Common among people with light skin, skin cancer globally accounts for at least 40% of cancer cases. Nonmelanoma skin cancer is the most common type affecting almost 2 – 3 people each year. About 80% of nonmelanoma skin cancers are basal-cell cancers & the remaining 20% are squamous-cell cancers. However, both these types rarely result in death. As most skin cancers are caused due to exposure to ultraviolet (UV) radiation from sunlight, one can also reduce risk by limiting or avoiding exposure to UV radiation. Checking skin for suspicious changes will help detect skin cancer in early stages & which will subsequently allow greater chance for successful skin cancer treatment.
What is Skin Cancer?
Skin cancers are basically cancers which arise from skin due to development of abnormal cells having ability to invade or spread to other areas of the body. There are three main types of skin cancers; melanoma skin cancer, which is the most aggressive, basal-cell cancer (BCC) & squamous-cell cancer. Basal-cell & squamous-cell cancers are one group known as non-melanoma skin cancer (NMSC). BCC grow slowly & damage tissue around it but rarely spread to distant tissue or result in death. Most often they appear as painless raised surface of skin, which may be shiny. At times BCC are raised areas with ulcer. SCC are most likely to spread & usually present as hard lumps with scaly tops or in form of an ulcer. Melanomas include moles which change in shape, size & color; with irregular edges they are itchy & bleed sometimes.
Types of Skin Cancer
There are three main types of skin cancers called Basal Cell Carcinoma or BCC, Squamous Cell Carcinoma or SCC & Melanoma. BCC & SCC are grouped together as Non-Melanoma Skin Cancers. Other unusual types of skin cancers include Kaposi Sarcoma, Merkel Cell Carcinoma, Sebaceous Gland Carcinoma,& Dermatofibrosarcoma Protuberans.
Basal Cell Carcinoma or BCC
BCC is a type of skin cancer which begins in basal cells within skin that produce new skin cells as old ones wither away. Though it can take other forms as well, BCC often appear as waxy bumps. These occur mostly in areas of skin like neck & face which are normally exposed to skin. Most BCC are believed to be caused by long-term UV radiation exposure from sunlight. Using sunscreen & avoiding sunlight may work as protection from basal cell carcinoma.
Squamous Cell Carcinoma or SCC
SCC of skin is a common type of skin cancer which develops in thin, flat squamous cells making up the outer layer of skin. SCC usually is not life-threatening, although it can be aggressive in many cases. Untreated SCC can grow large or spread to other parts of the body thereby causing serious complications. Most SCC result from prolonged exposure to UV radiation from sunlight or tanning beds or lamps. Risk of SCC & other types of skin cancers can be substantially reduced by avoiding UV light.Squamous cells are found in several places of the body & SCC can occur wherever they are found. SCC basically refers to cancers which forms in squamous cells found in skin.
Melanoma is the most serious type of skin cancer which develops in melanocytes cells producing melanin which pigments skin color. Melanoma can also occur in eyes & rarely in internal organs like intestines. Exact cause of melanoma is unclear, but UV radiation from sunlight & tanning lamps & beds increase risk of developing this cancer condition. Limiting exposure also helps reduce risk of melanoma. Risk of melanoma is found to be increasing among people under 40, especially women. Understanding warning signals of melanoma help ensure that this condition is detected early & treated before it has spread to other regions of the body. Melanoma can be effectively treated if detected in early stages.
Causes of Skin Cancer
Skin cancers occur due to mutations in DNA of skin cells. These mutations cause cells to grow abnormally & form mass of cancer cells. Starting from epidermis, the top thin layer of skin which provides a continuous cover of cells that our body sheds from time to time; epidermis consists of three main types of cells. Location of origin of skin cancer eventually decides the type & treatment option for skin cancer.
- Squamous cells which lie below outer surface & function as skin’s inner lining.
- Basal cells that produce new skin cells lay underneath squamous cells.
- Melanocytes that produce melanin pigment which give skin normal color. Located in lower part of epidermis, melanocytes produce melanin when in sun so as to help protect deeper layers of skin.
Although most damage to DNA in skin cells result from UV radiation found in sunlight & in lights used in tanning beds, but skin cancers developing on surfaces not ordinarily exposed to sunlight invariably refute this fact. This probably indicates that may be other factors are also contributing to risk of skin cancer. Being exposed to toxic substances or having conditions which weaken immune system may add to potential risks of developing skin cancers.
Signs & Symptoms of Skin Cancer
Skin cancers primarily develop on sun-exposed areas of skin including arms, chest, neck, ears, lips, face, scalp, hands & legs in women. However, quite a few also form well covered areas like palms, beneath toenails & fingernails & genital area. Skin cancer invariably affects people of various skin tones including dark complexions.
