Numerous tumors can affect the skin, which is the largest organ of our body and is made up of three layers: the epidermis (surface layer). The dermis (intermediate layer) and the subcutaneous tissue (deep layer). This article you can know about skin cancer treatment.
The epidermis, in turn, is made up of different types of cells: melanocytes, which have the task of producing melanin, a pigment that protects against the harmful effects of sunlight, and keratinocytes, which are more numerous.
The keratinocytes present in the outermost layer of the epidermis are called squamous cells if they turn into a tumor, they are called squamous cell carcinoma. Both are non-melanomatous skin tumors, i.e., skin tumors other than melanomas, which instead originate from melanocytes.
How widespread it is
The skin cancers melanoma is among the most common cancers of all. Excluding melanomas, 8 out of 10 skin cancers are basal cell carcinomas, while the remaining 2 are squamous cell carcinomas.
Who is at risk?
Basal cell and squamous cell carcinomas develop mainly in the parts of the body most exposed to the sun: face, ears, neck, scalp, shoulders, and back. One of the main risk factors is exposure to ultraviolet rays (UVA and UVB), which derives mainly from the sun, but also from sunbeds and sunlamps, which must, therefore, be used with extreme caution. Contact with arsenic and exposure to ionizing radiation, some genetic anomalies, and an insufficient immune system due to previous therapies, transplants, or AIDS have also been identified as risk factors. Plus, smoking and some psoriasis treatments may increase the risk of developing squamous cell carcinoma (especially of the lips in smokers).
Having very fair skin, advanced age, and being a man are included among the so-called non-modifiable risk factors, on which it is not possible to intervene.
Types: Skin Cancer Treatment
Skin cancers other than melanoma are classified according to the cells from which they originate.
The basal cell carcinoma (or basal ) originate from basal cells, in the deepest layer of the epidermis, while the squamous cell carcinomas (or squamous cell ) from the more superficial cells of the epidermis. Squamous cell carcinomas and basal cell carcinomas account for almost all (over 99 percent) of the non-melanoma skin cancers, but there are other rare types of skin cancer, such as the cancer of Merkel cells, sarcoma in Kaposi and the skin lymphoma.
Types of skin cancer
- Basal cell carcinoma – It is the most recurrent and originates from the basal cells in the deepest layer of the epidermis. According to the depth of tumor formation, there are different types of this carcinoma. The risk of spreading cancer is shallow.
- Squamous cell carcinoma – It is more common in those with weak immune systems. It originates from the most superficial cells of the epidermis. In most cases, its biological progress is very similar to that of basal cell carcinoma, with minimal risk of spread. Only in some cases, in fact, these tumors can present themselves in more aggressive forms and cause metastases.
- Melanoma – It is the skin cancer with the lowest incidence. It develops with the cancerous transformation of melanocytes, the cells that form the skin.
- Other less common skin cancers are Merkel cell carcinoma, atypical fibroxanthoma, cutaneous lymphoma, and dermatofibroma.
Skin Cancer: Symptoms
These skin cancers only rarely cause symptoms in the early stages. In some cases, when they get large enough and are more advanced, they can bleed or cause itching and pain.
Generally, therefore, the signs are mainly the appearance or change in the presence of some lesion or stain on the skin. Bleeding rarely and usually have little margin defined. The basal cell carcinomas appear as small nodules instead of pearly appearance or as pink spots, slowly increase in size. In the presence of these signs.
The most effective prevention strategy to reduce the risk of basal cell and squamous cell carcinomas is undoubted to protect oneself from ultraviolet rays. This means avoiding exposure to the sun during the hottest hours (between 10 and 16). When exposed, always wear a hat and dark glasses and use a sunscreen suitable for your skin type—applying it several times to ensure complete and continuous coverage. All these measures are especially valid for children. Whose skin is much more sensitive to the damage caused by the sun.
For prevention purposes, it is essential to avoid harmful chemicals such as arsenic. It is also instrumental to periodically check the appearance of your skin, ideally in a well-lit room, in front of a mirror, and with the help of others to monitor the areas not reachable by your eyes.
During a complete visit, the dermatologist evaluates the patient’s personal and family history and performs an accurate visual examination of the skin thanks to the use of chemiluminescence—a special technique for enlarging and illuminating the surface.
The stage of a tumor indicates how widespread the disease is in the body and is a critical parameter for determining the prognosis and deciding the type of treatment to be undertaken. Basal cell and squamous cell carcinomas, unlike other skin cancers like melanoma. They metastasize only in rare cases and many years after their appearance.
