Skin Cancer

A brief about Skin Cancer

The uncontrolled growth of abnormal cancerous cells in the epidermis (the outermost layer of skin) is called skin cancer. This abnormal growth of skin cells occurs most often on the surface, which is exposed to the sun. But this type of cancer can also develop in areas that are not usually exposed to the sunlight. The major cause of skin cancer is harmful sunlight, which causes a mutation in the DNA leading to unrepaired DNA damage. It shows the strong relationship between molecular biology and genetics with skin cancer. The occurrence rate is the same in  both males and females.

The risk rate can be reduced by avoiding exposure to ultraviolet (UV) radiation. Spreading awareness is very important to control its incidence. So that early checking of suspicious changes can help in early detection of skin cancer, which can increase the possibility of successful treatment. Nowadays, the survival rate of skin cancer patients has increased due to the boon of recent advancements in diagnostic technologies and cancer treatment.

What are the types of skin cancer?

Like all other body tissues, even the skin is made up of cells. The cells are :

  •       Melanocytes
  •       Basal Cells
  •       Squamous Cells

The different skin cancer types are named after the cell where cancer develops. Cancer is also called a carcinoma. Squamous cell carcinomas are often grouped with Basal cell carcinomas and referred to as common skin cancers.  The various types are –

 

  • Melanoma:

 

It is the most serious skin cancer. It tends to spread quickly. If proper skin cancer treatment is not provided, melanoma can become life-threatening in six weeks. If left untreated, melanoma can spread to other body parts. Melanoma can even appear on skin that has not been exposed to the sun.

It has an uneven smudgy outline and is flat. Melanoma can be of more than one color as well. Mostly, it develops within a mole that is already present on the skin. It can also appear as a dark spot on the skin. Early diagnosis is crucial for the treatment of melanoma.

Nodule melanoma is a highly risky type of melanoma that should be treated as soon as possible. It looks different from other melanomas and has an even tone. This type of melanoma is known to grow rapidly. Hence the patient should undergo skin cancer treatment as soon as possible. Studies have concluded that melanoma can be cured in the earlier stages.

 

  • Squamous Cell Carcinoma

 

Squamous Cell Carcinoma is the second most common skin cancer type after Basal Cell carcinoma. Squamous Cell Carcinoma or SCC is not as dangerous as a melanoma. But it can spread to other body parts if cancer treatment is not provided. It is formed mostly on the skin that is frequently exposed to the sun. The face, neck, arms, ears, and back have a higher chance of developing SCC.

The Squamous Cell Carcinoma accounts for approximately 20% of the total number of skin cancer cases. It is more likely to be seen in immunosuppressed human beings. Mostly, its behavior is like basal cell carcinoma. The only difference is the smaller chance of distant spread. SCC is most likely to develop in people who have light skin.

Precancerous skin growth might also lead to the development of SCC. At times, actinic keratoses (AK) can develop on the skin of a person. AK is a dry or scaly spot on the skin. This precancerous skin growth can turn into Squamous Cell Carcinoma. AK is not skin cancer. But, if left untreated, an AK can turn into skin cancer. 

 

  • Basal Cell Carcinoma

 

It is the least dangerous skin cancer type. However, it is the most common skin cancer type, as well. It grows slowly on the upper torso, neck, and head. It may appear as a dry and scaly area or as a pearl-like lump. It might ulcerate as it grows and appears as a sore that has not healed properly. Basal Cell Carcinoma or BCC is likely to develop in people who have fair skin. People with skin of color might also get this cancer type.  

BCC develops after years of frequent exposure to the sun. It might also develop due to outdoor tanning. BCC can be formed anywhere on the body. However, they are more common on the arms, head, and neck. Early skin cancer diagnosis and proper cancer treatment are important in the case of BCC. If allowed, BCC can grow deep and penetrate the nerves and bones. This can lead to a disfigurement of the body. 

 

  • Merkel Cell Carcinoma

 

It is one of the rare types of skin cancer. Researchers have concluded that almost everyone who develops Merkel Cell Carcinoma is more than 50 years old. Though it is rare, Merkel Cell Carcinoma can be aggressive. It is advised to be treated by a certified dermatologist or a radiation oncologist. Patients diagnosed in the earliest stage of MCC are known to have the best outcomes in terms of cancer treatment.

Other rare skin cancer types are sebaceous carcinoma and cutaneous T-cell lymphoma.

What are the symptoms and signs of skin cancer?

