard treatments for melanoma skin cancer include:
- Wide surgical excision
- Sentinel lymph node mapping to check spread to local lymph nodes
- Chemotherapy for widespread metastatic disease
- Radiation therapy for local control of advanced melanoma in areas such as the brain
- Clinical trials
- Treatments for metastatic melanoma include biologic immunotherapy agents
If disease has spread, palliative care is used to improve quality of life.
Factors affecting the Cost of Treatment of Skin Cancer
The cost to the patient depends on a variety of factors like:
- The hospital patient chooses
- The type of room
- Fees for the team of doctors
- Medicine cost
- Cost of Tests and diagnostic procedure
- Type of treatment - Cost of surgery, cost of radiotherapy, cost of chemotherapy, etc.
- Cost of follow-up care required.
- Cost of reconstructive procedure, if required