Skin cancer is a malignant disease of the skin. This form of the tumor process is considered one of the most common in the world. Until now, experts in the field of oncology have not established the exact causes of the pathological focus. Like many other oncological neoplasms, skin cancer refers to polyetiological diseases. Predisposing factors and precancerous diseases are identified, the presence of which increases the possibility of the development of the tumor process of the skin. Depending on the stage and type of cancer, appropriate treatment is selected. You can suspect the presence of skin cancer on your own by examining the skin, paying special attention to the nevi. The prognosis for life and disease with a detected tumor of the skin surface also depends on the form and stage of the process. In accordance with the international classification of diseases (ICD-10), skin cancer has the code C43-C44.
Skin Cancer: Causes
There is currently no single answer to the question of what causes skin cancer. Like many other oncological diseases, a skin tumor is considered a polyetiological pathology. There are several predisposing factors, the presence of which increases the risk of a tumor lesion. These include:
- Excessive exposure to ultraviolet rays on the skin. A similar situation arises with prolonged and frequent exposure to sunlight, visiting a solarium, working on the street. Residents of the southern regions are at risk for developing skin cancer.
- The presence of fair skin. The lack of production of melanin increases the likelihood of a tumor of the skin.
- Skin burn. A high degree of burn is accompanied by scarring of the skin. This process contributes to the occurrence of latent carcinogenesis.
- Irradiation. Exposure to radioactive, ionizing rays has a detrimental effect on the skin. The risk of radiation dermatitis is increasing.
- Skin contact with toxic substances. This group of carcinogens includes arsenic, aluminum, titanium, nickel and other heavy metals.
- Immunodeficiency. Conditions in which there is a decrease in the protective functions of the body predispose to the formation of a tumor focus.
- Age. Most often, the skin tumor process affects people over the age of 50.
- Concomitant systemic diseases. Doctors distinguish a group of pathologies in which the risk of developing skin cancer increases significantly. These include systemic lupus erythematosus, leukemia, chronic skin diseases.
- Heredity. The presence of a skin tumor in previous generations of relatives is not a major risk factor. However, burdened heredity in combination with other predisposing conditions increases the likelihood of developing skin cancer.
- Drawing tattoos. In this case, there are two risk factors. This is a violation of the integrity of the skin and the introduction of paint with carcinogens. Cheap ink for a tattoo can contain impurities of aluminum, titanium, arsenic.
- A large number of nevi. Doctors urge to monitor the condition of moles and, at the slightest change, turn to specialists. Trauma to the nevus increases the likelihood of developing skin cancer.
- Excessive drinking, smoking. Chronic intoxication has a detrimental effect on the body as a whole. Against this background, the risk of the formation of a tumor process increases several times.
- Eating foods high in nitrates.
Oncologists identify several precancerous conditions, the presence of which significantly increases the risk of developing skin cancer. These include:
- Pigment xeroderma.
- Bowen's disease.
- Paget's disease.
- Skin horn.
- Radiation sickness in the late stage.
- Dermatitis and dermatoses.
Skin Cancer: Symptoms and Signs
The clinical picture of skin cancer development depends on its type. Often, the first signs of a tumor are mistaken for other skin diseases. From this comes an untimely appeal to the doctor and the spread of the malignant process. Common signs for all types of skin cancer are:
- The appearance on the skin of a spot or seal small size. The color of the formation may be pinkish, gray-yellow. The difference in the color of the neoplasm from moles and freckles is noteworthy.
- Irregular shape and asymmetric contours of the pathological focus.
- The appearance of itching, slight discomfort in the area of the tumor process. This symptom appears some time after the formation of cancer.
- Progressive growth of the neoplasm.
- The presence of fatigue, weakness, a sharp breakdown.
- Decreased appetite, resulting in a sharp weight loss.
- As cancer develops, regional lymph nodes are affected.
If any of the above symptoms appears, it is recommended to seek medical help. The following symptoms are distinguished depending on the type of skin cancer:
1. Basal cell carcinoma. Refers to the most common form of skin tumor. It is characterized by a favorable prognosis for detection at the initial stage. Appears in the form of a nodule, painless on palpation. It has a grayish pink color. The surface of the nodule is usually smooth. The formation of scales is possible. As the tumor process spreads, the affected area increases. The neoplasm is covered with a bloody film. The primary localization of basal cell carcinoma is the face, neck, and arm area. A significant change in the state of basal cell does not cause. This is the reason for late seeking medical help.
2. Squamous cell carcinoma. At an early stage, it looks like a dense nodule of red or brown color. A tumor of this species is prone to rapid decay, and therefore an ulcer forms as the process progresses. Its edges are heterogeneous, the ulcer often bleeds. Squamous cell carcinoma rapidly grows into nearby tissues. If detected at a late stage, metastasis to regional lymph nodes or organs is possible.