Skin cancer primarily occurs on the sun-exposed parts of the skin, like- scalp, face, lips, ear, neck, chest, arms, hands, and in women, it can also develop on the legs. However, it can also occur in the areas that are rarely exposed to the sunlight. For example- palms, beneath the fingernails and toenails, and genital areas. Skin cancer affects all skin tones. Changes in the skin are a warning sign for different skin cancer types. Being alert for the changes in your normal skin may help you to get an earlier diagnosis.

Some skin cancer symptoms are:

  • Skin lesions – new mole, unusual growth, scaly patch, bump, sore, or dark spots which don’t scrape off or go away.
  • Asymmetry – The two halves of the lesions are not identical.
  • Border – The lesions have ragged and uneven borders.
  • Color – These spots on skin have an unusual color like white, red, pink, black, or blue.
  • Diameter– The diameter of the spot is big. The spot is larger than one-quarter inch.

What are the causes of skin cancer?

All types of skin cancer occurs when mutation or any kind of error develops in the DNA of the outermost layer of skin cells. These mutations lead to the uncontrollable growth of skin cells, which form a mass of cancer cells.

Basal cell skin cancer is generally caused by ultraviolet radiation from the sun or tanning beds. These UV rays damage your DNA, and your cells start multiplying unusually.

The squamous cell skin cancer also develops due to exposure to UV radiation. This type of cancer can also be developed due to long time exposure to cancer-causing chemicals. This may occur within a burn scar or an ulcer and may also be caused by some viruses like- (HPV) human papillomavirus.

The main cause of melanoma is not clear until now and not every mole turns into melanoma. Like basal and squamous cell skin cancers, melanoma  is caused by UV rays, but melanoma can also develop in the parts of the body that are not generally exposed to sunlight.

Risk factors involved in skin cancer

A risk factor for cancer refers to anything that can increase the chances of a person developing skin cancer. Certain risk factors like exposure to sunlight can be controlled. Others, like the age of a person or his family history, cannot be changed. However, even having many risk factors does not guarantee that a person will surely develop cancer. Many people who have developed cancer might not have any of the known risk factors. Below are a few risk factors for skin cancer:

 

 

  • Ultraviolet light: The main source of Ultraviolet radiation or UV radiation is sunlight. It can damage the genes of the skin cells. UV light is a major risk factor for skin cancer. Tanning lamps are also a source of UV radiation. High amounts of exposure to UV radiation results in a higher risk of developing skin cancer symptoms. Spending a lot of time outdoors without using sunscreen can increase the risk of developing cancer. People living in places with bright sunlight throughout the year have a higher chance of developing skin cancer.

 

  • Fair Skin: The risk of developing symptoms of skin cancer is higher for fair-complexioned people as compared to dark-complexioned people. Melanin present in dark-complexioned skin  is known to protect against UV radiation. This reduces a major risk factor. People with fair skin have a higher probability of developing skin cancer.

 

  • Older age: The risk of squamous and basal skin cancer types increases as people grow older.

 

  • Chemicals: Frequent exposure to large amounts of arsenic increases the chances of developing skin cancer. People exposed to tar and paraffin are at an increased risk as well.

 

  • Psoriasis Treatment: Patients with psoriasis are treated with UV light. This increases the risk of developing squamous cell carcinoma. People who have had other radiation treatment are also more likely to develop skin cancer.

 

  • Long-term skin problems: Certain scars from bad burns or skin damaged due to various skin diseases increase the chances of developing skin cancer.

 

  • History of skin cancer: 20% of the patients who have a history of skin cancer are more likely to develop second skin cancer within two years.

 

 

How to prevent Skin cancer?

Most types of skin cancers can be prohibited by avoiding triggers that result in the development of tumors. Several prevention strategies can be deployed. People can protect themselves from the sun by using protective clothing or sunscreens. Ideally, 2 tablespoons of sunscreen should be applied to the body before going outdoors. Exposure to sunlight during peak hours should also be avoided. Parents must ensure that their children are protected from the sun. The usage of tanning beds must also be avoided. These tanning beds are a source of excessive UV radiation exposure. This radiation is a major risk factor for skin cancer.

It is advised to visit a dermatologist once a year and have a professional skin exam conducted. Examining the skin every month can also result in the diagnosis of skin cancer symptoms in the earlier stages. This will make skin cancer treatment easier.

Diagnosis of skin cancer

A dermatologist will conduct a skin examination to get a definitive skin cancer diagnosis. In most of the cases, the appearance is enough to make the diagnosis and move on to skin cancer treatment. A skin biopsy is used to confirm the development of skin cancer. A local anesthetic like lidocaine is used to numb the area under the tumor and carry out the biopsy. After using the anesthetic, a small part of the tumor is sliced off and sent to a pathologist for examination. The pathologist examines the tissue under a microscope and provides a skin cancer diagnosis based on the characteristics of the extracted tumor.