In case of problems with the immune system, squamous cell carcinomas can be at high risk of metastasis, and for this, we proceed with the staging with the TNM system: tumors can be classified into four stages (I, II, III and IV) based on the size and location of the disease (T). The involvement of the lymph nodes (N) and the presence of metastases (M).
In case of problems with the immune system, squamous cell carcinomas can be at high risk of metastasis, and staging follows the TNM system—the involvement of the lymph nodes (N) and the presence of metastases (M).
Skin Cancer Treatment: How to cure
Basal cell and squamous cell carcinomas, if treated in the initial stages, heal in almost all cases and can often be cured thanks to surgery or local treatments completely.
Surgery is usually the treatment of choice for these tumors. In some cases, an operation under local anesthesia, which closely resembles a skin biopsy, is sufficient to altogether remove the squamous cell carcinoma.
The Mohs surgery instead will remove thin layers of tissue, which are then observed under a microscope: if cancer cells are present, we proceed with the removal of another layer. Otherwise, we stop. Finally, laser surgery is used to vaporize the cells of squamous cell carcinoma and very superficial basal cell carcinoma.
Skin Cancer Treatment: Local therapies
Among the local therapies (also called topical). It consists of burning the tumor cells with the cold and applying liquid nitrogen to the tumor.
The photodynamic therapy consists of applying on the tumor and finally, a liquid drug that, in a few hours. Accumulates inside of the cancerous cells—making them sensitive to certain types of light. Chemotherapy is useful in cases where the tumor has reached the lymph nodes.
In the sporadic cases of advanced basal cell carcinoma or that returns after a first therapy. We can also focus today on targeted therapies that act specifically against the altered molecular mechanisms in many of these tumors.
MELANOMA AND SKIN TUMORS
It is a very aggressive cancer that results from the malignant transformation of melanocytes. The cells that determine the color of the skin. Melanoma can arise on apparently healthy skin or from the modification of a pre-existing mole.
The frequency of this cancer is increasing all over the world: in the last 30 years, the number of cases of melanoma has practically doubled. Around 100,000 new cases occur worldwide each year. However, if not detected in time and untreated, melanoma can spread to other parts of the body. Such as the liver, lungs, bones, and brain. This type of skin cancer has an unfavorable prognosis. However, metastatic melanoma is relatively rare.
Why does melanoma occur?
Melanoma arises due to the uncontrolled growth and proliferation of “melanocytes.” The cells that produce “melanin.” The pigment that gives color to skin, eyes, hair and protects the skin from ultraviolet (UV) rays of sunlight.
Who are at risk of melanoma?
The people most at risk are those who have one or more of the following characteristics:
- evident and progressive modification of a mole;
- the appearance of a new mole in adulthood;
- subjects already treated for melanoma;
- family history of melanoma (other cases of melanoma in the family);
- one or more moles with a diameter greater than 5 mm and irregular in shape;
- presence of one or more large congenital ones;
- the high number of moles;
- red-blond hair, light eyes, mainly white complexion and extremely sensitive to the sun;
- presence of freckles;
- frequent sunburn during childhood and adolescence;
- constant exposure to artificial ultraviolet radiation from tanning lamps or sunbeds.
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The other malignant skin tumors
Skin Cancer Treatment: Actinic keratoses
Actinic keratosis (AC) is a precancerous skin lesion as it can progress to an invasive squamous cell or squamous cell carcinoma. It is by far the most common skin lesion with malignant potential in the USA in 11-26% and in Europe in 6-15%.
For this reason, the main sites affected are the photo-exposed areas. Such as the face, ears, dorsal forearms, hands, and in men the bald scalp. The typical patient is elderly, has fair skin, sensitive to the sun, with a previous history of intense photo-exposure. Clinically, these lesions begin as small “rough” macules, slightly raised, which over time enlarge, becoming red and flaking. Most of the injuries are 3-10 mm in size. But they can enlarge up to several centimeters in the surface, creating areas called “cancer fields.”
Skin Cancer Treatment: carcinomas
The most frequent malignant tumors of the skin are basal cell carcinoma and squamous cell carcinoma. Also, generically referred to as “epitheliomas.” Carcinomas are widespread in the population but rarely spread to other organs. People with the prototype I and II (photosensitive skin), light eyes, red or blond hair, with intense and intermittent sun exposure and sunburn during childhood are most affected by these tumors.