Skin Cancer:Understanding, Symptoms, and Treatment

Skin cancer is an abnormality in skin cells caused by mutations in cell DNA, which makes cell growth fast, cell age is longer and cells lose their basic properties. Skin cancer generally occurs in the skin that is often exposed to sunlight, but this condition can also occur in the skin that is not exposed to direct sunlight.
Based on the type of cell being attacked, skin cancer is divided into three types, namely:

1. Melanoma. This is a skin cancer that occurs in the part of melanocytes or cells producing skin pigments. Melanoma skin cancer is a rare, but dangerous, skin cancer.
2. Non-melanoma skin cancer. This is a skin cancer that occurs in skin tissue other than melanocytes. Non-melanoma skin cancer is divided into two types as follows: 

• Origins of Boma ( Basal Cell Carcinoma , BCC ), which is skin cancer that occurs at the bottom of the epidermis. Basal cell cancer is the most common type of non-melanoma cancer in humans.
• Squamous Cell Carcinoma (SCC ), a skin cancer that occurs in the upper part of the epidermis. Squamous cell cancer is quite common, but the frequency is not as much as basal cell cancer.

Symptoms of Skin Cancer

Skin cancer generally occurs in areas that are often exposed to sunlight such as the scalp, face, lips, ears, neck, chest, arms, and legs. However, in some cases, skin cancer can also occur in areas that are rarely exposed to sunlight such as the palms of the hands and feet, the lower part of the fingers, even in the genital area. Skin cancer can occur to anyone, including people who have dark skin color. The symptoms of skin cancer are different for each type. The general description is as follows:

• Ka Basal Cell Shinoma (BCC). BCC generally occurs in areas that are often exposed to sunlight such as the neck or face. Symptoms of basal cell cancer include:
• Lumps are soft and shiny on the skin. 
• Lesions are flat on dark brown or reddish-brown skin like meat.

• Ka Squamous Cell RSS (SCC). SCC also commonly occurs in areas of the skin exposed to sunlight. But in people with dark skin, squamous cell cancer often occurs in the skin in parts of the body that are rarely exposed to sunlight. Symptoms of SCC in general are as follows.
• Hard red bumps on the skin. 
• Lesions on the skin are flat and hard scaly like crust.

• Melanoma. Melanoma can grow in any part of the skin, either in normal skin or on an existing mole that turns into a malignant. In men, melanoma cancer usually appears on the face and body. Whereas in women, melanoma appears more frequently in the lower limbs. Both men and women, melanoma can appear on the skin that is not exposed to sunlight. Melanoma can be experienced by anyone regardless of the color of the skin. In dark-skinned people, melanoma generally occurs in the palms of the hands or feet and the lower part of the fingers or toes. Common symptoms of melanoma are as follows:
• A brown lump with black spots on the lump. 
• Moles that experience discoloration and size or bleed. 
• The appearance of small lesions on the skin with irregular edges, or red, white, blue and blackish blue lesions. 
• The appearance of dark lesions on the palms, soles of the feet, fingertips or feet. 
• The appearance of dark colored lesions on the mucous membranes in the mouth, nose, vagina, or anus. 

Also Read :  White Blood Cells: The Key to Body Fighting Infection 

The following is a list of ABCDE regarding the characteristics of melanoma to distinguish it from ordinary moles.

• Asymmetrical. The form of melanoma is generally asymmetrical when compared to ordinary moles.
• Border (periphery). The melanoma fringe is generally curved, not round like a normal mole. 
• Color . The color of melanoma is a combination of two or more colors. 
• Melanoma diameter is generally more than 6 mm. 
• Enlargement (enlargement). Melanoma will enlarge over time.

Other Skin Cancer Cases

The following are other types of skin cancer that are less common, including:

• Sarcoma K aposi. Kaposi's sarcoma occurs due to a viral infection that causes mutations in endothelial cells, in the form of red or purple spots on the tissue under the skin. Kaposi's sarcoma can occur in people with immune system disorders such as AIDS patients or organ transplant recipients, who are infected by human herpesvirus 8 (HHV-8).
• M erkel cell cancoma . Merkel cells are cells that are located close to nerve endings in the skin, and are related to the function of the skin as a sense of touch. Malignancy in Merkel cells is very rare, and causes the formation of hard lumps under the skin or in hair follicles. 
• Ka of oil glandoma (sebaceous glands). Cancer of the sebaceous glands is a rare cancer, but is aggressive. Cancer of the sebaceous glands generally appears in the oil glands on the skin, then forms a hard lump that does not hurt. Sebaceous cancer can occur anywhere, but usually occurs on the eyelids and is often misdiagnosed as another eye disorder.