The skin cancer biopsy provides information about the stage of cancer. Imaging tests are further conducted to see whether cancer has spread to other parts of the body. These can be evaluated by

  •       MRI scan (Magnetic Resource Imaging)
  •       An X-ray of the chest
  •       Positron emission tomography or computed tomography

A lymph node biopsy might also be conducted in case the patient shows symptoms of advanced melanoma.

Treatment for various stages of skin cancer

The recommended cancer treatment will depend on different factors like- size, location, type, and stage of skin cancer. After considering these factors, cancer patients will be treated with one or a combination of these skin cancer treatments.

  • Cryotherapy: The growth is frozen by the doctor in liquid nitrogen, and the tissue is destroyed as it thaws.
  • Excisional surgery: Cutting out of the cancerous part along with the surrounding healthy skin.
  • Mohs surgery: In this method, the cancerous growth is removed layer by layer, and each layer is examined under a microscope until no cancer-causing cell is seen.
  • Curettage and electrodesiccation: It is the scraping away of cancer cells by using a long spoon-shaped blade and burning the remaining cancerous part with the help of an electric needle.
  • Chemotherapy: To kill cancer cells, drugs are taken orally, applied topically, or injected with a needle or an IV (intravenous) line.
  • Photodynamic therapy: A combination of laser light and some drugs are used for the destruction of cancer cells.
  • Radiation: For the killing of cancer cells, high- powered energy beams are used.
  • Biological therapy: It is stimulating the immune system of a cancer patient to fight against the cancer cells by using a biological treatment.
  • Immunotherapy: To stimulate the immune system of the cancer patient, a cream is applied over the skin of the cancer patients.

To determine the severity of skin cancer, your doctor will find out the size of the spread of the cancerous part if it has spread to your lymph nodes or other parts of the body. Skin cancer is mainly divided into two groups for staging purposes: nonmelanoma skin cancer and melanoma.

 

Nonmelanoma skin cancer includes basal cell cancer and squamous cell cancer.

  • Stage 0:  In this condition, the cancer cells have not spread beyond the outermost layer of skin. In the case of superficial basal cell carcinomas, the topical application of some gels, creams, and solutions is useful to treat cancer. Wide local excision is used to remove the tumor. The success rate is maximum in this stage because it is highly curable.

 

  • Stage 1:  In this condition, cancer may have spread to the second layer of skin, dermis, but the spread is not more than two centimeters. It can be treated by wide local excision, minor surgery, Mohs micrographic surgery, cryotherapy, and topical imiquimod.

 

  • Stage 2:  The tumor is larger than two centimeters but has not spread to the surrounding areas of lymph nodes. It can be removed by minor surgery with some topical applications. The success rate is 85-95%.

 

  • Stage 3:  Cancer has spread from the primary tumor to the nearby tissues and bone. The size of the tumor in this stage is larger than three centimeters. The survival rate is 65% in this stage. The risk rate of spreading is high.

 

  • Stage 4:  The tumor is larger than three centimeters and has spread from the primary tumor to lymph nodes, tissue, and bone. Sentinel lymph node biopsy is recommended by the physician to verify it. Chemotherapy and radiotherapy are used for treatment. The survival rate is 25%.

Stages of melanoma skin cancer

  • Stage 0: This type of cancer has not reached beyond the epidermis. It can be treated by excision or minor surgery. For melanoma in the sensitive areas of skin like the face, some doctors believe in Mohs surgery.

 

  • Stage 1:  In this condition, the small tumor may have spread to the second layer of skin, dermis. Stage 1 melanoma is treated by wide excision to remove the tumor as well as margins of normal skin around it. Some doctors prefer the sentinel lymph node biopsy (SLNB). If cancer cells are found in the lymph nodes, then the doctor will watch the lymph node closely by getting an ultrasound of the node every few months. Along with this process, some immune checkpoint inhibitors or targeted therapy drugs are given.

 

  • Stage 2: These tumor cells are not spread out of the original tumor, but it is larger, thicker, and may have some other symptoms of scaling, bleeding, and flaking. Wide excision is the standard treatment for stage 2 melanoma. SLNB is also done in this stage because cancer has spread in the lymph nodes. Along with this targeted therapy, drugs are also used.

 

  • Stage 3:  In this stage, cancer has metastasized or spread to lymph nodes and nearby skin and tissues. For the treatment of stage 3 melanoma, surgical excision of the primary tumor is done along with lymph node dissection. And after the surgery, additional treatment like immune checkpoint inhibitors or targeted therapy drugs (for cancer with BRAF gene change) can also be given to reduce the risk of recurrence of melanoma. Other options of the treatment include injections of the T- VEC vaccine, Bacille Calmette – Guerin (BCG) vaccine, or interleukin-2 directly into the melanoma. According to studies, the survival chances are 63.6%.

