My 73 year old
grandfather who grew up in the viciously hot sun of
Nebraska and who still can do an eight mile hike faster than I can developed basal cell
cancer about two years ago. I hadn't heard of it then, but I've learned a good deal about it and the other types of skin cancer since. Basal cell cancer is a less serious form of
skin cancer which is is caused by long term exposure to
sunlight. It usually occurs in very light-skinned folks, which both myself and my grandfather are.
Skin protects the body's internal organs against heat, light, injury and infection. It also serves as a storage place for water, fat, and Vitamin D. Human skin is quite sensitive and flexible when compared to that of other mammals and is therefore more easily damaged, resulting in such things as skin cancer.
Human skin has two main layers and contains various types of cells. The outer layer is known as the epidermis. It contains three kinds of cells, all of which are subject to various types of cancers:
The next skin layer is called the dermis. This layer is much thicker that the outer epidermis and is where the sweat glands, blood vessels and nerves are located. Also, hair grows from small pockets in the dermis known as hair follicles. The dermis is vital to the overall care of the skin in that it produces sweat and oils which help to cool the body and keep the skin from drying out.
There are several types of cancer which originate in the skin. The two most common are basal cell cancer and squamous cell cancer which are known as nonmelanoma skin cancer. Melanoma is a very serious form of skin cancer which starts in the melanocytes. It is not as common as the other two types of skin cancer. Other types of cancer that may affect the skin are cutaneous T-cell lymphoma and Kaposi's sarcoma.
Types of Skin Cancer
- basal cell cancer: Basal cell cancer is the most common type of nonmelanoma skin cancer. It is most often caused by exposure to sun and as such will occur in areas that receive sunlight on a regular basis. Often it will appear as a small raised bump. Sometimes it will take on the form of a scar that feels firm to the touch. Though this type of cancer can spread, usually it will remain localized in the area of the original tumor without going to other parts of the body.
- squamous cell carcinoma: Squamous cell cancer is also caused by exposure to sunlight and usually appears on the nose, forehead, cheeks and hands. Also, this cancer could occur on parts of your body that have been burned, exposed to chemicals, or had x-ray therapy at some point. Usually this cancer appears as a firm red bump. Sometimes it will develop a crust and bleed or feel scaly. Sometimes this type of cancer will spread to the lymph nodes near the tumor and therefore is somewhat more serious than basal cell cancer.
- melanoma: Melanoma affects the melanocytes which contain melanin, the substance that gives skin its color. Because of this, melanoma is more likely to develop in areas with a high concentration of melanin such as moles and freckles. Like any cancer, melanoma is best treated when it is diagnosed early; this type of cancer can metastasize quickly to other areas of the body via the lymph system and through the bloodstream.
- Warning Signs of Melanoma: See a doctor if you have noticed a change in the shape, color, or overall size of a mole. Also look for the bleeding or oozing of a mole as well as one that it is itchy, sensitive to the touch, hard, lumpy or swollen. Melanoma can also appear as a new mole somewhere on the body. Men usually get melanoma on their torso, head and neck; women usually get it on their arms and legs. If your doctor thinks that the area doesn't look normal, they will perform a local excision on it and do a biopsy of the tissue.
- Stages of Melanoma:
- Stage 0: Abnormal cells only occur in the outer layer of the skin and are not found in deeper tissues.
- Stage 1: Abnormal cells are found in the epidermis as well as the dermis but have not yet spread further. In this stage, the tumor is usually less than 1.5 mm thick.
- Stage 2: Abnormal cells are found in the epidermis as well as the dermis but have not yet spread further. In this stage, the tumor is usually between 1.5 and 4 mm thick.
- Stage 3: Characterized by several developments in the tumor. Either it is larger than 4 mm thick, the tumor has spread to deeper body tissue, there is cancer found in nearby lymph nodes, or there are satellite tumors within about 20 mm of the original tumor.
- Stage 4: The tumor has spread to the vital organs or to lymph nodes far away from the original tumor.
Skin cancer can also be recurrent. After initial treatment, the cancer may appear in the original site or in different areas of the body. After being treated for the cancer, it is important to watch for abnormal growth in the future.
Treatment of Skin Cancer
Treatment of skin cancer is dependent on the type of cancer diagnosed. However, in general, the types of treatment available are as follows.
- surgery: There are several types of surgery that could be performed based on many factors. Re-excision is an operation that will cut out any remaining cancerous cells that exist after the biopsy along with a small amount of skin that surrounds it. Skin grafts may be used to repair the area where the cancer was removed. Electrodesiccation and curettage burns the lesion and removes it. Cryosurgery kills the tumor by freezing it. Micrographic surgery and laser therapy are other methods used to remove cancerous cells.
- chemotherapy: Chemotherapy uses drugs to kill cancer cells and is usually the hardest method of treatment to endure. It may be administered by pills or intravenously. If the cancer is found in an arm or leg, a type of chemotherapy called arterial perfusion is used; drugs are injected directly into the bloodstream near the cancer to maximize their effect on the tumor. Chemotherapy alone is not usually effective for treating melanoma; usually adjuvant chemotherapy is used for people with melanoma. This type of treatment employs chemotherapy drugs only after the patient has undergone surgery. It is especially effective in patients where the cancer has spread to the lymph nodes.
- radiation therapy: This method uses high-energy x-rays to literally shrink tumors. Radiation may be given by a machine; this technique is called external radiation therapy. However, radioisotopes may also be inserted directly into the cancerous area through thin plastic tubes which will kill the cancer.
Another type of therapy which is still mainly in clinical trials is called biological therapy; this is a method which focuses on using the body's immune system to help kill the cancer by directing its efforts towards the tumor. This technique is thought to be much less invasive, as opposed to chemotherapy and its effects.
It is important to remember that basal cell and squamous cell cancer are easy to remove if caught quickly. Melanoma is the more serious of the cancers; it is likely to be deadly if it is allowed to metastisize. Go to the doctor if you notice any change. If they're a good doctor, they'll be glad to know you're checking even if it turns out to be nothing.
Skin cancer is the most common in people who have pale skin who also spend a lot of time in the sun. If you fall into this group, take the necessary precaution of sunblock; you'll be happy you did later. Look for skin cancer in the places which are exposed to the sun the most — face, neck, arms and hands. However, don't forget that it can occur on other places on the body. The cancerous area itself can appear many different ways. Usually, it appears as a growth or a sore that won't heal. Sometimes there will be a small lump under the skin. The lump can be smooth, shiny or waxy looking. It can also be odd colors: red, brown, sometimes even a bluish color. Also it can look scaly, rough, or hard. Above all, it will look different. In most cases, there will be some noticeable change in the skin. My grandfather's was a flat red spot that was about the size of the fingernail on your pinky finger. His appeared on his left temple, just below his hairline.
Your prognosis will be positive if you catch it early. Not all changes in the appearance of your skin will be cancerous, obviously, but it is important to take care of yourself by being wary.
Sources:
http://www.skincancer.org/
http://www.nlm.nih.gov/medlineplus/skincancer.html
http://www.plasticsurgery.org/surgery/skincncr.htm
http://www.jas.tj/skincancer/
http://www.eurohealth.ie/cancom/skin02.htm
http://www.maui.net/~southsky/introto.html