3. Melanoma. Refers to an aggressive type of tumor. Most often, melanoma occurs at the site of an injured nevus, which increases in size, changes color and acquires uneven contours. A characteristic feature of this type of cancer is an asymmetric form of formation, as well as a tendency to bleeding. Malignant neoplasm itches, increases in size. As the process develops, the tumor turns into an ulcer. Melanoma progresses rapidly and often gives metastases.
4. Adenocarcinoma. At the initial stage of development, it looks like a dense nodule. It is localized most often in the armpit, under the chest. With the development of the tumor process, adenocarcinoma germinates in nearby tissues. A tumor of this species is detected extremely rarely and is characterized by slow growth.
Types of Skin Cancer
Depending on the type of cells from which the tumor is formed, several main types of skin cancer are distinguished. Determining the structure of the tumor is necessary to clarify the diagnosis and conduct appropriate treatment. In addition, the rate of its spread and further prognosis depend on the type of cancer site. Oncologists distinguish the following types of skin cancer:
1. Basal cell (basal cell carcinoma). Basal cell carcinoma is one of the most common forms of skin cancer. It originates from basal cells of the epithelium. Basal cell carcinoma is characterized by a slow, sudden development and relatively favorable course. Unlike other types of skin cancer, it rarely gives metastases. Basal cell carcinoma, as a rule, is localized in the area of the wings of the nose, nose, eyebrow, upper lip and nasolabial fold. A rare location for this type of cancer is the neck and ears. Several forms of basal cell carcinoma will be distinguished:
Skin cancer - what is the prognosis?
This type of oncology ranks third in the frequency of cases detected in Russian men (after lung cancer and prostate cancer) and second (after breast cancer) in women. On average, the disease occurs in 1 out of 4,000 people, but in the southern regions of our country, where solar radiation is more intense, this figure is much higher. People of the “northern type” (with fair skin and hair) who have moved to live in warmer climes or were born into a family of immigrants are especially susceptible to skin cancer. In addition, doctors noticed that more often tumors of this group are found in patients who spend a lot of time outdoors.
Since skin cancer is widespread in many countries of the world (including Australia, Brazil, the USA and Switzerland), medical specialists pay special attention to the development and implementation of new methods for the diagnosis and treatment of this disease. In addition to traditional methods of fighting tumors - surgical operations, radiation therapy and chemotherapy - scientists are looking for more effective and less hazardous ways to defeat cancer. There are more and more publications on virotherapy (treating cancer with viruses) and immunotherapy (using vaccines with tumor fragments that stimulate the body's defenses).
The situation in Russia remains alarming: often patients simply ignore the first symptoms of skin cancer and go to the hospital with an advanced stage of the tumor, when there is no guarantee of recovery. So at the 4th stage of melanoma, even with the right treatment, only 1 out of 10 patients lives longer than 5 years. But unlike neoplasms located inside the body, skin cancer is almost always in sight.
Causes of Skin Cancer
The appearance of any malignant neoplasm is a consequence of a malfunction in the body: normally the immune system destroys defective cells before they start uncontrolled division. If, for some reason, the protective mechanisms do not work, the tumor grows in size and becomes invulnerable to biologically active substances and killer cells.
In the case of skin cancer, the most dangerous environmental factors that increase the likelihood of developing a tumor are ultraviolet and ionizing radiation, as well as exposure to aggressive chemicals. Therefore, such malignant tumors are often detected in people who have had contact with radiation or worked in the chemical industry. Experts note that skin cancer is often triggered by a visit to the solarium: a fashion for bronze tanning has led to a significant increase in the incidence of malignant neoplasms in women (for this reason, more than 170 thousand new cases of cancer are detected every year).
Symptoms and signs of skin cancer
Any kind of malignant tumors initially appears locally - at the site of the lesion, and then, if untreated, affects the well-being of the patient as a whole. In the case of skin cancer, the ratio between local and general symptoms is in favor of local ones: until the later stages of the disease, others may not suspect that the person is sick.
Local skin cancer symptoms visible to the naked eye: it can be a wound that does not heal for several weeks, a spot that gradually grows in size, or a mole that changes shape or color. Depending on the type of tumor, the growth of the neoplasm is slow or fast, but in any case, the change in the skin integrates. In the affected area, redness, itching, pain, bleeding or peeling are often observed. It is important to know that skin cancer can develop, including on the mucous membranes - in the mouth or in the nasal cavity, as well as under the hair on the head.
Common symptoms manifest equally in all types of cancer: loss of appetite, chronic fatigue, weight loss, periodic episodes of causeless increase in temperature to subfebrile values (about 37.5 ° C). Such complaints should alert not only the patient, but also his family - postponing a visit to the doctor in such cases is strictly not recommended.