 

  • Stage 4: This stage is the most advanced stage of melanoma. In this stage, the spread of cancer is beyond the original primary tumor, in lymph nodes, surrounding skin, tissues, and organs distal to the site of cancer. This enlarged tumor is removed by surgery and treated with radiation therapy, immunotherapy, and chemotherapy. The survival rate is a meagre 22.5%.

Integrative Treatment

Integrative treatments are designed to take care of your mind and body. The rate of action of medical treatment is slow. It takes time for an effective result. In that duration, you can make some positive changes in your daily routine like following a healthy diet, getting proper sleep, trying to keep the metabolism maintained, and follow the plans regarding skin cancer awareness. Integrative cancer treatments are very effective. These help to boost the weakened immune system and help to build sustainable health.

Life in Remission

All skin cancer treatment has side effects. The radiotherapy and chemotherapy are very helpful for cancer patients, but it may cause some adverse reactions in the body. Radiotherapy is used to kill cancer cells, but it also damages the healthy skin surrounding the cancerous area.  Chemotherapy can also result in side effects which are :

  • Weakness: Due to the heavy dose treatment for skin cancer, you may feel tired. It drains your body energy and makes you feel exhausted. To overcome weakness, you should take proper sleep of 7 hours approximately and have a healthy diet.
  • Changes in the skin: Radiotherapy of skin makes it slightly red and sore during the treatment. Although this redness will disappear after the treatment, the skin may still  have clusters and scabs over it. The scab will fall off with time, and healthy skin will appear.
  • Hair loss: If you undergo radiotherapy on any part of the body that has hairs, there is a strong possibility of hair loss in that area. But after some time of treatment, your body hair will start growing again. It may take up to one year, depending upon the treatments taken. The regrowth of hair may be patchy initially.
  • Loss of appetite: Radiotherapy and chemotherapy result in loss of appetite. In such a condition, it is very hard for your body to get appropriate nutrition for recovery. You should take your meals at proper intervals, which should be nutritious and have good fats as well. Change it up occasionally with liquid diets if you just don’t have the appetite.
  • Peripheral neuropathy: Some drugs damage your nerves, which might lead to pain, burning, or tingling sensation, sensitivity to cold or heat, and weakness. You should ask your doctor and follow the recommended medication for its treatment.
  • Nausea and vomiting: Skin cancer treatment has major side effects of vomiting and nausea. The patient will experience nausea after a few minutes to hours of chemotherapy. The peak of this vomiting sensation is around 5 to 6 hours after chemotherapy. You can use some drugs to control nausea and vomiting, but you should first ask your doctor or nurse before taking any medication.
  • Mouth sores: Chemotherapy can cause mouth sores, making your mouth dry. This treatment kills rapidly growing cells like cancer cells. But with it, it also damages the healthy cells of your mouth. If you have mouth sores which are taking time to heal, avoid spicy food and try to eat small pieces of food to prevent any problems further.

How can ZenOnco.io help?

ZenOnco.io is an integrative oncology cancer care center that guides cancer patients in all the phases of the cancer journey.

 

  • Nourish Yourself: 

 

Try to remain fit and nourished through the course of the treatment. Prepare meal-plans and take nutraceuticals to ensure that your body gets all the necessary nutrients. Follow a list of recipes that you should be eating during your cancer treatment. 

 

  • Stay fit yourself: 

 

Invest your time in several energy therapies and stretching exercises that will keep you fit during the treatment. You can also do yoga to reduce the exertion of cancer treatment. These actions will help you stay healthy.

 

  • Keep Calm: 

 

The chemotherapy sessions and the cancer treatment can take a toll on anyone. It is important to ensure the emotional and spiritual wellbeing of the patient. We will guide you with various mind-body approaches that will help you in remaining calm. 

 

  • Cancer-proof your home: –

 

Take care of your surroundings and ensure that they are cancer-proof. Avoid using personal-care items, lighting, and cookware that may have carcinogenic compounds and prohibit all other possible sources of radiation. This will make your home safer and reduce the chances of developing cancer. 

 

  • Get community support: –

 

We will help you get community support by connecting with cancer survivors, patients, doctors, and healers. This is important to keep you motivated while you are going through cancer treatment. To know more about the facilities we offer, call us at 91 9372796783. You can also drop us an email or sign up for more information.

ZenOnco.io is striving to create a world that is free from cancer. Visit our website to know more about our wellness protocol, designed to effectively guide you through this fight with support and care.