Skin Cancer, which is abnormal growth of skin cells that most often are found to develop upon skin which is exposed to the sun. However, this common type of cancer can also occur in areas of skin which are not ordinarily exposed to sunlight. Nevertheless, there are three major kinds of skin cancer; melanoma, squamous cell carcinoma & basal cell carcinoma. Most people can however reduce risk of skin cancer by avoiding exposure to the harmful UV or ultraviolet radiation. Regular checking of skin for suspicious changes can help detect skin cancer in early stages. Moreover, early detection of skin cancer gives patients a great chance for successful treatment of skin cancer.
Signs & Symptoms of Skin Cancer
Skin cancer is primarily found to develop on areas of skin which are exposed to sun including hands, arms, chest, neck, ears, lips, face, scalp, & on legs in women. But then, skin cancer can also form on areas which rarely see light of the day, like genital area, palms & beneath fingernails or toenails. Skin cancer is found to affect people of all types of skin tones including people with dark complexions. However, whenever melanoma occurs in people with darker skin tones, it is most likely to occur in areas of skin which are not exposed to skin like the palms of hand & soles of feet.
Signs & Symptoms of Basal Cell Carcinoma
Basal cell carcinoma cases are usually found to occur in sun-exposed areas of the body like the neck or face. Basal cell carcinoma is most often found to appear in the following ways.
- Flat & flesh-colored or brown scar-like lesions
- Way or pearly bump on skin
Signs & Symptoms of Squamous Cell Carcinoma
Squamous cell carcinoma is most often found to occur on sun-exposed area of body like hands, ears & face. People with dark skin are more prone to developing squamous cell carcinoma upon areas which are not often exposed to sunlight. Squamous cell carcinoma would usually appear like the following.
- Flat lesion with a scaly and/or crusted surface
- As a red & firm nodule
Signs & Symptoms of Melanoma
Melanoma can however develop anywhere on the patient’s body, either in normal skin or inside an existing mole which has become cancerous. Melanoma will most often appear on face or trunk of affected men. However, in women this type of cancer will most often develop on lower legs. Melanoma can also occur on skin which has not been exposed to sun in both men & women. Moreover, melanoma can affect people having any type of skin tone. Melanoma also tends to occur on palms or soles, or under fingernails or toenails among people with darker skin tones. Signs of melanoma most often occur as the following.
- Large brownish spot with dark speckles
- Mole which changes size, feel or color, or even begins to bleed
- Appear as a small lesion with irregular border & with portions that appear white, red, blue or blue-black
- Dark lesions on soles, palms, toes or fingertips, or upon mucous membranes which are lining the anus, vagina, nose or mouth
Signs & Symptoms of Less Common Skin Cancers
Less common types of skin cancer include the following.
- Kaposi Sarcoma – This is a rare type of skin cancer which develops in blood vessels of skin & causes purple or red patches on skin or mucous membranes. Mainly occurring among people with weakened immune systems, Kaposi sarcoma is usually found in people with aids & among people who have undergone organ transplants since they are taking medications which suppress natural immunity. Other people who are at increased risk of developing Kaposi sarcoma include older men of Italian or Eastern European Jewish heritage or young men living in the African continent.
- Merkel Cell Carcinoma – Signs of Merkel cell carcinoma include shiny & firm nodules which occur just beneath skin or inside hair follicles. Moreover, Merkel cell carcinoma is most often found on trunk, neck & head of patients.
- Sebaceous Gland Carcinoma – This is an uncommon & aggressive cancer which originates in oil glands of the skin. Sebaceous gland carcinomas usually appear as painless & hard nodules which can develop anywhere in the body, but mostly occur on the eyelids where they are often mistaken as other problems of the eyelids.
Seeking an Appointment with Doctor for Skin Cancer
Patients must make an appointment with the doctor when they notice any changes to skin which worrying them. However, not all skin changes cause skin cancer. Doctors will nevertheless investigate all changes in the skin so as to determine the cause behind them.
Causes of Skin Cancer
Skin cancers generally occur when mutations occur within the DNA of skin cells. Mutations however cause these cells to grow out of control & form a mass of cancerous cells. Cells involved in skin cancer begin within the skin’s top layer called epidermis. Epidermis is basically the thin layer which produces a protective covering of skin cells which the body sheds continuously. Epidermis is found to contain the following three types of main cells.
- Squamous Cells – These cells lie just below the outer surface of skin & function as the inner lining of the skin.
- Basal Cells – These cells produce newer skin cells & are located right beneath squamous cells.
