Posts Tagged ‘black skin cancer’

What causes Skin Cancer?

 

Ultraviolet (UV) light exposure, most commonly from sunlight, is overwhelmingly the most frequent cause of skin cancer.

Other important causes of skin cancer include the following:

  • Use of tanning booths
  • Immunosuppression-impairment of the immune system, which protects the body from foreign entities, such as germs or substances that cause an allergic reaction. This may occur as a consequence of some diseases or can be due to medications prescribed to combat autoimmune diseases or prevent organ transplant rejection.
  • Exposure to unusually high levels of x-rays
  • Contact with certain chemicals-arsenic (miners, sheep shearers, and farmers), hydrocarbons in tar, oils, and soot (may cause squamous cell carcinoma)

The following people are at the greatest risk:

  • People with fair skin, especially types that freckle, sunburn easily, or become painful in the sun
  • People with light (blond or red) hair and blue or green eyes
  • Those with certain genetic disorders that deplete skin pigment such as albinism, xeroderma pigmentosum
  • People who have already been treated for skin cancer
  • People with numerous moles, unusual moles, or large moles that were present at birth
  • People with close family members who have developed skin cancer
  • People who had at least one severe sunburn early in life

Basal cell carcinomas and squamous cell carcinomas are more common in older people. Melanomas are more common in younger people. For example, melanoma is the most common cancer in people 25-29 years of age.

Classification

The three most common types of skin cancers are:

  • Basal cell carcinoma
  • Squamous cell carcinoma
  • Malignant melanoma

Basal cell carcinomas are present on sun-exposed areas of the skin, especially the face. They rarely metastasize and rarely cause death. They are easily treated with surgery or radiation. Squamous cell carcinomas (SCC) are common, but much less common than basal cell cancers. They metastasize more frequently than BCCs. Even then, the metastasis rate is quite low, with the exception of SCCs of the lip, ear, and in immunosuppressed patients.

Melanomas are the least frequent of the 3 common skin cancers.

Less common skin cancers include: Dermatofibrosarcoma protuberans, Merkel cell carcinoma, Kaposi’s sarcoma, keratoacanthoma, spindle cell tumors, sebaceous carcinomas, microcystic adnexal carcinoma, Pagets’s disease of the breast, atypical fibroxanthoma, leimyosarcoma, and angiosarcoma

The BCC and the SCC often carry a UV-signature mutation indicating that these cancers are caused by UV-B radiation via the direct DNA damage. The indirect DNA damage is caused by free radicals and reactive oxygen species. Research indicates that the absorption of three sunscreen ingredients into the skin, combined with a 60-minute exposure to UV, leads to an increase of free radicals in the skin, if applied in too little quantities and too infrequently. However, the researchers add that newer creams often do not contain these specific compounds, and that the combination of other ingredients tends to retain the compounds on the surface of the skin. They also add the frequent re-application reduces the risk of radical formation.

Skin cancer as a group

The three main types of cancer are not similar and basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and malignant melanoma cannot be viewed as skin cancer.

  • the mechanism that generates the first two forms is different from the mechanism that generates the melanoma. The direct DNA damage is responsible for BCC and SCC while the indirect DNA damage causes melanoma.
  • the mortality rate of BCC and SCC is around 0.3% causing 2000 deaths per year in the US. In comparison the mortality rate of melanoma is 15-20% and it causes 6500 deaths per year.

Even though it is much less common than BCCs and SCCs, malignant melanoma is responsible for 75% of all skin cancer-related deaths.

While sunscreen has been shown to protect against BCC and SCC it may not protect against malignant melanoma. When sunscreen penetrates into the skin it generates reactive chemicals. It has been found that sunscreen use is correlated with malignant melanoma.

Experimental and the epidemiological evidence suggests that sunscreen use correlates with melanoma incidence. This gives rise to questions regarding the possibility that a sunscreen user’s lifetime exposure to ultraviolet light may be higher than average. Alternatively, one might question whether sun screens are themselves tumor promoters or carcinogens. Arguably, sunscreen users are the ones most likely to be burned or have been burned by sun light. Similarly, most sunscreens primarily screen UVB, the primary cause of sunburn, while UVA is the primary cause of melanoma. Thus, by limiting the discomfort of sunburn, UVB screening may indirectly result in more UVA exposure. In any case, if some sunscreens promote skin cancer, physical light-scattering sunscreens based in zinc oxide, titanium dioxide or some other natural base are likely safer than chemical blockers such as benzones, etc., as they will be less chemically active.

What are the Symptoms of Skin Cancer?

A basal cell carcinoma (BCC) usually looks like a raised, smooth, pearly bump on the sun-exposed skin of the head, neck, or shoulders.

  • Small blood vessels may be visible within the tumor.
  • A central depression with crusting and bleeding (ulceration) frequently develops.
  • A BCC is often mistaken for a sore that does not heal.

A squamous cell carcinoma (SCC) is commonly a well-defined, red, scaling, thickened patch on sun-exposed skin.

  • Like BCCs, SCCs may ulcerate and bleed.
  • Left untreated, SCC may develop into a large mass.

The majority of malignant melanomas are brown to black pigmented lesions.

