Skin cancer is a disease that occurs when skin cells begin to grow abnormally and out of control, forming a mass or tumor. In a normal or healthy situation, cells after their normal period of life end up dying, multiplying only when necessary so that there is a balance. When a cell is damaged, namely its DNA, it no longer has the ability to regulate when it should multiply, ending up replicating without any control. This exaggerated number of damaged cells en bloc is what we call cancer.
The skin is made up of several types of cells that can cause cancer, including cells in the most superficial layer of the skin (epidermis) and cells that produce our pigmentation (melanocytes). The three most common types of skin cancer are Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC) and Melanoma.
The exact process by which a normal, healthy skin cell becomes cancerous is highly complex and not yet fully understood, however it usually involves mutations or changes in its DNA. These mutations can be caused by exposure to UV radiation, exposure to other carcinogens, or other factors that can induce these changes in the DNA of cells.
If skin cancer is not treated in time, it can spread to other parts of the body, which can lead to serious health complications and even death. However, if it is detected and treated in time, in the initial stage of its formation, the prognosis of most skin cancers is quite positive, with high cure rates and minimal long-term effects.
If you notice any changes in your skin, such as the appearance of moles, spots or warts, it is important that you see your doctor.
There are 3 main types of skin cancer: Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC) and Melanoma.
• Basal Cell Carcinoma (BCC) – is the most common type of skin cancer and usually develops on areas of the skin that tend to be more exposed to the sun, such as the face, neck and arms. BCC starts in the basal cells, which are found in the deepest part of the epidermis. These cancer cells usually grow slowly and tend to remain confined to the original tumor site. However, if left untreated, it can still invade surrounding tissues and bones (metastasize);
• Squamous Cell Carcinoma (SCC) – this type of skin cancer is the second most common and also tends to develop in areas frequently exposed to the sun, such as the face, neck, hands and arms. SCC begins in the squamous cells of the epidermis, which are located in the most superficial layer of the epidermis. These types of cancer cells usually grow faster, sometimes much faster, and can spread to other parts of the body more easily if not treated in time;
• Melanoma – this is the most dangerous type of skin cancer, due to its ability to metastasize to other parts of the body very quickly. Melanoma develops in melanocytes, which are the cells responsible for producing the pigment that gives color to our skin, melanin. Melanoma, although it is more common to develop in areas more exposed to sunlight, can develop in areas of the body that are not usually exposed, such as the genitals or intestines.
Symptoms of skin cancer can vary depending on the type of cancer and the stage of its development. Some common signs and symptoms of skin cancers are:
• a new mole or mole on the skin that does not go away;
• a wound that won’t heal or keeps coming back;
• a bump or hardening of the skin;
• redness or swelling of the skin;
• itchy, swollen, or crusted skin;
• changes in the size, shape or texture of existing moles or warts;
• formation of black lines under the fingernails or on the palms of the hands or soles of the feet.
It should be noted that not all skin changes and existing signs translate into something carcinogenic. There are even some types of skin cancer that don’t even cause any observable symptoms in their early stages. However, if you notice a change in your skin and it persists for two weeks or more, or seems to be getting worse over time, you should see your doctor for an evaluation. Early detection allows effective treatment of skin cancer and increases the chances of a favorable outcome.
Diagnosis of skin cancer is usually carried out by a specialist in Dermatology. The diagnosis is based on a combination of factors, which include the appearance of the skin lesion, the patient’s medical history and other symptoms or factors that the Dermatologist sees as relevant.
In order to make the diagnosis, the Dermatologist performs an examination of the skin, looking for any moles or warts outside of normal parameters, lesions or abnormal growths on the skin. In this procedure, the doctor uses a specialized instrument to carry out a dermoscopy, in order to obtain a more detailed view of the lesions found. If the doctor suspects skin cancer, the most likely thing is to perform a biopsy, that is, to remove a small part of the lesion to be observed in greater detail under a microscope.
There are several types of biopsies that can be performed, the scraping biopsy, punch biopsy and excision biopsy. The type of biopsy to be performed will depend on the size and location of the lesion. Once the results are available, the doctor can determine whether or not the lesion is cancerous and, if so, what type of cancer it is.
Treatment for skin cancer largely depends on the type of cancer, the size and location of the tumor, as well as the patient’s general state of health.
The most common methods of treating skin cancer are:
• Surgery – this is the most common method of treating skin cancer. Depending on the size and location of the tumor, the surgeon may remove the tumor using a technique called surgical excision, in which the entire tumor is removed, as well as an area of healthy tissue that surrounds it. In certain cases, more precise surgery is required, so the surgeon resorts to Mohs surgery, which allows removing the tumor layer by layer until all the cancer cells are removed;
• Radiation Therapy – this method involves the use of high-intensity X-rays, or another type of radiation, that is directed at cancer cells in order to destroy them. Radiation therapy can be used as an initial treatment for skin cancers, or after the surgical procedure, in order to neutralize any cancer cells that may remain;
• Topical medication – some types of skin cancers, such as BCC, can even be treated using topical medications that are applied directly to the skin over the lesion. These medications may include creams, gels or preparations that contain specific components that kill cancer cells;
• Cryotherapy – this method involves freezing the cancer cells using liquid nitrogen, which destroys them. Cryotherapy is generally applied to skin cancers that are small in size and in their early stages;
• Chemotherapy – this method involves taking drugs that are intended to kill cancer cells. Chemotherapy is usually used in more advanced cases of the disease where the skin cancer has spread to other parts of the body.
Although all these treatment methods exist, it is imperative that preventive measures are adopted so that skin cancer does not even form. These measures include:
• the use of sunscreen with a high protection index (SPF of at least 30), all year round, even on cloudy days;
• avoid prolonged exposure to the sun, paying special attention to hours of higher incidence of UV radiation;
• wear protective clothing against UV rays;
• avoid using a solarium or other sources of UV radiation;
• regularly check your skin and see a dermatologist whenever necessary.