- Melanocytes – These cells produce melanin, which is the pigment that gives normal color to the skin. It is located in the lower portion of the epidermis. Melanocytes are found to produce more melanin when skin is exposed to sun in order to protect deeper layers of skin.
Location of origin of skin cancer will determine the type of cancer & the type of treatment option which is most suitable.
Ultraviolet Light & Other Potential Causes of Skin Cancer
Much damage to DNA in skin cells usually results from UV or ultraviolet radiation which is found in sunlight & artificial lights which are used in tanning beds. However, sun exposure fails to explain skin cancers that develop on skin which is not ordinarily exposed to sunlight. This probably indicates that there may be other factors which are contributing to risk of developing skin cancer like being exposed to toxic substances or living with a weakened condition of the immune system.
Risk Factors Contributing to Skin Cancer
Factors which increase risk of skin cancer in people include the following.
- Fair Skin – Although anyone, regardless of skin color can get cancer, people having less melanin pigment in skin are able to provide less protection from the damaging ultraviolet radiation. Therefore people who are having blond or red hair or light-colored eyes & freckle or sunburn easily, they are much more likely to develop skin cancer than people with darker skin tones.
- History of Sunburns – Having history of one or more blistering sunburns in childhood or as a teenager increases risk of developing skin cancer in adulthood. Sunburns in adult age are also considered as a risk factor.
- Excessive Exposure to Sun – People who spend considerable amount of time in sun may eventually develop skin cancer, especially when the skin is not protected by clothing or sunscreen lotion. Tanning, which includes exposure to tanning lamps & beds, also put people at risk of developing skin cancer. Tan basically is a response offered by skin to excessive ultraviolet radiation.
- Moles – People having several moles or abnormal moles known as dysplastic nevi are at increased risk of developing skin cancer. These type of abnormal moles which appear irregular & are generally large in size than normal moles, are most likely than others to become cancerous over time. People having abnormal moles of this kind should however watch them regularly for changes.
- High Altitudes or Sunny Climates – People living in sunny & warm climates are generally more exposed to sunlight than people who are living in colder climates. Therefore, living at higher elevations where sunlight is stronger also exposes people to more intense radiation.
- Precancerous Skin Lesions – People having skin lesions which are commonly known as Actinic Keratoses will increase their risk of developing skin cancer. These are precancerous skin growths which typically appear as rough & scaly patches which range from dark pink to brown in color. They most commonly appear on hands, head & face of fair-skinned people whose skin has been damaged by sun.
- Personal History of Skin Cancer – People who have developed skin cancer once are most likely at risk of developing it once again.
- Family History of Skin Cancer – When a sibling or one of the parents has had skin cancer, such a person would have an increased risk of developing skin cancer as well.
- Exposure to Radiation – People who have earlier received radiation treatments for skin conditions like acne & eczema invariably have an increased risk of developing skin cancer in future, particularly the basal cell carcinoma type.
- Weakened Immune System – People having a weakened immune system face a greater risk of developing skin cancer. This normally includes people having HIV/AIDS & also those who are taking immunosuppressant drugs following an organ transplant procedure.
- Exposure to Certain Substances – Exposure to certain substances like arsenic might also increase risk of developing skin cancer in people.
Initial Appointment for Skin Cancer
An appointment with the family doctor or a general practitioner should be first sought when people notice unusual changes in skin which worry them. Some of these cases may subsequently be referred to dermatologists who specialize in conditions & diseases of the skin. Since these appointments will most often be brief & because there is a lot of ground to be covered, it would be a good idea to stay well-prepared. Following information is meant to help people get ready & to know what to expect during initial appointment with dermatologists. Patients should therefore prepare in the following manner.
- Be Aware of Pre-Appointment Restrictions – At the time of making an appointment, patients must make sure to ask if there is anything they are required to do in advance, like restricting their diet for tests & examinations.
- Write Down Experience of Symptoms – This list must also include symptoms which may seem unrelated to the reason for which the patient is scheduling this initial appointment.
- Jot Down Key Personal Information – This should also include any major stress conditions or recent changes in life.
- Make a List of Medications – This list must include all supplements, vitamins & medications which the patient is presently taking.
- Take Along a Friend or Family Member – This should be considered as sometimes it can be quite difficult for the patient to remember all information which was provided to them during initial consultation. Someone who will accompany the patient can help them remember if anything they have missed or forgotten.
- Writing Down Questions to Ask the Doctor – Since it would be difficult to remember all questions which the patients would like to ask the specialist doctor, it would be sensible to write down all they would like to ask the doctor during initial appointment. This will also help the patient make the most of the limited time they have with the dermatologist. Listing questions from most important to least important will be helpful in case time runs out.
