Skin Cancer Symptoms, Diagnosis and Treatment Options

Basic Information About Skin Cancer

       Skin cancer is the abnormal growth of skin cells, most often develops on skin exposed to the sun. But this common form of cancer can also occur on areas of your skin not ordinarily exposed to sunlight.
        Skin cancer occurs when the body does not repair damage to the DNA inside skin cells, allowing the cells to divide and grow uncontrollably. Skin cell damage may be caused by a variety of factors, including genetics and skin type. But most cases of skin cancer are caused by overexposure to ultraviolet (UV) light produced by the sun. Skin cancer may appear as a dark spot, lesion, a wound that does not heal or a bump on the skin. The type of skin cancer depends on the cells that are damaged.
You can reduce your risk of skin cancer by limiting or avoiding exposure to ultraviolet (UV) radiation. Checking your skin for suspicious changes can help detect skin cancer at its earliest stages. Early detection of skin cancer gives you the greatest chance for successful skin cancer treatment.

Skin cancers, including basal cell carcinoma, melanoma,  and squamous cell carcinoma, often start as changes to your skin. They can be new growths or precancerous lesions, changes that are not cancer but could become cancer over time. An estimated 40% to 50% of fair-skinned people who live to be 65 will develop at least one skin cancer. Learn to spot the early warning signs. Skin cancer can be cured if it’s found and treated early.

Symptoms of skin cancer.
Where skin cancer develops
Skin cancer develops primarily on areas of sun-exposed skin, including the face,  scalp, lips, neck, ears, chest, arms and hands, and on the legs in women. But it can also form on areas that rarely see the light of day, your palms, beneath your fingernails or toenails, and your genital area.
Skin cancer affects people of all skin tones, including those with darker complexions. When melanoma occurs in people with dark skin tones, it’s more likely to occur in areas not normally exposed to the sun, such as the palms of the hands and soles of the feet.

Basal cell carcinoma signs and symptoms
Basal cell carcinoma usually occurs in sun-exposed areas of your body, such as your face or neck.
Basal cell carcinoma may appear as:
A pearly or waxy bump
A bleeding or scabbing sore that heals and returns
A flat, flesh-colored or brown scar-like lesion
Squamous cell carcinoma signs and symptoms
Most often, squamous cell carcinoma occurs on sun-exposed areas of your body, such as your hands, face, and  ears. People with darker skin are more likely to develop squamous cell carcinoma on areas that aren’t often exposed to the sun.

Squamous cell carcinoma may appear as:
A firm, red nodule
Melanoma signs and symptoms
A flat lesion with a scaly, crusted surface
Melanoma can develop anywhere on your body, in otherwise normal skin or in an existing mole that becomes cancerous. Melanoma most often appears on the face or the trunk of affected men. In women, this type of cancer most often develops on the lower legs. In both men and women, melanoma can occur on skin that hasn’t been exposed to the sun.
Melanoma can affect people of any skin tone. In people with darker skin tones, melanoma tends to occur on the palms or soles, or under the fingernails or toenails.

Melanoma signs include:
A large brownish spot with darker speckles
A painful lesion that itches or burns
A small lesion with an irregular border and portions that appear red, pink, white, blue or blue-black
A mole that changes in color, size or feel or that bleeds
Dark lesions on your soles, palms, fingertips or toes, or on mucous membranes lining your mouth, nose, vagina or anus

Signs and symptoms of less common skin cancers
Other, less common types of skin cancer include:
Kaposi sarcoma.
This form of skin cancer develops in the skin’s blood vessels and causes red or purple patches on the skin or mucous membranes.
Kaposi sarcoma mainly occurs in people with weakened immune systems, such as people with AIDS, and in people taking medications that suppress their natural immunity, such as people who’ve undergone organ transplants.

Merkel cell carcinoma.
Merkel cell carcinoma causes firm, shiny nodules that occur on or just beneath the skin and in hair follicles. Merkel cell carcinoma is most often found on the head, neck and trunk.
Sebaceous gland carcinoma. This uncommon and aggressive cancer originates in the oil glands in the skin. Sebaceous gland carcinomas, which usually appear as hard, painless nodules, can develop anywhere, but most occur on the eyelid, where they’re frequently mistaken for other eyelid problems.

