Diagnosis and Treatment of Skin Cancer

SKIN CANCER

Basal cell carcinoma is the most common type of skin cancer, and does not metastasize often. On the other hand, squamous cell carcinoma is less frequent but is more likely to spread to other parts of the body. Melanoma are the rarer still, and are the most aggressive.

Causes and Symptoms of Skin Cancer

Causes and Risk Factors

• Ultraviolet light, such as from long durations of sunlight exposure and from tanning beds
• Previous radiation exposure and harsh chemicals such as arsenic, tar and coal may also increase your risk for basal and squamous cell carcinoma
• Previous history of skin cancer, if you or a close family member have previously had skin cancer, then you are at increased risk of developing the illness.
• Smoking has to been linked to increased chances of skin cancer
• Genetic syndromes such as Xeroderma pigmentosum, Gorlin syndrome and others.
• As you age, the risk of developing basal or squamous cell carcinoma increases.
• If you have been diagnosed with Human Papilloma Virus, your chances of developing skin cancer increase
• Individuals with a weakened immune system due to varying conditions are also susceptible to developing skin cancer
• If you have a lighter skin tone or burn easily, you are also at a higher risk.

Symptoms

The different types of skin carcinomas have symptoms that are specific to them, listed below are some general signs of the disease:

• Sores or cuts that do not heal for an unexpectedly long duration
• Pink growths with unusually colored areas edges or with an abnormal blood vessel in the center. These lumps may grow over time, and bleed or develop into ulcers
• Red patches with a scaly or rough texture
• Growths similar to warts

These usually occur on the head, neck, facial area but can also develop on your arms or genital areas. If you suspect you have similar symptoms, please follow up with a dermatologist or an oncologist. The description is merely meant to describe the most common examples, it is wholly possible to have spots/lumps which do not exactly match the descriptions stated above.

Diagnosis and Treatment

Diagnosis and Screening

• Medical history - In your oncology consultation, the doctor will take note of any previous illnesses, current illness and medications you may be on.
• Physical examination: Oncologists recommend carrying out self examinations at least once a month, to look for any spots or moles that change or are unusual. At a formal checkup, the doctor would do this using a dermatoscope to get a clearer image of your skin.
• Biopsy: A skin biopsy is performed by removing a small sample of your skin tissue and examining it under the microscope for signs of cancer.

How is skin cancer treated?

Surgery
The different types of surgery to remove skin cancer are:

• Excision: In this procedure, the surgeon removes the affected part of the skin and some surrounding tissue. The surgery is performed under local anaesthesia.
• Curettage and electrocautery: Using a special tool known as a curette, the cancerous spot/lump/area is removed and then an electric needle is used to kill any remaining cancerous cells in the surrounding tissue.
• Cryosurgery: Cryosurgery uses liquid nitrogen, and applies it to the cancerous region to freeze and kill the cells. It is generally used for precancerous and smaller skin cancers.
• Mohs surgery: Invented in the 1930s, this surgery is very specialized and aims to preserve as much healthy tissue as possible. The surgery works in cycles, after applying local anesthesia the doctor will remove a layer of cancerous skin tissue and some of the surrounding tissue. This excised tissue is then checked under the microscope for any remaining signs of the cancer. If there are any signs, the surgeon will remove another layer, and the process continues until there is no sign of the cancer.
  

Chemotherapy
Uses anti-cancer drugs to kill or shrink the cancer causing cells and to prevent the spread of cancer to other areas of the body. Topical chemotherapy drugs are used to treat skin cancer, i,e., drugs that can directly be applied onto the surface of the skin. The more common delivery forms of chemotherapy are used for more aggressive squamous cell carcinomas that have spread to other parts of the body. It is rarely used for basal cell carcinomas.

Immunotherapy
Immunotherapy works by helping/boosting your immune system to fight against cancer cells. Most immunotherapy drugs work as checkpoint inhibitors. Our immune system has certain ‘checkpoints’ which allow the major immune cells to switch on or off and begin an immune response. Cancerous cells take advantage of these checkpoints by portraying themselves as non-threatening and hence do not get destroyed by our immune system. Checkpoint inhibitor drugs block these deceptive proteins on cancer cells, or the receptors on the T-cells (a type of immune cell) that respond to them and hence an immune response can be launched against them.

Targeted Therapy
Targeted therapy drugs, are as the name suggested more specific, i.e, they aim to kill cancer cells. As of now, targeted therapy drugs are used in tandem with chemotherapy drugs but can also be used when chemotherapy drugs do not show any results. Currently there are some targeted therapy drugs that focus on inhibiting the hedgehog signalling pathway that plays a role in cell differentiation.

Radiation Therapy Radiation therapy works by aiming high energy waves at the cancerous cells. In skin cancer treatment, radiation therapy is mostly used only if surgery is not an option or is used complementary to the surgery.

What should I expect from this procedure?

Please bear in mind, that your medical history, your environment which includes family and friends, your lifestyle habits, genetics, the type and intensity of cancer you have, all play a role in deciding the course of your treatment. Many times a combination of treatments is recommended, and this may change through the duration of your illness. This is done so the doctor can ensure that you are getting the best possible treatment for your individual case.

How do I find the right doctor?

We understand that before going through a major treatment like surgery or radiotherapy, you may be feeling unsure and want a second opinion, or you would like to look for the top oncologist specializing in skin cancer, or for a clinical trial doing cutting edge research. For support with any of these queries and question, Qunomedical is here for you 24/7.