Skin Cancer

​What is Skin Cancer?​

Skin is made up of two different types of layers: the Epidermis (Outer layer) and dermis (Inner layer). The formation of malignant cells in the skin is known as skin cancer. Based on their origin sites, the skin cancer may be melanoma and non-melanoma. Long or short-term exposure to sun and UV rays can be major causes of skin cancer. Skin cancer is treatable in the early stages. Some studies report that daily use of sunscreen with high SPF (more than 30) and beta-carotene supplements helps in the prevention of basal cells of the skin from exposure. The doctor suggests treatment options depending on the stage and how much cancer spreads in the body. These can vary from surgery to chemotherapy cream.

Basic facts to be known about Skin Cancer

●  Skin cancer is the 17th most prevalent cancer worldwide and the 14th most common cancer among males and females.

●  It is reported that there were 3,31,722 people diagnosed with skin cancer. Out of which 60,000 people died from skin cancer globally in 2022.

●  Most affected people are white-skinned people with sunburns, including Australia, followed by Denmark.

●  Non-melanoma skin cancer cases are 18-20% higher than melanoma skin cancer.

●   According to recent research, India reported less than 1% (0.70 cases in 100,000 population) of skin cancer in 2020.

Signs and symptoms of Skin Cancer

It is quite difficult to observe any symptoms of this disease at early stages. As they can be associated with other skin problems. Consultation with a dermatologist is important if you see any abnormal mole growing on your skin. Signs and symptoms of skin cancer may vary from person to person. Some of them are discussed here:

●  Sore skin

●  Ulcer

●  lump formation

●  Visibility of new moles and freckles

●  Non-healing skin for more than a month

●  Red or pale patches

●  Itching and bleeding in the skin

●   Unusual visible growth in skin

Risk actor causing Skin Cancer

The exact cause of skin cancer is still unknown. Research is still going on the factors that lead to changes in DNA (Deoxyribose Nucleic Acid). Various risk factors may result in skin cancer. The risk depends on age, genetics, daily exposure, and lifestyle. Some of the major risk factors leading to skin cancer are:

●  People more than 55 years old

●  UV and radiation exposure

●  Weaken immune system

●  living at high altitudes (High sun exposure)

●  Excessive use of sunbeds (Artificial tanning)

●  Family history of skin cancer

●  Human Papilloma Virus and Other Genetic Conditions

●  Exposure to certain carcinogenic chemicals (arsenic, coat tar, creosote, and petroleum products).

●  Skin conditions like Actinic keratosis, and Xeroderma pigmentosum, may result in skin cancer.

Type of Skin Cancer

Skin cancer is most common in body parts that are highly exposed to sun and UV rays. When cancer begins in basal cells, it is called basal cell carcinoma. When they start to show coloration on the skin, it becomes melanoma. On the basis of a specified area, Skin cancer is divided into two types, i.e., melanoma and non-melanoma.

Melanoma Skin Cancer : it is well known as a black tumor. They are the most invasive type of skin cancer and are complicated to treat. Because they grow and spread very quickly. Melanoma cancers originate from cells, known as melanocytes that are responsible for melanin production. Melanoma cancer can also occur from a mole. It is only curable if it is diagnosed at an early stage. It only accounts for only 1% of skin cancer but is responsible for most deaths.

Non-melanoma Skin Cancer : These are common types of skin cancer. People who have fair skin and long-time sun exposure are more prone to this disease. Non-melanoma skin cancer can appear anywhere on the skin and can be itchy or bloody. These are further subdivided into basal cell carcinomas (BCC) and squamous cell carcinomas (SCC).

Stages of Skin Cancer

The size and affected areas in layers of skin describe the cancer stages. Based on that, there are five common stages of skin cancer.

●  Stage 0: Very early stage, known as carcinoma in situ. Cancer cells are only found in the area where they originated.

●  Stage 1: Early stage where cancer spreads within 2cm of distance in the epidermis (Outer layer of skin). This stage is generally curable.

●  Stage 2: Cancer cells start spreading in a surface area between 2cm to 4cm.

●  Stage 3: In this stage, cancer has proliferated around areas more than 4 cm and associated nerves.

●  Stage 4: Cancer has spread fully, in one or more Lymph Nodes, and other parts of the body. This stage is not curable.

Method used in the detection of Skin Cancer

Visit a dermatologist if start noticing any change in moles or new growing moles, skin spots, or freckles. Next step, the doctor will examine the skin and consult for further diagnosis. The prescribed methods for the detection of skin cancer include:

●  Biopsy: If the doctor suspects cancer, he/she will go for a biopsy. In a biopsy, skin tissue is removed and examined under a microscope for detection of any cancerous growth.

●  Blood test: A blood sample is taken to measure lactate dehydrogenase. CBC test can also be performed before starting any further treatment.