Some Basic Skin Cancer Questions Patients Can Ask Doctors
- Am I having skin cancer?
- What type of skin cancer am I having?
- Will I require any additional tests?
- How quickly will my type of skin cancer grow or spread?
- What treatment options do I have?
- What potential risks does each treatment carry?
- Will my skin cancer surgery leave any scars?
- Am I having any increased risk of additional skin cancers?
- How can I reduce risk of additional skin cancers?
- Do I require regular skin examination so as to check for additional skin cancers?
- Do I need to see any other specialists for my skin cancer?
- Is there a generic alternative to medicines you are prescribing?
- Can you provide me brochures or any other printed material with more information on skin cancer that I can take with me?
- Which websites do you recommend I refer to?
- What can determine whether I should plan for follow-up visits?
Patients should not hesitate to add any number of questions which occur to them that they should ask the doctor during the initial consultation for skin cancer.
What Skin Cancer Doctors Would Like to Know From Patients?
Doctors are most likely to ask a number of questions to patients. It would be ideal to be ready to answer them & allow time to cover other points which patients want to address. Common questions which dermatologists would ask patients include the following.
- When did you first notice these skin changes?
- Have you noticed any skin lesion which has changed or grown?
- Are you having any skin lesion which itches or bleeds?
- How severe are symptoms that you are experiencing?
Tests & Diagnosis for Skin Cancer
Doctors may undertake the following steps so as to diagnose skin cancer.
- Examine Patient’s Skin – Doctors may take a look at the patient’s skin so as to determine whether these changes in skin are likely to be skin cancer. Further testing may however be needed in order to confirm skin cancer diagnosis.
- Skin Biopsy – Remove Sample of Suspicious Skin for Testing – Doctors may remove suspicious looking skin for testing in a laboratory. This skin biopsy can effectively determine whether the patient is having skin cancer, & if so, the type of skin cancer it is.
Determining the Extent of Skin Cancer
When doctors determine that the patient is having skin cancer, they may ask the patient to undergo additional tests in order to determine the extent or staging of skin cancer. Since superficial skin cancers like basal cell carcinoma rarely spread, the biopsy which effectively removes the entire growth of cancer is most often the only test which is required to determine the skin cancer stage. But for patients having Merkel cell carcinoma, large squamous cell carcinoma or melanoma, doctors may invariably recommend further tests so as to determine extent of cancer. These additional tests may include imaging tests to examine nearby lymph nodes for signs of cancer spread or another procedure which is meant to remove nearby lymph nodes & test them for signs of cancer. This procedure is known as sentinel lymph node biopsy. Doctors normally use Roman numerals from I through IV to indicate stage of skin cancer. Stage I cancer is however small & limited to areas where they begin. Stage IV skin cancer indicates an advanced stage which has spread to other areas inside the body. Nevertheless, stage of skin cancer helps doctors determine which treatment option would be the most effective in each individual case.
Treatment & Drugs for Skin Cancer
Treatment options for precancerous skin lesions known as actinic keratoses & skin cancer will vary depending upon the type, size, depth & location of lesions. Small skin cancers which are limited to surface of skin may not require any treatment beyond initial skin biopsies which effectively remove the entire growth. Additional options for treatment which may be required include the following.
- Freezing – Also known as cryosurgery, doctors may be able to destroy actinic keratoses & some small & early skin cancers by freezing them with liquid nitrogen. Dead tissue will subsequently slough off when it thaws.
- Excisional Surgery – This treatment procedure might be appropriate for all types of skin cancers. Surgeons can excise or cut out the cancerous tissue along with a surrounding margin of healthy skin. However, a wide excision including removing extra & normal skin around the tumor is often recommended in some cases of skin cancer.
- Mohs Surgery – This surgical procedure is mostly for larger & recurring or difficult to treat types of skin cancers. Mohs surgery may include both basal & squamous cell types of carcinomas. This procedure is often used in areas where it is necessary to conserve as much skin as possible, like as on the nose. Doctors remove skin growth layer-by-layer during Mohs surgery, examining each layer under microscope, until no abnormal cancerous cells remain. Mohs surgery allows removal of cancerous cells with taking any excessive amounts of healthy skin surrounding the cancer.
- Cryotherapy or Curretage & Electrodesiccation – Surgeons will scrape away layers of cancerous cells with help of a curet device with a circular blade. An electric needle is also employed so as to destroy any remaining cancerous cells. Another variation of this procedure uses liquid nitrogen to freeze the base & edges of treated areas. These simple & quick procedures may largely be utilized in treatment of basal cell cancer or thin squamous cell cancers.
