Skin Cancer

Skin cancer – Risk Factors

• Exposure to solar radiation
• All technical means of tanning.
• People with light skin, blue eyes and blond or red hair
• Immunocompromised people on chemotherapy
• AIDS patients
• People who are treated with cortisone.
• People who exposed to radiation and chemicals like Arsenium

We should also not forget that a person who has developed skin cancer has a 20% chance of showing such a tumor again.

Most common forms of skin cancer are the following

• Basal cell carcinoma: It is the most common form of skin cancer in the world. Basal cell carcinoma usually occurs in the form of an open wound that often bleeds and does not close or as a pink spot or a glossy nodule (like a pearl). Surgical removal of the tumor to healthy limits is the treatment. It grows locally but rarely gives any metastases.
• Spinocellular carcinoma: It is the second most common form of skin cancer. It concerns an epidermal form of cancer and can occur anywhere on the epidermis, even in the genitals. It is common in the lower lip mainly in smokers but also inside the mouth. It appears as a rough nodule on the skin or as a white spot on the inside of the mouth. Surgical removal of the tumor with healthy limits is also the most effective treatment. Radiation therapy can help in inoperable tumors.
• Melanoma: It is one of the most dangerous and aggressive forms of skin cancer. The main risk factor is exposure to sunlight and significant burns from the sun even in childhood. The clinical signs for high-risk skin damage are the following:

1. 1. Asymmetry of the mole.
   2. Irregular outline of the mole
   3. Different coloration.
   4. A size greater than 6 mm.
   5. Resizing and progression of the malfunction.

If melanoma is diagnosed at an early stage, it is curable. But if diagnosed at an advanced stage, it can even cause death. In individuals who have many dysplastic warts in their bodies, we recommend annual testing and mapping by a qualified dermatologist. If once again you see a mole with the above characteristics and, above all, see a change in its shape then you should consult a specialist.

• Merkel Carcinoma: It is a rare aggressive form of skin cancer, which usually affects the neuroendocrine cells on the face, the head, the neck, but also the extremities, either on the skin or underneath it in the area of ​​the hair follicles. It appears as a hump on the skin pink, blue or purple, which grows radically, changing size. 80% of these tumors are due to MCV. It often goes unnoticed or appears like a small bladder. Surgical exclusion is the first choice in such tumors. The biopsy of the lymph node is essential. Depending on the stage of the disease, additional therapies such as radiotherapy, chemotherapy or systemic therapy are applied. The most important of all is the early diagnosis and surgical removal of the tumor.
• Dermatosarcoma: Dermatosarcoma is a rare form of cancer that develops in the deep layers of the skin and can spread to nearby fat muscles and bones. The likelihood of local relapse is great. Treatment is initially surgical with wide tumor resection. Often, the resulting deficit needs to be rectified by cutaneous cuts or local flaps. Surgery is associated with the stage of the disease with systemic therapy and radiotherapy. Monitoring of these patients is often due to the high probability of recurrence of the tumor.

Skin Cancer – Diagnosis

The lesion appears like a nose of red, purple or skin color, but it can also appear as a change in skin quality. Many times the diagnosis is difficult or takes too much time. Dermatovenic sarcoma is often confused with other skin conditions, especially in the early stages. If the dermatologist suspects skin cancer, a biopsy during the first visit to the clinic is the only sure way to rule out the possibility of skin cancer. MRI may be useful for assessing the extent of the tumor and may be important for surgical planning purposes.

Skin Cancer – Treatment

Treatment is a multidisciplinary approach. This interdisciplinary team may include a dermatologist, physician, radiologist, oncologist, radiotherapist and plastic surgeon to remove the tumor and repair the deficiency.

1. Mohs surgery technique involves gradual removal of the tumor on the same day. Each layer removed is then placed under special treatment for microscopic testing. The procedure continues until no more cancer cells are identified in the incisions. The procedure is often performed under local anesthesia.
2. Extensive resection with 2- 3 cm is a surgical procedure that can be used if a tumor is large. This procedure is performed under general anesthesia.
3. Correction of the skin graft or flap defect is made in case the deficit cannot be closed by simply approaching the wound edges. In cases of advanced dermatosarcomas, cancer has spread deeply and may have reached muscles or bones, even spreading to distant parts of the body in rare cases. In this case, more than one treatment should be applied. Healing options for advanced cases include:
4. Systemic Therapy: Target Imatinib therapy has been approved by U.S. Food and Drug Administration (FDA). It is intended for the treatment of cases that cannot be treated by surgery, in relapses but also in distant metastases.
5. Radiotherapy: Usually it is only applied after surgical removal when the risk of relapse is high. It can also be a therapeutic option in cases where surgical treatment is not possible.

The general prognosis is excellent when the tumor is recognized early and is properly removed. A poor prognosis is associated with metastasis. However, recent results for patients with metastasis using Imatinib therapy are encouraging. The treatment of each tumor depends on the type of cancer, its position, the age of the patient, and whether it is firstly appeared or recurrent. In most cases, and especially for facial tumors, reconstructive surgery is necessary for the incisions to be as discreet as possible.

Prevention is, of course, the best treatment. Every person should be checked by his dermatologist once a year and should avoid irrational exposure to sunlight and tanning techniques. If it is judged that a suspicious body area should be removed, we should not postpone it.