Types and stages of skin cancer
Skin cancer refers to several oncological diseases of different origin, specific symptoms and prognosis. Tumors such as basal cell carcinoma, squamous cell carcinoma of the skin and melanoma are diagnosed statistically more often than others, but we must not forget that there are other neoplasms. Only an oncologist-dermatologist can reliably establish a diagnosis.
- Basalioma - The most common type of skin cancer that develops from epidermal cells. The tumor looks like a small swollen nodule, under the surface of which a network of blood vessels is visible. As it grows, the tumor can ulcerate and bleed. More often, basal cell carcinoma occurs on the skin of the face, sometimes on the scalp. Usually the disease develops slowly and does not give metastases, therefore the prognosis for patients is favorable.
- Squamous cell carcinoma also sometimes called mushroom-shaped, due to the specific appearance of the tumor. It is a large (up to several centimeters in diameter) formation, similar to a wart on a thin stalk. In 95% of cases, it is located on the lower lip, but is also often found in the mouth, especially in people who wear dentures. The surface of the tumor can be covered with horny scales, and when touched it is easily damaged. This cancer is able to penetrate into the deeper layers of the skin and, with a blood stream, is transported through the body to other organs and tissues.
- Melanoma - A tumor that develops from pigmented blood cells, melanocytes. As a rule, it develops on the site of moles or freckles, which are an accumulation of pigment. Melanoma is prone to rapid aggressive growth and is able to form metastases (distant tumors) in the early stages. Therefore, it is so important to monitor the appearance of moles: if one of them has changed shape, color or looks swollen, it is necessary to immediately consult a doctor.
People who are diagnosed with cancer are always interested in the prognosis of the course of the disease. “Doctor, how long will I live?” Is a popular question in the practice of oncologists. If we are talking about skin cancer, then the prospects for recovery in most cases are good, because the most common tumor - basal cell carcinoma - almost never gives metastases, and a little surgical intervention is enough to eliminate it. In the case of other types of cancer, doctors use the following classification:
- Cancer Zero (it is also called "cancer in situ" - cancer in place) is diagnosed in cases where the tumor is located in the surface layer of the skin. Proper and timely treatment guarantees complete recovery.
- Stage 1 : the tumor is less than 2 mm in thickness with melanoma (or no more than 2 cm in diameter with squamous cell carcinoma) and does not extend to the nearest lymph nodes.
- 2 stage : the thickness of the tumor does not exceed 4 mm for melanoma, and in the case of squamous cell carcinoma, such a diagnosis means that the diameter of the focus is more than 2 cm and affects all layers of the skin. There are still no metastases.
- 3 stage characteristic of progressive tumor growth with involvement of the nearest lymph nodes. In this case, metastases in distant organs are not observed.
- At 4 stages new tumors are found far from the primary focus - in the bones, lungs, and brain. This state of affairs virtually eliminates the possibility of complete healing.
Doctors specializing in the diagnosis of skin cancer have an impressive arsenal of diagnostic methods to confirm or refute the diagnosis, as well as classify the tumor.
Inspection - The most obvious and easiest way to suspect the presence of a neoplasm. If you are worried that you are developing skin cancer, show the unusual area of the body to the doctor. He will compare a suspicious mole or sore with other accumulations of pigment cells. If there is reason for concern, the doctor will prescribe additional diagnostic methods.
Laboratory methods. The human eye is not always able to distinguish skin cancer from a benign tumor or other health-friendly formation. Therefore, for more accurate diagnosis, oncologists and dermatologists use a dermatoscope - a device that allows you to see the structure of the neoplasm in detail, in polarized light. To finally confirm the nature of the tumor, a biopsy is used, in which the doctor with a needle, tweezers or a scalpel takes a small portion of the patient’s tissue from the affected area in order to examine it under a microscope in a laboratory. Confocal laser scanning microscopy, which does not require trauma to the skin, is now gaining popularity: this is especially important when the tumor is located in open areas of the body.
Instrumental methods. Ultrasound and tomography are necessary to evaluate the size of the tumor and identify possible metastases.The most reliable type of diagnostic diagnostic examination for skin cancer is positron emission tomography: with it, a radiopharmaceutical is injected into the human body, which accumulates in the tumor cells and allows the doctor to see parts of the body affected by cancer during the scan. They are displayed on the tomogram as glowing spots.
Doctors sometimes say that when detecting cancer it is important not to give a diagnosis of "paralysis of consciousness." Awareness of modern diagnostic and therapeutic possibilities and cooperation with doctors will help you defeat an insidious disease and leave skin cancer only as a reference that has lost its relevance on the pages of a medical record.