  • Warning signs include change in size, shape, color, or elevation of a mole.
  • The appearance of a new mole during adulthood, or new pain, itching, ulceration, or bleeding of an existing mole should all be checked by a health-care provider.

The following easy-to-remember guideline, “ABCD,” is useful for identifying malignant melanoma:

  • Asymmetry-One side of the lesion does not look like the other.
  • Border irregularity-Margins may be notched or irregular.
  • Color-Melanomas are often a mixture of black, tan, brown, blue, red, or white.
  • Diameter-Cancerous lesions are usually larger than 6 mm across (about the size of a pencil eraser), but any change in size may be significant.

 

Skin Cancer At A Glance

 

 

There are three main types of skin cancer: basal cell carcinoma, squamous cell carcinoma (the nonmelanoma skin cancers), and melanoma.

  • Skin cancer is the most common form of cancer in humans.
  • Ultraviolet light, which is in sunlight, is the main cause of skin cancer.
  • The most common warning sign of skin cancer is a change in the appearance of the skin, such as a new growth or a sore that will not heal. Unexplained changes in the appearance of the skin lasting longer than two weeks should be evaluated by a doctor.
  • Nonmelanoma skin cancer is generally curable. The cure rate for nonmelanoma skin cancer could be 100% if these lesions were brought to a doctor’s attention before they had a chance to spread.
  • Treatment of nonmelanoma skin cancer depends on the type and location of the skin cancer, the risk of scarring, as well as the age and health of the patient. Methods used include curettage and desiccation, surgical excision, cryosurgery, radiation, and Mohs micrographic surgery.
  • Avoiding sun exposure in susceptible individuals is the best way to lower the risk for all types of skin cancer. Regular surveillance of susceptible individuals, both by self-examination and regular physical examination, is also a good idea for people at higher risk. People who have already had any form of skin cancer should have regular medical checkups.

Skin Cancer

 

What about follow-up care for skin cancer?

Skin cancer has a better prognosis, or outcome, than most other types of cancer. It is generally curable. Even though most skin cancers are cured, people who have been treated for skin cancer have a higher-than-average risk of developing a new cancer of the skin. This is the reason why it is so important for patients to continue to examine themselves regularly, visit their doctor for regular checkups, and follow their doctor’s instructions on how to reduce their risk of developing skin cancer again.

How about vitamin D and cancer?

Some recent reports suggest that getting vitamin D from sun exposure may prevent the occurrence and spread of cancers, both of internal organs and of the skin. In spite of the occasional controversy surrounding these studies, their common-sense implications are simple enough. Even those doctors who recommend sun for vitamin D only suggest 15 minutes a few times a week. For most people, especially those who have day jobs or live in cooler climates, following this advice is not likely to result in markedly higher risk of skin cancer. No responsible authority suggests that to help with vitamin D, people ought to sunbathe or visit tanning salons.

What does basal cell carcinoma look like

A basal cell carcinoma usually begins as a small, dome-shaped bump and is often covered by small, superficial blood vessels called telangiectases. The texture of such a spot is often shiny and translucent, sometimes referred to as “pearly.” It is often hard to tell a basal cell carcinoma from a benign growth like a flesh-colored mole without performing a biopsy. Some basal cell carcinomas contain melanin pigment, making them look dark rather than shiny.

Superficial basal cell carcinomas often appear on the chest or back and look more like patches of raw, dry skin. They grow slowly over the course of months or years.

Basal cell carcinomas grow slowly, taking months or even years to become sizable. Although spread to other parts of the body (metastasis) is very rare, a basal cell carcinoma can damage and disfigure the eye, ear, or nose if it grows nearby.

How is basal cell carcinoma diagnosed?

To make a proper diagnosis, doctors usually remove all or part of the growth by performing a biopsy. This usually involves taking a sample by injecting a local anesthesia and scraping a small piece of skin. This method is referred to as a shave biopsy. The skin that is removed is then examined under a microscope to check for cancer cells.

How is basal cell carcinoma treated?

There are many ways to successfully treat a basal cell carcinoma with a good chance of success of 90% or more. The doctor’s main goal is to remove or destroy the cancer completely with as small a scar as possible. To plan the best treatment for each patient, the doctor considers the location and size of the cancer, the risk of scarring, and the person’s age, general health, and medical history.

Methods used to treat basal cell carcinomas include:

