Skin cancer, melanoma - Causes, symptoms and treatment. MF.
Jun 14, 2018
Skin cancer is a malignant tumor that develops from epidermal cells( integumentary) skin cells.
Melanoma is an extremely malignant tumor from skin pigment cells.
Causes of skin cancer
The causes of skin cancer can be divided into: exogenous and endogenous.
1. Exogenous factors( external).
- One of the most important exogenous factors of skin cancer is the effect of UV radiation( in particular, the UV spectrum of sunlight).While the development of basal cell and squamous cell carcinoma of the skin is important for chronic skin damage with UV radiation, the risk of developing melanoma increases most with occasional( perhaps even a single) intense exposure to sunlight. This position is confirmed by the fact that melanoma of the skin appears more often on the body-protected areas of the body. It has been established that melanoma of the skin more often affects people who spend most of their time indoors, but who are periodically exposed to intense UV exposure( outdoor recreation under the sun).While skin cancer occurs in unprotected areas. It is believed that the increase in the incidence of skin cancer to a certain extent
is associated with the destruction of the ozone layer, which is in the stratosphere and retains most of the UV rays.
- An important and very frequent etiological factor of skin melanoma is trauma to pigment nevi( bruises, abrasions and cuts).
- There are reports of the possible etiological role of the rays of fluorescent lighting devices, chemical carcinogens, in particular hair dyes, as well as ionizing radiation and strong electromagnetic fields.
2. Endogenous factors.
- Ethnic factors affect the incidence of skin cancer. The tumor is more common among people with fair skin, in representatives of the Negroid race it occurs less often.
- The most common cancer and melanoma of the skin occurs in individuals with a small amount of pigment in tissues( ie, with light skin, hair, eyes), which is combined with increased sensitivity to UV rays. Taking into account the color of the skin and hair, the risk of developing cancer is increased 1.6 times for blondes, 2 times for people with fair skin and 3 times for redheads.
- In recent years, the increasing importance in the occurrence of skin cancer is attached to the immune factors of the body. Immunodepression and immunodeficiency of the body increase the risk of the disease. In addition, endocrine factors play a role. In particular, it is established that pregnancy can
have a stimulating effect on the degeneration of pigment nevi.
- Effect on sex, age and anatomic tumor location. These factors are closely interrelated. Melanoma of the skin is 2 times more common in women, with a peak incidence of 41-50 years;most often affects people in the 5th decade of life;the most frequent localizations of the tumor are the skin of the limbs and trunk;in women, primary melanoma is localized more often on the face, buttocks and legs, in men - on the skin of the anterior and lateral surfaces of the thoracic wall, thigh, brushes, heel region and toes.
- in addition, there are a number of hereditary skin diseases predisposing to the development of cancer( pigment xeroderma, Bowen's disease, Paget's disease and others).
Types of skin cancer:
1. basal cell carcinoma( basalioma) - a tumor from the upper layer of the epidermis, bearing the same name, it is characterized by growth in the depth of tissues with their destruction, is not able to metastasize, does not relapse.
It can be manifested in the form of drainage nodules measuring 2-5 mm, prone to ulceration, or as a large node up to 2 cm or more in size.
It is not dangerous, except for cases on the face or the auricles, in this case it can reach a large size, sprout the face: the nose, the eyeball, the auricle with destruction and the development of the infection until the brain is damaged.
More common in the elderly. Maybe in combination with tumors of internal organs: intestines, stomach and others.
2. Squamous cell carcinoma - arises from the cells of deeper layers of the skin, has aggressive growth, is able to reach large sizes and give metastases to the lymph nodes and internal organs. The tumor looks like a knot or knot, or a kind of "cauliflower".
Squamous cell carcinoma
3. Cancer of the appendages of the skin is a malignant tumor from the sebaceous, sweat glands or hair follicles.
Cancer of the appendages of the skin
4. Melanoma - not to be treated with skin cancer, is an extremely aggressive malignant pigmentary skin tumor, quickly gives metastases that are almost not treatable. Has the form of a pigmented spot( birthmark), bright black or pink color, a rapidly growing spot( pigmentless melanoma, occurs less frequently).Often a birthmark degenerates into a melanoma.