- Chemotherapy – Chemotherapy uses drugs so as to kill cancerous cells. Creams or lotions containing anti-cancer agents may be applied directly to skin for skin cancers which are limited to top layer of skin. Systemic chemotherapy can also be used in order to treat skin cancer which has spread to other regions of the body.
- Radiation Therapy – This therapy utilizes high-powered beams of energy like X-rays so as to kill cancerous cells. Radiation therapy is an ideal option when skin cancer cannot be completely removed with surgery.
- Photodynamic Therapy – This is a treatment procedure which destroys skin cancer cells with an effective combination of drugs & laser light which eventually make cancerous cells sensitive to light.
- Biological Therapy – This therapy utilizes the body’s own immune system in order to kill skin cancer cells.
Preventive Measures for Skin Cancer
Most skin cancers are in fact preventable. Follow these skin cancer preventive tips in order to stay away from developing one.
- Avoid Sun during Middle of the Day – Especially for people living in North America, sun’s rays are found to be strongest between 10 a.m. to 4 p.m. people should therefore schedule outdoor activities to other times of the day, even when the sky is cloudy or during the winter season since all of us absorb ultraviolet radiation throughout the year & clouds in fact offer little protection from the damaging UV rays. Avoiding sunlight when it is the strongest will help people avoid sunburns & suntan which can cause damage to skin & increase risk of developing skin cancer. Accumulated sun exposure over time may also cause skin cancer.
- Always Wear Sunscreen – Sunscreens do not filter-out all harmful ultraviolet radiation, especially the kind which can lead to melanoma. However, they are able to play an effective role in overall sun protection program. Using a broad-spectrum sunscreen protection with SPF of at least 15 will be helpful. Sunscreen should be generously applied & reapplied every 2 hours or more often in case people are perspiring or swimming. Use generous amounts of sunscreen on all skin which is exposed to sun, including lips, tips of ears & backs of hands & neck.
- Avoid Tanning Beds – Lights which are used in tanning beds emit ultraviolet rays which can increase risk of developing skin cancers.
- Wear Protective Clothing – Wearing sunscreens will not provide complete protection from harmful ultraviolet rays. People should also cover their skin with dark & tightly woven clothing which covers arms & legs as well. They should also wear a broad-brimmed hat which can provide better protection than a visor or baseball cap can. There are many companies which are also selling photo-protective clothing & dermatologists can recommend & help people choose appropriate brands. People are advised not to forget wearing sunglasses as well. Find those which can block both types of ultraviolet radiation, UVB & UVA rays.
- Beware of Sun-Sensitizing Medications – Commonly available over-the-counter & prescription drugs, including antibiotics, can often make skin more sensitive to sunlight. Therefore, it would be sensible to ask the pharmacist or doctor about possible side effects of any medication before taking them. In case these medications are bound to increase sensitivity to sunlight, it is advised to take extra precaution to stay out of sunlight in order to protect skin.
- Regularly Check Skin & Report Changes to Doctors – People should often examine skin for new skin growths & changes in existing bumps, freckles, moles & birthmarks. Check scalp, ears, neck & face areas with the help of a mirror. Examine trunk & chest & undersides of hands & arms. Also examine both front & back of feet & legs including soles & spaces between toes. It is also important to check the genital area & in between the buttocks region.
Affordable Treatment for Skin Cancer in India
Healthcare is an extremely expensive proposition nowadays, especially within the developed western world. More & more people are therefore seeking affordable medical solutions across the globe. India, with some of the best & most reputed surgeons in the world has largely benefited from this growing trend, thanks to the extensive advanced healthcare infrastructure it has built over the past two decades. With several internationally accredited hospital facilities catering to large numbers of international patients, India is in a position to offer a wide spectrum of high-quality but low-cost healthcare solutions including oncology treatments like for skin cancer to people from all around the world. IndianMedTrip which is based in South Asia is one of the most reputed global medical tourism companies. Associated with top doctors & the best hospital facilities in the country, they are offering seamless healthcare packages for men & women across the globe. IndianMedTrip services which start with the first telephonic conversation with the patient goes on to identifying the best doctor & the ideal hospital for treatment. Other services offered by IndiaMedTrip include a warm reception at airport on arrival, convenient transfer to a comfortable hotel of choice or a serviced apartment, scheduled appointments with doctors & surgeons, timely treatment without any waiting period, exotic recuperative vacation option, follow-up evaluation checks & a healthy farewell at airport when the patient is heading back home.