Basal Cell Carcinoma Signs & Symptoms
BCC generally occurs in sun-exposed areas like neck or face.
Basal cell carcinoma can appear as
- Pearly or waxy bumps
- Flat, flesh-colored or brown scar-like lesions
Squamous Cell Carcinoma Signs & Symptoms
SCC most often occurs on sun-exposed areas like hands, face & ears. People with dark skin are more likely to develop SCC on areas which are not often exposed to sunlight.
Squamous cell carcinoma can appear as
- Firm, red nodules
- Flat lesions with crusty or scaly surface
Melanoma Signs & Symptoms
Melanoma can develop anywhere on body. It can form on normal skin or within an existing mole that has turned cancerous. Often appearing on face or trunk of affected men, this type of cancer most often develops on lower legs in women. Melanoma also occurs on skin which has not been exposed to sun. Affecting people of all skin tones, including dark skin, melanoma occurs on palms, soles, or under toenails or fingernails.
Signs of Melanoma include
- Large, brownish spots with dark speckles
- Moles which change color, size, and/or feel, and/or bleed
- Small lesions with irregular border & portions which appear red, white, blue or blue-black
- Dark lesions on palms, soles, toes, fingertips, or on mucous membrane lining nose, mouth, vagina or anus
Other Less Common Skin Cancers
- Kaposi Sarcoma – This is a rare form of skin cancer developing in blood vessels of the skin. It usually causes red or purple patches on skin or mucous membranes. Mainly occurring among people with weakened immune systems like in cases of AIDS or in people taking immunosuppressive medications after organ transplants, young men living in Africa or old men of Italian or Eastern European Jewish heritage are risk groups as well.
- Merkel Cell Carcinoma –This cancer causes firm, shiny nodules occurring on or beneath skin & inside hair follicles. Most often, Merkel Cell Carcinoma is found on trunk, neck & head.
- Sebaceous Gland Carcinoma – It is an uncommon & aggressive cancer which originates in oil glands of the skin. Sebaceous gland carcinomas usually appear as hard, painless nodules which can develop almost anywhere, but mostly occur on eyelids where they are often mistaken for eyelid problems.
- DermatofibrosarcomaProtuberans – DFSP in short, is a very rare kind of tumor. This rare neoplasm of dermis layer of skin is classified as sarcoma. Just about one case per million every year, DFSP is fibrosarcoma& precisely a cutaneous soft-tissue sarcoma.
Diagnosing Skin Cancer
Diagnosing skin cancer will require doctors take the following steps.
- Skin Examination – Doctors will look at the skin so as to determine whether skin changes are likely to be cancer of the skin. However, further tests may be needed in order to confirm diagnosis.
- Skin Biopsy –Removing a sample of suspicious looking skin tissue for testing in laboratory is an essential part of biopsy. Biopsy can effectively determine whether patients have skin cancer, & if so, the type of skin cancer as well.
Skin Cancer Staging
Once doctors have determined presence of skin cancer, the next step would involve additional tests to evaluate extent of skin cancer. Superficial skin cancers like BCC rarely spread, therefore a biopsy which removes entire growth is all that is needed to determine cancer stage. But in cases of SCC, Melanoma or Merkel Cell Carcinoma require additional tests so as to determine staging. Additional test may include imaging procedures to examine lymph nodes nearby & follow it up with sentinel lymph node biopsy if signs of cancer are detected. While Stage I cancer is small & limited to local area where they begin, Stage IV indicates an advanced stage which has spread to other regions of the body. These skin cancer stages help doctors determine as to which treatment option will be most effective in particular case.
Skin Cancer Risk Factors
Most common factors which can increase the risk of developing skin cancer include –
- Fair Skin – Regardless of the color of skin, almost anyone can get skin cancer. However, persons with less melanin pigment provide less protection from harmful UV radiation. You are more likely to develop skin cancer if you have blond or red hair & light-colored eyes & freckle or sunburn easily, when compared to people with dark skin.
- History of Sunburns –Having had blistering sunburns as children or teenagers increase risk of developing skin cancer in adults. Sunburns during adulthood are also a risk factor.
- Excessive Sun Exposure – People who spend considerable time in the sun are prone to develop skin cancer. Especially if skin is unprotected by clothing or sunscreen. Tanning, with or without tanning beds & lamps increase risk. Tan is basically skin injury response to excessive amounts of UV radiation.
- High Altitude Sunny Climates – People living in warm, sunny climates are usually more exposed to sunlight than people living in colder climates. Living at high altitudes where sunlight is strong, also expose people to more radiation.
