Skin Cancer Treatment
The skin is the largest organ of the body, protecting us from heat, sunlight, injury, and infection. It also helps regulate body temperature and stores water, fat, and vitamin D. The skin consists of several layers, with the two main layers being the epidermis (the outer layer) and the dermis (the inner layer). There are three types of cells in the skin:
• Squamous Cells: thin, flat cells that make up the upper layer of the epidermis.
• Basal Cells: round cells located beneath the squamous cells.
• Melanocytes: cells that produce melanin and are found in the lower part of the epidermis. Melanin is the pigment that gives skin its natural color. When it is exposed to sunlight, melanocytes produce more pigment, causing the skin to darken.
Skin cancer can occur anywhere on the body but is more common in areas frequently exposed to sunlight, such as the face, neck, and hands.
Types of skin cancer:
Skin cancer may form in basal cells, squamous cells, or melanocytes, causing a variety of skin cancers. Basal cell carcinoma and squamous cell carcinoma are the most common types of skin cancer and are also referred to as non-melanoma skin cancer. Melanoma is less common but is more likely to invade nearby tissues and spread to other parts of the body.Basal cell carcinoma:
Basal cell carcinoma is the most common type of skin cancer and typically occurs in sun-exposed areas, most often on the nose. This cancer usually appears as a raised bump that looks smooth and pearly. A less common type may resemble a scar or be flat and firm, possibly matching the skin color or appearing yellow or waxy. Basal cell carcinoma may spread to surrounding tissues but usually does not metastasize to other parts.Squamous cell carcinoma:
Squamous cell carcinoma occurs in areas of the skin damaged by the sun, such as the ears, lower lip, and back of the hands. It may also appear in areas exposed to sunburn, chemicals, or radiation. This cancer often looks like a persistent red bump and may be scaly, bleed, or form a crust. Squamous cell carcinoma can spread to nearby lymph nodes, but localized squamous cell carcinoma is usually treatable.Melanoma:
Melanoma is a type of skin cancer that develops in the pigment-producing cells known as melanocytes, typically occurring in areas of the body that have been excessively exposed to sunlight. Benign melanomas are non-cancerous growths on the skin that are usually brown or black but can also be flesh-colored. Moles are clusters of melanocytes and may be raised or flat. They are also called nevuses.Risk factors for basal cell carcinoma and squamous cell carcinoma:
• Prolonged exposure to sunlight.• Having fair skin, which includes:
o Skin that freckles and burns easily, does not tan, or tans poorly.
o Blue or green eyes or other light-colored eyes.
o Red or blonde hair.
While fair skin increases the risk of skin cancer, individuals of all skin colors can develop skin cancer.
• A history of sunburns.
• A family history of skin cancer, as well as a personal history.
• Certain genetic changes or hereditary syndromes.
• Having long-lasting skin inflammation.
• A weakened immune system.
• Previous radiation treatment.
• Advancing age.
• Using nail drying devices as they emit ultraviolet rays.
How does skin cancer start?
The most common early sign of skin cancer is a change in the skin, typically a new growth or a change in an existing mole. Symptoms of skin cancer include the appearance of a new mole or a mole that changes in size, shape, or color, or begins to bleed.Symptoms of skin cancer: How to know if you have skin cancer:
The effects of cancer on the skin vary from person to person and depend on the type, size, and location of the skin cancer. Skin cancer can occur anywhere there is skin, but it is more common in areas frequently exposed to sunlight: the scalp, face, lips, ears, neck, chest, arms, hands, and legs.Individuals with darker skin are more likely to develop skin cancer in areas not often exposed to sunlight, such as the palms of the hands, soles of the feet, thighs, inside the mouth, and under their nails. Early symptoms of skin cancer can sometimes be confused with the presence of a mole or pimple.
Symptoms of basal cell and squamous cell carcinoma:
• A sore that does not heal.• Characteristics of cancerous spots may include:
o Raised, smooth, shiny, and pearly-looking.
o Hard and resembling a scar, which may be white, yellow, or waxy.
o Raised and reddish or brownish.
o Scaly or bleeding.
Symptoms of melanoma skin cancer:
• Changes in the size, shape, color, or elevation of a mole.• The appearance of a new mole during adulthood, or new pain, itching, ulceration, or bleeding from an existing mole.
• In adults, melanoma often has more than one color, with brown or black being one of the colors. In children, melanoma may be a single color and not black or brown.
• In adults, melanoma tends to be flat, while in children, the symptoms may include a raised tumor.