●  CT Scan: CT scan uses X-rays to provide visible images of the epidermis layer of skin. It shows the skin layers and its parts where the cancer cells may be spread.

●  MRI scan: An MRI scan of the skin helps to find out the presence and location of cancer cells in the skin and its layers. Non-melanoma cancer is easily detectable through an MRI scan.

Way to prevent Skin Cancer

Nowadays, sun exposure is very harsh. If you are not wearing sunscreen, there is a possibility that you can get exposed to harmful UV rays. Simple changes in habits of your daily lifestyle and routine can prevent the chances of occurring skin cancer. Just take care of your skin and follow some safety steps. Some of the precautionary actions are discussed below:

●  Apply high-SPF sunscreen while going out.

●  Use lip balm with sunscreen

●  Wear hats to protect your neck and head.

●  Wrap clothes with UV protection to protect your arms and legs

●  Avoid sunbeds or artificial UV exposure.

●  Wear sunglasses to block UVA and UVB exposure.

●  Say no to carcinogenic cosmetic products

●  Stay away from arsenic water exposure to the body

Treatment method for Skin Cancer

Treatment depends on the stage of cancer diagnosed. Sometimes, only a biopsy can remove cancer cells if it is limited to a particular mole or spread in a small surface area of skin. Treatment varies as cancer cell spreads on different layers of skin and other parts of the body. Other treatment options are discussed below:

Surgery: Surgery is the best treatment option for melanoma cancer at its early stages. In this procedure, melanocyte cells are removed from the affected area. Unfortunately, It is not possible in the intermediate and advanced stages of skin cancer.

Radiotherapy: Radiation therapy uses external high-energy rays to destroy the cancer cells. It also kills the cancer cells which can't be removed via surgery. Radiation therapy may also help to slow down the growth of cancer and control symptoms like bleeding and sore skin.

Immunotherapy: Immunotherapy is used to boost immunity against cancer cells. These drugs are provided to patients so that their immune system can train itself to fight against cancer. Imiquimod cream is used on the affected area of the skin that helps the skin to produce more chemicals such as interferon and these destroy the skin cancer cells.

Chemotherapy: Chemotherapy uses anti-cancer drugs to kill cancer cells. In the case of area-specific skin cancer, anti-cancer ointment can also be applied on the skin directly (Topical chemotherapy). Avelumab 200mg injection (bavencio) and cemiplimab-rwlc 350mg injection (libtayo) is available at magicine pharma. they deal with all kind of anticancer medicines.

Cryotherapy: In this process, the doctor uses liquid nitrogen to freeze the cancer cells. Cancer cells die due to low-freezing temperatures. Then dead cells are disposed of from the body after this procedure.

Target cancer therapy: Drug-targeted therapy uses drugs that reach most of the skin and its layers and destroy cancer cells.

FAQs

1. Is skin cancer treatable?

Skin cancer is treatable when detected early. Treatment becomes trouble-full if the cancer starts spreading to other skin layers. Early-stage skin cancer is treatable even by a dermatologist. Consult a dermatologist if you're getting any suspicious spots on your skin.

2. Can skin cancer cause death?

Melanoma has a higher risk of death by skin cancer. It is curable if it is diagnosed early. Prevention and treatment become unfavorable and risk increases if you have fair skin, blue eyes, or blonde, and have long time exposure to UV rays.

3. How prevalent is skin cancer in India?

In comparison, Skin cancer is less common in India than in other countries. A study revealed that India reported less than 1% of cases of skin cancer in 2020. In India, Squamous cell carcinoma is the most common skin cancer with a prevalence rate of 30-60%.

4. Can I live a normal life with skin cancer?

Yes, you can live a normal life with skin cancer with early detection and treatment. Skin cancer does not have that much effect on lifestyle and daily routine. There are chances of full recovery if cancer is found at an early stage.

5. How can I avoid skin cancer?

You can avoid cancer by using a proper skin barrier when exposed to UVA and UVB. Wear High SPF while going out in the sun. Avoid direct sun rays by wearing shade and wrapping around your neck, hand, ear, and head to block extra UV rays.

Reference

https://www.wcrf.org/preventingcancer/cancerstatistics/skincancerstatistics/#:~:text=Related%20content,Latest%20skin%20cancer%20data,shown%20in%20the%20tables%20below.
https://www.iarc.who.int/cancer-type/skin-cancer/
https://www.jcdr.net/article_fulltext.asp?id=8051#:~:text=The%20reported%20incidence%20of%20skin,one%20year%20at%20our%20centre.
https://www.researchgate.net/publication/346207580_Incidence_of_melanoma_and_nonmelanoma_skin_cancers_in_Indian_and_the_global_regions​​