- Moles – Some people have many moles. Abnormal moles are called dysplastic nevi which increase risk of skin cancer. Even though they look regular & are a bit larger than normal moles, they are more likely to become cancerous in future. In case you have history of abnormal moles, keep a regular watch on them for changes.
- Precancerous Skin Lesions – Skin lesions called actinic keratoses increase risk of developing skin cancers. Typically appearing as rough, scaly patches, these precancerous skin growths range from brown to dark pink in color. Most common on hands, head & face of fair-skinned people whose skin is damaged by sun.
- Family History of Skin Cancer – When one parent or a sibling has had skin cancer, it increases your chance of developing one as well.
- Personal Skin Cancer History – In case you had developed skin cancer in the past, risk of developing it again is higher.
- Weak Immune System – People with weak immune systems are at greater risk of developing skin cancer. People living with HIV/AIDS & patients taking immunosuppressant drugs after organ transplant are at increased risk of developing skin cancer.
- Exposure to Radiation – People receiving radiation treatments for eczema & acne have increased risk of developing skin cancer like basal-cell carcinoma.
- Exposure to Certain Substances – Exposure to some substances like arsenic are also found to increase risk of developing skin cancer.
Treatments for Skin Cancer
Treatment options for precancerous skin lesions & skin cancer are known as actinic keratoses. These depend upon the type, size, depth & location of the lesion. Skin cancers which are small in size & limited to the surface of the skin do now require treatments beyond initial biopsy which removes entire growth.
Additional treatment options may include –
- Mohs Surgery –It is for larger, recurring & difficult to treat skin cancer types. This may include both squamous & basal cell carcinomas. Often used in locations where it is necessary to conserve as much skin as possible, like on nose. During this procedure, doctors remove skin layers one-by-one, examining each under microscope until all abnormal cells are eliminated, without damaging any excessive amount of surrounding healthy skin.
- Excisional Surgery – This treatment is appropriate for all types of skin cancers. Surgeons cut out the cancerous tissues along with a margin of healthy skin. This wide excision which removes extra normal skin around tumor is recommended in some cases.
- Freezing – Surgeons may destroy actinic keratoses& small early skin cancers by freezing them in liquid nitrogen. Known as cryosurgery, it sloughs off dead tissues when it thaws.
- Curettage &Electrodesiccation or Cryotherapy–When the surgeon has removed most of the cancerous growth, s/he will subsequently scrape away layers of cancer cells using a circular blade called curet. Electric needle in this device eventually destroys any remaining cancer cells. Liquid nitrogen can also be used to freeze base & edges of treated area as a variation of this procedure. This is a quick simple procedure that may be used to treat thin squamous cell cancers & basal cell cancers.
- Chemotherapy–Chemotherapy drugs are utilized to kill cancer cells. Cancers limited to top layers of skin can be effectively treated with creams or lotions containing anti-cancer agents directly applied to skin. Systemic chemotherapy can be utilized to treat skin cancers which have spread to other areas of the body.
- Radiation Therapy–It uses high-power energy beams like X-rays to destroy cancer cells. Radiation therapy is an excellent option in cases where cancer cannot be completely eliminated during surgery.
- Photodynamic Therapy–This treatment is designed to eliminate skin cancer cells in combination of laser light with drugs that make cancer cells more sensitive to light.
- Biological Therapy – This treatment procedure uses body’s own immune system in order to destroy skin cancer cells.
Skin Cancer Survival Rates
Most patients with melanoma are cured by initial surgery. The percentage of survival rate is of people who survive for about five years after cancer has been detected. The five year survival rate of melanoma patients is almost 91%, while the ten year survival rate is 89%. Overall survival rate however depends on the thickness of primary melanoma, whether lymph nodes are involved & if cancer has spread to distant sites. Five year survival rate of early stage melanoma which is located near where it started is 98%. Five year survival rate of melanoma which has spread to nearby lymph nodes is 63% while five year survival rate of melanoma that has spread to other parts of the body is 16%. However, survival rates often vary depending on a number of other associated factors. Cancer survival statistics always need to be interpreted with caution as these estimates are based on data from thousands of people where actual risks of particular individuals may be different.
Low Cost Skin Cancer Treatment in India
India is an ideal medical tourism destination offering a variety of affordable skin cancer treatments. Featuring the most advanced world-class technologies handled by expert oncologists, Travcure skin cancer treatments are performed in some of the best cancer hospitals in the subcontinent. Skin cancer treatment options available with Travcure include a range of procedures like Mohs Surgery, Cryotherapy, Freezing, Excisional Surgery, Curettage, Chemotherapy, Radiation Therapy, Photodynamic Therapy, & Biological Therapy.[free_quotes_and_consultation]