Symptoms of skin cancer on the face:
• A firm, round growth may be flesh-colored, brown, or black on dark skin.• A scaly, pink, or clear patch on the skin.
• A sore that does not heal.
• An atypical mole that may change in appearance.
Symptoms of skin cancer in the foot:
Squamous cell carcinoma is the most common type of skin cancer on the feet. This type of skin cancer may initially appear as a small rough area or bump on the foot. It can also manifest as an open sore. Typically, it does not cause pain but may crack, bleed, or itch.Symptoms of skin cancer in women:
In women, melanoma tends to occur more frequently on the back or legs, while in men, these tumors are more often found on the neck, back, or chest.Unexpected places where skin cancer can develop:
Under the nail:
Melanoma can also occur under the toenails. The thumb and the big toe are the most common sites, but it can happen under any nail. This is usually not due to sun exposure, but past injuries may be a cause. One of the key symptoms of nail melanoma is the presence of a dark line under the nail without an obvious reason.Scalp:
Growths or tumors on the scalp are common, but they are mostly not cancerous. Only about 13% of all skin cancers occur on the scalp, and they are usually less serious non-melanoma types like basal cell and squamous cell carcinoma. Symptoms of scalp skin cancer may include a sore or a small, soft, waxy lump that may bleed or become crusty.Diagnosis of skin cancer:
In addition to asking about your personal and family health history and conducting a physical examination, the staff at the best cancer treatment institution in Iraq performs the following tests and procedures:• Skin examination: A visual inspection of the skin for any bumps or spots that appear abnormal in color, size, shape, or texture.
• Skin biopsy: All or part of the abnormal growth on the skin is removed and examined under a microscope by a pathologist to check for signs of cancer.
Factors that affect cure rates and treatment options for skin cancer:
• The stage of the cancer.• The type of cancer.
• Whether the patient has a weakened immune system.
• Whether the patient is a smoker.
• The overall health of the patient.
• The size of the tumor and the part of the body it affects.
Tests to determine the spread of the cancer cells within the skin or to other parts of the body:
Basal cell carcinoma rarely spreads to other parts of the body, so staging tests are usually not required to check for the spread of basal cell carcinoma. However, the following tests and procedures may be used in the staging process for squamous cell carcinoma:• Computed Tomography (CT) Scan: This creates detailed images of the skin, such as the head and neck, from different angles. A contrast dye may be injected into a vein or swallowed to help the tissues appear more clearly.
• Chest X-ray: X-rays of the organs and bones inside the chest.
• Positron Emission Tomography (PET) scan: This procedure detects cancer cells by injecting a small amount of radioactive glucose into a vein. Cancer cells appear brighter in the images because they are more active and consume more glucose than normal cells.
• Ultrasound examination: High-energy sound waves (ultrasound) bounce off internal tissues, such as lymph nodes or organs, creating an image of the body's tissues. This image can be printed for later review. Ultrasound is used to examine lymph nodes.
• Dilated eye examination: This eye examination involves dilating the pupil with medicated eye drops to allow the doctor to look through the lens and pupil at the retina and optic nerve. The inside of the eye, including the retina and optic nerve, is examined with light.
• Lymph node biopsy: Removal of all or part of a lymph node to examine the lymph node tissue under a microscope to check for cancer cells. A lymph node biopsy may be performed for squamous cell carcinoma.
• Simple blood test for skin cancer spread: The test, known as TFP12, examines chemical changes in a gene called TFP12 to identify patients whose skin cancer has started to spread to other parts of the body. The analysis detects DNA shed from cancer cells into the bloodstream and searches for chemical changes in the TFP12 gene, which usually plays an anti-cancer role by preventing the uncontrolled growth of healthy skin cells.
Methods of treating skin cancer in the best cancer institution in Iraq:
1- Surgical treatment for skin cancer:
One or more of the following surgical procedures may be used to treat basal cell carcinoma or squamous cell carcinoma:• Simple excision: The tumor is cut out along with some surrounding healthy tissue from the skin.
• Mohs micrographic surgery: The tumor is removed in several thin layers of skin. During the procedure, the edges of the tumor and each layer removed are examined under a microscope to check for cancer cells. Layer removal continues until no more cancer cells are seen. This type of surgery removes the least amount of healthy tissue and is often used to remove skin cancer from the face.
• Curettage: The abnormal area on the skin surface is scraped away with a small blade.