Not all abnormalities or bumps on the skin are caused by cancer, but often also skin cancer appears in the form of mild abnormalities in the skin, therefore the diagnosis of a doctor is very important in determining the cause and type of abnormalities in it.

Causes of Skin Cancer

Generally skin cancer is caused by exposure to ultraviolet light, causing DNA damage to the skin tissue. The main source of ultraviolet light is sunlight which consists of three types, namely:

• Ultraviolet A (UVA)
• Ultraviolet B (UVB) 
• Ultraviolet C (UVC) . 

Of the three types of ultraviolet light, the most dangerous for the skin is UVC rays. However, UVC rays can be absorbed by the atmosphere before reaching the ground. UVA and UVB can damage skin cells, especially those that are pale, and have the potential to cause skin cancer.

Artificial UV light sources such as UV lamps and tanning beds can also cause skin cancer.
Some factors that can increase a person's risk of developing skin cancer are:

• Have white skin . Everyone, regardless of skin color, can suffer from skin cancer. But white skin has a weaker UV protection compared to darker skin. Darker skin has a greater amount of melanin so that it has stronger UV protection. Besides that, it is easy to form spots on the skin, indicating that the skin is more prone to skin cancer.
• Often exposed to sunlight. People who are often exposed to sunlight are more at risk of developing skin cancer than those who are rarely exposed to sunlight. Some conditions that can increase sun exposure include 
• Living in an area that has a sunny climate. 
• Living in a higher area. 

• Moles. People who have many moles or have abnormal moles (larger than usual) are more at risk of developing skin cancer than people who have few moles.
• Age. People with advanced age are more prone to skin cancer compared to children or adolescents. 
• Skin that has been sunburned . Blisters from the sun make the skin more at risk for skin cancer, especially if the skin blisters occur when children or adolescents. 
• Actinic keratosis . In people with bright skin color, exposure to the sun is easy to cause the formation of patches in the form of thickened scaly skin on the face, hands and head area. This condition is pre-cancerous, and has the potential to turn into skin cancer. 
• History of skin cancer. If someone has had skin cancer and is cured, it is possible that the same condition will reappear.
• History of skin cancer in a family member. Someone is at high risk of developing skin cancer if you have a relative or parent who has had skin cancer. 
• Weakening of the immune system. People with a weakened immune system have a high risk of developing skin cancer. Including people with HIV / AIDS, people who take immunosuppressant drugs, and recipients of organ transplants. 
• Radiation therapy . Eczema or acne sufferers who are given radiation therapy have a high risk of developing skin cancer, especially basal cell cancer. 
• Exposure to certain chemicals. Some carcinogenic chemicals, such as arsenic, can increase the risk of developing skin cancer.

Skin Cancer Diagnosis

To accurately diagnose skin cancer, the doctor will apply the following steps to the patient:

• Physical examination of the skin. The doctor will examine the form of skin abnormalities, especially changes that occur in his physical appearance. With this examination, the doctor will determine whether the changes are caused by cancer or other diseases.
• Perform a skin biopsy. Examination of skin tissue samples taken through biopsy in the laboratory.

After the diagnosis is made, the doctor will determine the severity of the skin cancer suffered based on the stage as follows:

• Stage 0 , indicating that the cancer tissue is still in the place where it first appeared and has not yet spread (in situ).
• Stage 1 , shows that cancer tissue is still small and has not spread. 
• Stage 2 , shows that the cancer tissue has grown, but has not spread. 
• Stage 3 , indicates that the cancer has enlarged and has spread to the surrounding tissue or to the nearest lymph nodes. 
• Stage 4 , shows that the cancer has spread to other parts of the body or has metastasis.

Staging of skin cancer is done to determine the right treatment. In basal cell carcinoma, cancer cells usually do not spread so that a skin biopsy can determine the type and stage of cancer. But in other types of skin cancer, such as squamous cell carcinoma, mercury cell carcinoma, or melanoma, the doctor will carry out a follow-up examination to get more accurate results. One of the advanced examinations that is usually done is lymph node biopsy in the area of cancer.

Skin Cancer Treatment

Handling is done depending on the type and stage of skin cancer. The main treatment for skin cancer is surgery to remove cancer cells, especially in types of melanoma.