Diagnosing skin cancer
Diagnosing skin cancer usually begins with a visual examination. Monthly self-examinations and annual doctor visits very recommended to screen for potential skin cancer. If a suspicious spot is found, your doctor will first examine the area, noting its size, shape, color and texture, as well as any bleeding or scaling. Your doctor may also examine nearby lymph nodes to see whether they are enlarged. If you are being seen by a primary care physician, you may be referred to a dermatologist who can perform more specialized tests and make a diagnosis.

A doctor may use a special microscope or magnifying lens to examine the suspicious spot more closely, a process called dermatoscopy. In many cases, skin cancer is removed in the dermatologist’s office. If a dermatologist determines the skin cancer is melanoma or Merkel cell carcinoma, more aggressive treatment may be required.

The 2 types of tests used in diagnosing skin cancer.
Biopsy
In many cases, your doctor will remove the whole growth. During this procedure, your doctor will numb the area before removing a tissue sample.
There are several different biopsy methods, but an excisional biopsy in which the doctor removes the entire growth is often sufficient to treat the skin cancer.
Other types of biopsies include a shave biopsy, in which your doctor shaves off the top layers of the lesion, and a punch biopsy, in which the doctor uses a special tool to cut a tiny round piece of the tumor, including deeper layers of the skin.
Your doctor may also take a biopsy of any suspicious lymph nodes to see if they contain cancer cells.

Imaging tests
Most skin cancers—especially basal cell carcinoma, the most common form of skin cancer—remain local and do not spread to distant organs. Melanoma and Merkel cell carcinoma are more prone to spread. In those cases, one of several medical imaging procedures may be used to determine whether cancer cells have metastasized to internal organs and bones. Imaging procedures include:
X-ray
CT scan
MRI

These imaging procedures are non-invasive and painless. If they reveal suspicious spots or metastases, a more invasive biopsy may be required.

Skin Cancer Treatment Options
       Most cases of skin cancer may be treated in a dermatologist’s office or with outpatient surgery. But more aggressive skin cancers, such as melanoma or Merkel cell carcinoma, may form tumors and require more extensive treatments, such as surgery, chemotherapy or immunotherapy. Your multidisciplinary team of doctors and clinicians at CTCA® will answer your questions and recommend treatment options based on your unique diagnosis.

Ttreatments for skin cancer are:
Surgery
Most skin cancers are treated with surgery, especially basal cell and squamous cell carcinomas, which are typically removed by a dermatologist in as part of an outpatient procedure. More aggressive cancers, such as melanoma, may require more extensive surgeries to remove tumors.

Chemotherapy
Chemotherapy may be an option for patients with advanced skin cancer, such as Merkel cell carcinoma that has spread elsewhere in the body. These anticancer drugs are designed to stop or slow the growth of rapidly dividing tumor cells.

Topical treatments
These nonsurgical forms of therapy include photodynamic therapy, topical chemotherapy and immune response modifiers. They are typically used to treat early-stage basal or squamous cell carcinomas or noncancerous lesions.

Targeted therapy
Targeted therapy drugs are used to treat melanoma and some non-melanoma skin cancers, such as rare cases of advanced basal cell carcinoma.

Immunotherapy
Checkpoint inhibitors and cytokines are two types of immunotherapy drugs that may be used to treat some cases of Merkel cell carcinoma and melanoma. The drugs are designed to trigger the immune system to identify and attack cancer cells.

Radiation therapy
Radiation treatments may be recommended after surgery, to kill remaining cancer cells in the area where lymph nodes had been removed. This treatment may also be used for recurrent skin cancer to relieve symptoms or to reduce the spread of the disease (metastasis).

       Skin cancer is the most common form of cancer in the United States. Each year, more than 3 million cases of skin cancer are diagnosed. Most skin cancers are non-melanoma, and if caught early, may be treated by a dermatologist in an outpatient procedure. Melanoma comprises only about 1 percent of all skin cancers, but it is responsible for more than 90 percent of skin cancer deaths.

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