Skin Cancer

What is Skin Cancer?

Skin cancer is a disease in which abnormal cells in the skin start to grow uncontrollably. The skin is the body's largest organ, serving as a protective barrier against the environment. It comprises several layers, with the top layer being the epidermis and the bottom layer being the dermis. Skin cancer can develop in any of these layers, but it most commonly starts in the epidermis, where your skin cells are located.

Impact of Skin Cancer On Anatomy and Health

Skin cancer can impact your anatomy and overall health in several ways:

• Local Skin Damage: In its early stages, skin cancer can lead to changes in the appearance of your skin. It may cause sores, bumps, or scaly patches that can be painful or itchy.
• Disfigurement: If left untreated, certain types of skin cancer, especially basal cell carcinoma, can grow larger and deeper, potentially causing disfigurement. This can be emotionally distressing.
• Metastasis: The most serious concern with skin cancer, particularly melanoma, is its potential to spread to other body parts, such as the lymph nodes, liver, lungs, and brain. When cancer cells spread, it becomes more challenging to treat and can severely affect your health.
• Treatment Side Effects: Treatments for skin cancer, including surgery, radiation therapy, and chemotherapy, can have side effects. These can range from pain and discomfort to fatigue and changes in skin texture.
• Psychological Impact: Dealing with a skin cancer diagnosis can be emotionally taxing. It can lead to anxiety, depression, and stress. Seeking support from healthcare professionals and support groups can be essential for mental well-being.

Cause and Risk Factors for Skin Cancer

Several factors can increase a person's risk of developing skin cancer. Understanding these risk factors is crucial for prevention and early detection. The following groups are most at risk:

• Sun Exposure: People who spend much time outdoors, especially without proper sun protection, are at a higher risk. This includes individuals who work outdoors or enjoy outdoor activities.
• Fair Skin: People with fair skin that burns easily and freckles are more susceptible to skin damage from UV radiation.
• Family History: Your risk is elevated if you have a family history of skin cancer, particularly melanoma.
• Tanning Beds: Using indoor tanning beds increases the risk of skin cancer by exposing the skin to high levels of UV radiation.
• Age: Skin cancer risk increases with age. Older individuals have accumulated more sun exposure over their lifetime.
• Weakened Immune System: People with weakened immune systems, such as those with HIV/AIDS or undergoing organ transplantation, are at a higher risk.
• Precancerous Skin Lesions: Certain types of precancerous skin lesions, such as actinic keratosis, can increase the likelihood of developing skin cancer.
• Gender: Men are more likely to develop skin cancer than women, particularly melanoma.

Symptoms of Skin Cancer

Common signs to watch for include:

• New Growth: The development of a new growth on the skin, which may appear as a bump, sore, or patch.
• Change in an Existing Mole: Changes in the colour, size, shape, or texture of an existing mole can be a warning sign. Look for irregular borders or moles that become itchy, painful, or bleed.
• Sore that Doesn't Heal: Skin cancers may manifest as sores that don't heal or heal and reopen.
• Red or Scaly Patches: Persistent redness or scaliness on the skin can indicate skin cancer, especially squamous cell carcinoma.
• Shiny Bumps: Basal cell carcinoma often presents as shiny, translucent, or pearly bumps with visible blood vessels.
• Irregular Pigmentation: Melanoma often starts as an irregularly pigmented area with shades of brown, black, blue, or red. It may be asymmetrical with an uneven border.
• Tender or Painful Area: Skin cancer can sometimes cause tenderness, pain, or itching in the affected area.
• Change in Nail Beds: Melanoma can develop under the fingernails or toenails and may cause dark streaks or changes in nail colour.
• Enlarged Lymph Nodes: In advanced stages of skin cancer, lymph nodes near the affected area may enlarge.

