June 17, 2011

Things You Should Know About Skin Cancer

Skin cancer describes three malignant condition of the skin – Squamous cell carcinoma, Basal cell carcinoma and Malignant melanoma. The skin consists of two layers – the inner dermis and the outer epidermis. Skin cancer occurs in the epidermal layer. Therefore, all the three variants are clearly visible by naked eye and make it possible for early diagnosis. It is the most common form of all the cancers occur in human body. According to a recent survey, more than one million people get affected by skin cancer in a year. The major cause of skin cancer is exposure to Ultraviolet rays.

People with fair skin develop skin carcinoma earlier than blacks. Continuous exposure to sunlight causes exposure to UV rays. This ray can change the character of the cells present in the epidermis. Having sunburn in early childhood doubles the risk of developing skin cancer. However, sunburn in adulthood does not reduce the risk.  A person residing in high altitudes or deserts possesses greater risk towards development of skin cancer. It is seen that constant handling of some chemicals increases the possibility. Patient having family history of skin cancer has threefold chance of the same.

Exact cause of any cancer is not known. Cancer occurs due to uncontrolled and unregulated multiplication of cells.

Before the development of overt malignancy, changes of the morphology of the epidermal cells occur in quick succession. After continuous exposure to UV ray, dysplastic change occurs in the cells with deposition of keratin materials. This precancerous condition if the skin is called ‘Actinic keratosis. They are usually less than 1 cm in diameter. They may be red, skin or tan brown colored. They have a rough and sandpaper like consistency. In excess production of keratin, a ‘Cutaneous horn’ develops. There is no consolidated opinion regarding development of clear cut cancerous lesion from all ‘Actinic keratosis. But if it occurs, a lesion usually produces ‘squamous cell cancer’ of the skin.

Basal cell carcinoma is the most common form of skin cancer. Most common site for this tumor is facial skin. They are slow growing tumors and occasionally metastasize. Persons having Xeroderma pigmentosum (a disease where there is inherited disorder of DNA repair) has absolute chance of developing basal cell carcinoma. There tumors appear as pearly papules, the blood capillaries are usually visible from outside (telangiectasia). Some of the tumors may contain melanin and can mimic melanomas. Advanced condition of basal cell carcinoma generally ulcerates and there is extensive local foray of bones. That is why; basal cell carcinoma was previously called as ‘Rodent ulcer’.

Squamous cell carcinoma is the second most common skin cancer. It usually occurs over the sun-exposed parts of the skin. It can also occur after exposure to industrial carcinogens (tar and various oils), discharging osteomyelitis cases and old burn scars. Patients having lowered immunity also posses high risk for squamous cell carcinoma. DNA sequence of certain viruses (Human Papilloma Virus – I) are accepted as potential precursors of this type of skin cancer.

Treatment of most of the variants of skin cancer is complete, even for the aggressive cancers. The modes of treatment include – 

Surgery – complete excision of the lesion leaving a healthy margin can cure most of the cancers. Surgery followed by skin grafting may be necessary for a large lesion.

Curettages – the area is curetted and electrodessication is done afterwards.

Cryosurgery – extreme low temperature can destroy the cancer cells. It is useful in ‘Actinic keratosis.

Laser ablation – controlled beam of laser is used to kill the cancer cells.

Radiation therapy – surgically inoperable lesions are being treated with radiation therapy.

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