In melanoma type skin cancer, treatment is adjusted to the stage of cancer. General description of treatment for each stage of cancer is as follows:

• Stage 1 and 2 melanoma can be treated by surgery to remove cancerous tissue and healthy skin around the tissue. This surgery is known as excision surgery. If the surgical excision process is expected to leave extensive scars, this procedure can be combined with skin grafting . Excision surgery has quite good success in stage 1 and 2 melanoma cancer patients, which is around 80-90 percent. After surgery, the patient will be monitored intensively by the relevant health worker.
• Stage 3 melanoma can be treated by excision surgery on cancerous tissue. To keep the cancer from spreading to other organs, lymph node biopsy can be performed. If the lymph node biopsy results show the cancer has spread to the gland, surgery can be done to remove lymph nodes to prevent further spread of cancer. 
• Stage 4 melanoma occurs when cancerous tissue has spread to other organs (metastasis). The goal of treatment for stage 4 cancer is no longer to kill cancer cells, but to extend the patient's life expectancy, slow the growth of cancer, and reduce the symptoms that arise. Medications include radiotherapy or immunotherapy.

In non-melanoma skin cancer, treatment can be done through the following methods:

• Excision surgery combined with skin grafts. The goal is to remove cancer cells and prevent them from spreading.
• Mohs micrographic surgery ( Mohs micrographic surgery / MMS ). This method is used if cancer cells are feared to have spread or occur in very important parts of the skin, such as in the eye or nose area. In MMS surgery, the edge of the cancer tissue is examined microscopically to make sure all cancer cells have been completely wasted. If the cancer tissue is still there, surgery is done again. 
• Curettage. This treatment method is applied to very small non-melanoma cancers. Here the doctor will carry out cancer tissue until the remaining healthy tissue, then burn (cautery). The curettage method can be performed several times to ensure that no cancer cells remain. 
• Cryotherapy. This cancer treatment method is carried out using cold temperatures to kill cancer cells at an early stage. In cryotherapy, patients will be given liquid nitrogen to freeze cancer tissue which causes the formation of scabs in the area. After a few weeks, scabs that contain cancerous tissue will then be released on their own. 
• Anticancer cream. Anticancer cream is used for cancer tissue treatment that is only found in the upper layers of the skin, such as basal cell cancer or Bowen's disease. There are two types of anti-cancer creams, namely: 
• Cream of chemotherapy 
• Immune system stimulating cream

• Photodynamic therapy. This therapy is used to treat basal cell cancer, Bowen's disease, and acitic acid keratose. This therapy uses certain creams to make the skin of the cancer more sensitive to light. After the cream is used, the skin is illuminated with strong intensity light to kill cancer cells.
• Radiotherapy . That is treatment through radiation methods. This therapy is done if surgery cannot be done or the cancer has spread widely. 
• Electrocemotherapy. This is a more complex, but more effective chemotherapy method. Electrocemotherapy is applied if surgical methods, radiotherapy and chemotherapy do not work effectively in eliminating cancer. Electrocemotherapy is done by giving chemotherapy to patients intravenously, followed by an electric shock using electrodes to the cancer tissue. Electricity will make it easier for chemotherapy drugs to enter cancer cells so that cancer cells become more easily damaged. This method is usually carried out using total anesthesia to the patient, although in some cases, the patient is only given local anesthesia. Electrochemotherapy procedures usually last for several hours and the results can be seen in six weeks.

Skin Cancer Prevention

Here are some ways you can do to prevent skin cancer:

• Avoid sunshine at midday. This step can be done by arranging the schedule of outdoor activities during the day. UV accumulation that affects the skin for a long time can damage the skin and cause cancer. By avoiding sunlight during the daytime, UV accumulation can be reduced.
• Use sunscreen regularly. Sunscreen or sunscreen cannot absorb all types of harmful UV radiation, but can reduce the adverse effects and damage to the skin caused by sunlight. 
• Use clothes that can protect from sunlight. Because sunscreen cannot absorb UV radiation entirely, using clothing that covers the body, including the arms and legs, can provide additional protection against the harmful effects of sunlight. In addition, hats and sunglasses can provide more protection for the head and eyes from sunlight radiation, especially UVA and UVB. 
• Avoid using tanning beds . Tanning beds used to darken skin tone emit UV radiation which can be harmful to the skin. 
• Be careful in using drugs with side effects on the skin. Some types of drugs such as antibiotics increase skin sensitivity to light. If taking drugs with side effects, should reduce outdoor activities, especially at midday. 
• Perform regular skin checks and consult skin changes that are considered unnatural to the doctor.

Share this post