Types of Skin Cancer

There are three primary types of skin cancer:

• Basal Cell Carcinoma (BCC) is the most common type of skin cancer. BCC usually appears as a pinkish or shiny, translucent bump with visible blood vessels on the skin's surface. It typically doesn't spread to other body parts but can cause disfigurement if left untreated.
• Squamous Cell Carcinoma (SCC): SCC is the second most common type. It often looks like a rough, scaly patch or a sore that won't heal. SCC can spread to other parts of the body if not treated promptly.
• Melanoma: Although less common than BCC and SCC, melanoma is the most dangerous form of skin cancer. It usually begins as a dark-coloured mole or a new, unusual growth on the skin. Melanoma can spread rapidly to other organs if not detected early.

Stages of Skin Cancer

The most commonly used system for staging skin cancer is the American Joint Committee on Cancer (AJCC) staging system. It consists of several stages:

• Stage 0 (In Situ): The cancer is localised to the top layer of the skin (epidermis) and has not invaded deeper layers. It's often called "in situ" or "non-invasive" cancer.
• Stage I: The cancer is small and confined to the skin, with no evidence of spread to lymph nodes or other organs.
• Stage II: The cancer has grown larger or spread to nearby lymph nodes but not distant organs.
• Stage III: The cancer has spread to nearby lymph nodes or structures, indicating regional involvement.
• Stage IV: The cancer has spread to distant organs or structures, such as the lungs, liver, brain, or bones.

Diagnosis of Skin Cancer

• Visual Examination: Skin cancer is often first suspected through a visual examination of the skin. A dermatologist or healthcare provider will examine the suspicious area closely, looking for signs of skin cancer, such as changes in colour, shape, size, or texture.
• Dermoscopy: Dermoscopy involves using a handheld instrument called a dermatoscope to examine skin lesions more closely. This helps healthcare professionals distinguish between benign and malignant lesions.
• Skin Biopsy: A skin biopsy is typically performed if a suspicious area is found. A small skin sample is removed during this procedure and sent to a laboratory for analysis. The biopsy results can confirm the presence of cancer and determine the type and stage.

Treatments for Skin Cancer

Here are common treatment options:

• Surgery: Surgery is the primary treatment for most skin cancers. It involves removing the cancerous tissue and a margin of healthy skin. The extent of surgery depends on the size and stage of the cancer. Mohs surgery is a precise technique for certain skin cancers to minimise damage to healthy tissue.
• Radiation Therapy: Radiation therapy uses high-energy beams to target and kill cancer cells. It's often used when surgery is not an option or for cancers in sensitive areas where surgery might be disfiguring.
• Topical Medications: Medications like creams or gels may be prescribed for certain superficial skin cancers or precancerous lesions. These medications stimulate the body's immune system to attack cancer cells.
• Cryotherapy: Cryotherapy involves freezing the cancerous tissue using liquid nitrogen. It's typically used for small, early-stage skin cancers.
• Photodynamic Therapy (PDT): PDT combines a light-activated drug with specific wavelengths of light to destroy cancer cells. It's used for superficial skin cancers and precancerous lesions.
• Immunotherapy: Immunotherapy drugs boost the body's immune system to recognise and attack cancer cells. They can be used for advanced skin cancers, particularly melanoma.
• Targeted Therapy: Targeted therapy drugs are designed to block specific molecules that promote cancer growth. They are used for certain types of skin cancer, like advanced melanoma.

What if Skin Cancer is Untreated?

Leaving skin cancer untreated can have serious consequences:

• Local Damage: Skin cancer can continue to grow and invade deeper layers of skin, potentially causing disfigurement, pain, or ulcers.
• Metastasis: If left untreated, some types of skin cancer, especially melanoma, can spread to other body parts, such as lymph nodes, organs, and bones. This can lead to advanced cancer and make treating it much more challenging.
• Worsening Symptoms: Untreated skin cancer can cause symptoms like bleeding, itching, and discomfort, affecting your quality of life.
• Emotional Impact: The physical and emotional toll of untreated skin cancer can be significant. It can lead to anxiety, depression, and stress.
• Reduced Treatment Options: Delaying treatment can limit your options, as some therapies are most effective in the early stages of cancer.

Early detection and timely treatment are essential for better outcomes in skin cancer cases, so it's crucial to seek medical attention if you suspect skin cancer or notice any concerning skin changes.