• Electrosurgery: The tumor is cut from the skin, and then a needle-shaped electrode is used to treat the area with an electrical current to stop bleeding and destroy any remaining cancer cells around the wound's edge. This procedure can be repeated one to three times during surgery for complete removal.
• Cryosurgery: This treatment uses a tool to freeze and destroy abnormal tissues by spraying liquid nitrogen or liquid carbon dioxide. This type of treatment is also known as cryotherapy.
• Laser Surgery: A laser beam removes superficial skin tumors without bleeding.
• Dermabrasion: The top layer of skin is removed using a rotating wheel or small particles to scrub off skin cells.
2- Radiation therapy for skin cancer:
Radiation therapy for basal cell carcinoma and squamous cell carcinoma uses high-energy X-rays or other types of radiation to kill cancer cells or prevent their growth. External radiation therapy uses a machine outside the body to direct radiation toward the cancerous area.3- Chemotherapy for skin cancer:
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or preventing them from dividing. For basal cell and squamous cell carcinoma, chemotherapy is usually applied to the skin as a cream or lotion. Topical fluorouracil (5-FU) is commonly used to treat basal cell carcinoma.4- Photodynamic therapy for skin cancer treatment:
Photodynamic therapy (PDT) uses a medication and a specific type of light to kill skin cancer cells. The medication, which only becomes active after light exposure, is injected into a vein or applied to the skin. The drug accumulates more in cancer cells than in normal cells. Then, a laser light is directed onto the skin, activating the medication to kill the cancer cells. PDT causes minimal damage to healthy tissues.5- Immunotherapy for skin cancer:
Immunotherapy uses the patient’s immune system to fight cancer. It involves substances made by the body or in a laboratory to enhance, direct, or restore the body’s natural defenses against cancer. Various types of immunotherapy treat skin cancer, some of which are applied to the skin as creams.6- Targeted therapy for skin cancer:
Targeted therapy uses drugs or other substances to identify and attack specific cancer cells, such as treatments that block signals from one molecule to another within the cell. Blocking these signals may kill cancer cells.7- Chemical peeling for skin cancer:
Chemical peeling is a procedure used to improve the appearance of certain skin conditions. A chemical solution is applied to dissolve the upper layers of skin cells.Follow-up tests:
Some tests may continue to be performed periodically after treatment ends. The results of these tests show how the condition has changed or if the cancer has returned, as basal cell carcinoma and squamous cell carcinoma may recur within five years of the initial treatment.Can skin cancer be cured?
The cure rates for non-melanoma skin cancers are extremely high.Basal cell carcinoma:
Doctors can always treat basal cell carcinoma. It rarely spreads to another part of the body, so people do not usually die from this type of cancer. In a few cases, it may return and require further treatment.Squamous cell carcinoma:
Most people with squamous cell carcinoma are treated. It may spread in some individuals to nearby lymph nodes or other parts of the body, but it is still treatable.Skin cancer prevention:
You can reduce your risk of skin cancer by following these guidelines:• Limit exposure to intense sunlight between 10 a.m. and 4 p.m.
• Use sunscreen daily with a sun protection factor (SPF) of at least 30 every 60 to 80 minutes, and choose products that filter UVA and UVB rays.
• Wear long-sleeved clothing and wide-brimmed hats.
Is skin cancer fatal?
Many people wonder if skin cancer leads to death. The answer is that although the number of skin cancer cases continues to rise, early detection makes treatment easier. As a result, mortality rates have decreased. When treated properly, the cure rate for basal and squamous cell carcinoma approaches 95%.The difference between skin cancer and allergies:
Skin cancer is usually localized to a specific area, while rashes and other skin conditions can spread over a large part of the body. Certain skin conditions and rashes can produce flakes or shedding, while skin cancers are typically more rigid.The difference between benign and malignant skin tumors:
It is common for growths to appear on the skin as people age. Skin tumors can be malignant (cancerous) or benign (non-cancerous). While most skin growths are harmless and non-cancerous, such as skin tags, some may indicate something more serious, like melanoma.Skin Tags and Cancer: Skin tags are not cancerous, although some cancerous tumors may be confused with skin tags. Skin tags typically remain small, while skin cancer may grow and change.
Symptoms of benign skin tumor:
• Symmetry in shape, color, and texture.• Stable or slowly developing.
• Absence of spontaneous bleeding (bleeding or ulceration may be due to recent injury).
You can visit the Warith International Cancer Institute (WICI) to consult the best doctors for cancer treatment in Iraq and learn more about skin cancer with pictures.