Symptoms of skin cancer
There are several signs of malignant degeneration of a mole( nevus):
1) Horizontal growth;
2) Vertical growth over surrounding tissues;
3) The appearance of asymmetry or irregular outlines( falseness) of the edges, then its change in shape;
4) Complete or partial( uneven) discoloration, appearance of sites of related depigmentation;
5) Appearance of a feeling of itching and burning;
6) Ulceration of the epidermis above the mole;
7) Surface wetting and bleeding from its surface;
8) Lack or loss of hair on the surface of the nevus;
9) Inflammation in the area of the nevus and surrounding tissues;
10) Peeling of the surface of the nevus with the formation of "dry" crusts;
11) Appearance of small dot nodules on the surface of the mole;
12) Appearance of daughter pigmented or pink formations( satellites) in the skin around the nevus;
13) Change in the consistency of the nevus, that is, its softening or loosening;
14) Appearance of shiny glossy surface;
15) The disappearance of the skin pattern on the surface of the mole.
Diagnosis of skin cancer
Diagnosis of skin cancer is established on the basis of a series of surveys:
- visual inspection: the appearance of the tumor, the size, the condition of the nearby lymph nodes is assessed;
- a swab or scraping from a tumor makes the doctor a special tool, the taken material is sent to the cytology laboratory, for examination under a microscope, the outward appearance of the cells can accurately determine or suspect a particular skin tumor. In no case can you independently scrape or traumatize tumors that are suspect for melanoma, as this can cause the development of metastases.
- biopsy: taking a piece or whole tumor( total biopsy) for examination under a microscope;
- ultrasound examination of the tumor and nearby lymph nodes is used to more accurately diagnose the tumor and the presence of metastases;
- ultrasound examination of the abdominal cavity is performed in order to exclude distant metastases in the abdominal organs;
- X-ray of the lungs: to exclude metastases to the lungs.
Stages of skin cancer:
Stage 1: tumor size does not exceed 2 cm;
Stage 2: tumor size from 2 to 5 cm;
Stage 3: the tumor size is more than 5 cm or there is metastatic damage to nearby lymph nodes( for example, for tumors of the skin of the shoulder - axillary lymph node involvement);
Stage 4: the tumor sprouts the creeping organs( muscles, bones, cartilage) or distant metastases are detected.
This classification is not applicable for melanoma, for it staging is used according to the depth of germination in the skin and the underlying tissues.
Survival in skin cancer is certainly different, with different stages: in the first 2 stages the prognosis is much better and the survival rate reaches 100%, with 3-4 survival rates sharply reduced to 70% or less. With regard to melanoma, even with the initial stages of the prognosis is not always positive, this tumor can quickly give metastasis to any internal organs and brain.
Treatment of skin cancer
In the treatment of skin cancer, like any malignant tumor, the leading role belongs to the surgical method. Removing the tumor within healthy tissues, a pledge of long-term survival and no relapse.
For the treatment of basal skin, especially on the face, where there is not much skin and good cosmetic effect is difficult, radiation therapy with a dose of 40-50 Gy is successfully used. In addition, radiation therapy can be used to treat squamous cell carcinoma of the skin. Weakened, elderly patients used chemotherapeutic ointments, now they were replaced by more effective methods, such as surgical and radiation.
In the presence of metastases of skin cancer, with the impossibility of their complete removal, use chemotherapy, as well as it is used in the presence of metastases in the nearby lymph nodes, to prevent recurrence of the disease.
In the treatment of melanoma of the skin, a surgical method is also used, in the presence of metastases, different chemotherapy regimens are possible, but the effect is insignificant, since the tumor is practically not sensitive to any of the modern chemotherapeutic agents. Radiation treatment for melanoma is not used, since the tumor is not sensitive to it.
Treatment with folk remedies is unacceptable, especially in the case of melanoma, since any compresses and lotions can dramatically increase tumor growth.
Complications of skin cancer
Complications of skin cancer may be: development of infection( suppuration);bleeding from the tumor, tumor germination of vital organs( large vessels, eyeball, brain membranes and brain tissue when the tumor is localized on the head and in neglected cases).
Prevention of skin cancer
Prevention of skin cancer and melanoma, mainly, is to reduce exposure to the sun, especially in fair-skinned people, and in hot countries with a scorching and unusual climate. Similarly, professional injuries and skin lesions( chemicals, metals, arsenic) should be avoided.
Doctor's consultation on skin cancer and melanoma:
Question: How often does skin cancer occur?
Answer: This is the most common tumor, especially for basal cell carcinoma. These tumors are found everywhere after 60 years, many patients do not pay attention to them, as the tumor growth is slow and does not cause anxiety.
Question: What is melanoma and how dangerous is it?
Answer: Melanoma is an extremely malignant pigmentary tumor of the skin and mucous membranes. Danger of aggressive growth and rapid metastasis in both the nearby lymph nodes and internal organs. Metastases of melanoma can lead to the exhaustion and death of patients in a short time, even if the entire arsenal of modern medical equipment is used.