  • Curettage and desiccation: Dermatologists often prefer this method, which consists of scooping out the basal cell carcinoma by using a spoon like instrument called a curette. Desiccation is the additional application of an electric current to control bleeding and kill the remaining cancer cells. The skin heals without stitching. This technique is best suited for small cancers in non-crucial areas such as the trunk and extremities.
  • Surgical excision: The tumor is cut out and stitched up.
  • Rediation therapy: Doctors often use radiation treatments for skin cancer occurring in areas that are difficult to treat with surgery. Obtaining a good cosmetic result generally involves many treatment sessions, perhaps 25 to 30
  • Cryosurgery: Some doctors trained in this technique achieve good results by freezing basal cell carcinomas. Typically, liquid nitrogen is applied to the growth to freeze and kill the abnormal cells.
  • Mohs micrographic Surgery: Named for its pioneer, Dr. Frederic Mohs, this technique of removing skin cancer is better termed “microscopically controlled excision.” The surgeon meticulously removes a small piece of the tumor and examines it under the microscope during surgery. This sequence of cutting and microscopic examination is repeated in a painstaking fashion so that the basal cell carcinoma can be mapped and taken out without having to estimate or guess the width and depth of the lesion. This method removes as little of the healthy normal tissue as possible. Cure rate is very high, exceeding 98%. Mohs micrographic surgery is preferred for large basal cell carcinomas, those that recur after previous treatment, or lesions affecting parts of the body where experience shows that recurrence is common after treatment by other methods. Such body parts include the scalp, forehead, ears, and the corners of the nose. In cases where large amounts of tissue need to be removed, the Mohs surgeon sometimes works with a plastic (reconstructive) surgeon to achieve the best possible postsurgical appearance.
  • Medical therapy using creams that attack cancer cells (5-Fluorouracil–5-FU) or stimulate the immune system ( [Aldara]). These are applied several times a week for several weeks. They produce brisk inflammation and irritation. The advantages of this method is that it avoids surgery, lets the patient perform treatment at home, and may give a better cosmetic result. Disadvantages include discomfort, which may be severe, and a lower cure rate, which makes medical treatment unsuitable for treating most skin cancers on the face.

How is basal cell carcinoma prevented?

Avoiding sun exposure in susceptible individuals is the best way to lower the risk for all types of skin cancer. Regular surveillance of susceptible individuals, both by self-examination and regular physical examination, is also a good idea for people at higher risk. People who have already had any form of skin cancer should have regular medical checkups.

Common sense preventive techniques include

  • limiting recreational sun exposure;
  • avoiding unprotected exposure to the sun during peak radiation times (the hours surrounding noon);
  • wearing broad-brimmed hats and tightly-woven protective clothing while outdoors in the sun;
  • regularly using a waterproof or water resistant sunscreen with UVA protection and SPF 30 or higher;
  • undergoing regular checkups and bringing any suspicious-looking or changing lesions to the attention of the doctor; and
  • avoiding the use of tanning beds and using a sunscreen with an SPF of 30 and protection against UVA (long waves of ultraviolet light.). Many people go out of their way to get an artificial tan before they leave for a sunny vacation, because they want to get a “base coat” to prevent sun damage. Even those who are capable of getting a tan, however, only get protection to the level of SPF 6, whereas the desired level is an SPF of 30. Those who only freckle  get little or no protection at all from attempting to tan; they just increase sun damage. Sunscreen must be applied liberally and reapplied every two to three hours, especially after swimming  or physical activity that promotes perspiration, which can weaken even sunscreens labeled as “waterproof.”

 

What are risk factors for developing basal cell carcinoma?

Light-colored skin, sun exposure, and age are all important factors in the development of basal cell carcinomas. People who have fair skin and are older have higher rates of basal cell carcinoma. About 20% of these skin cancers, however, occur in areas that are not sun-exposed, such as the chest, back, arms, legs, and scalp. The face, however, remains the most common location for basal cell lesions. Weakening of the immune system, whether by disease or medication, can also promote the risk of developing basal cell carcinoma. Other risk factors include

  • exposure to sun. There is evidence that, in contrast to squamous cell carcinoma, basal cell carcinoma is promoted not by accumulated sun exposure but by intermittent sun exposure like that received during vacations, especially early in life. According to the U.S. National Institutes of Health, ultraviolet (UV) radiation from the sun is the main cause of skin cancer. The risk of developing skin cancer is also affected by where a person lives. People who live in areas that receive high levels of UV radiation from the sun are more likely to develop skin cancer. In the United States, for example, skin cancer is more common in Texas than it is in Minnesota, where the sun is not as strong. Worldwide, the highest rates of skin cancer are found in South Africa and Australia, which are areas that receive high amounts of UV radiation.
  • age. Most skin cancers appear after age 50, but the sun’s damaging effects begin at an early age. Therefore, protection should start in childhood in order to prevent skin cancer later in life.
  • exposure to ultraviolet radiation in tanning booths. Tanning booths are very popular, especially among adolescents, and they even let people who live in cold climates radiate their skin year-round.
  • therapeutic radiation, such as that given for treating other forms of cancer.

Annual skin check is sun-loving, older people avoid trouble

Older people who have exposed themselves in their lives much of the sun should be, especially its “terraces” – nose, throat, cheeks, forehead and hands – leave once a year check by the dermatologist, advises dermatologist Dr. Bettina Prinz, Starnberg, Pharmacy Magazine “Senior Advisor”. Read the rest of this entry »

Skin cancer

The black skin cancer (malignant melanoma) is a malignant skin tumor. He is one of the most dangerous types of cancer, because of black skin cancer, in comparison with other skin tumors, causing relatively early metastases in other organs.

The black skin cancer, including malignant melanoma, is among the most dangerous types of cancer. It spreads very rapidly and is already at the early stage of metastasis. When these malignant lesions detected early by a doctor, but this cancer is curable. Read the rest of this entry »

Research Tips

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