Melanoma and carcinoma are the two main families of skin cancers. The risk factors are diverse: fair skin, family cases, exposure to the sun, number of moles … How to recognize and treat skin cancer?
Definition: what is skin cancer?
The skin canceru denotes an abnormal multiplication of skin cells. This cancer can occur at any age. The areas most frequently affected (face, arms, etc.) are those exposed to ultraviolet rays (sun, tanning booth). The number of new cases of skin cancer more than tripled between 1980 and 2018 (source 1).
When detected and treated early, skin cancer is very treatable. Depending on its type, several treatments (surgery, drugs, etc.) can be used. Following the treatments, recurrences are possible. In some cases, death can occur.
The main types of skin cancer
There are two main types of skin cancer: carcinoma, which accounts for 90% of skin cancers (source 1), and melanoma, which is rarer but also more serious.
- The basal cell carcinoma, the most frequent (70% of cases) and the least serious, only develops locally. It appears most often after 50 years, but can affect younger people. It is usually localized on uncovered parts of the body (face, neck, back of the hands …). But it can extend to the surface, forcing major destruction of the affected areas with aesthetic and / or functional after-effects (eyes, etc.).
- The squamous cell carcinomaorsquamous cell : more aggressive than basal cell carcinoma, it can invade lymph nodes and metastasize. It represents 20% of skin cancers. It mostly appears after 60 years and, it also occurs mainly in open areas. It can sometimes develop on precancerous lesions, called actinic keratosis and due to chronic sun exposure. This skin lesion is recognizable by its appearance of scabs resting on a red base. “Actinic keratoses are not cancerous but can turn into squamous cell carcinomas,” says the National Union of Dermatologists (source 2).
The melanoma cutaneous represents 10% of skin cancers (source 1). It develops from pigment cells present in the skin (melanocytes). In 20% of cases, it is linked to the degeneration of a mole (nevus). Melanoma is the most common skin cancer dangerous : its risk of metastasis is high and it can affect organs such as the lungs. It is therefore essential to diagnose it early. Diagnosed at a metastatic stage, he has a poor prognosis.
Rarer skin cancers
Rarer forms of skin cancer exist:
– Kaposi’s sarcoma;
– Paget’s disease of the nipple or extra-mammary linked to breast cancer;
– cutaneous T-cell lymphoma (mycosis fungoides) …
Causes and risk factors
The risk factors may be, depending on the type of tumor:
- a clear skin never tanning and sunburning, many permanent freckles on the body (skin phototype type 1);
- the presence of more than 50 moles ;
- strong exposure to UV rays during childhood (numerous sunburns);
- a way of life with a intense sun exposure either for prolonged professional activities in the open air (fishermen, agricultural workers) or for leisure activities at least once a week;
- of family history skin cancer;
- the presence of precancerous lesions (leukoplakia, etc.);
- a history of radiation therapy;
- certain pathologies (albinism, etc.);
- prolonged contact with chemicals (arsenic, etc.);
- immunosuppression (weakened immune system during AIDS-like infections or after certain treatments);
Exposure to solar and artificial ultraviolet radiation is the most important risk factor for developing skin cancer.
The main symptoms of skin cancer
When they are located in inconspicuous areas (scalp, back, etc.) or that their appearance is not disturbing, the skin tumors can go unnoticed.
The skin lesions can be very different. They are likely to appear anywhere on the body (face, neck, ears, arms…) In the form of:
– shiny, clear, sometimes ulcerated nodules with crusts, or red, smooth, hard, scaly patches for basal cell carcinomas;
– red, hard, ulcerated and crusted lesion for squamous cell carcinoma;
– changes in a mole (blacker, more irregular, more voluminous…) or the appearance of a brown, black, gray, sometimes colorless, often spotted (white, red…) attack for the melanoma ;
– eczema patch surrounding the nipple for Paget’s disease;
– flat, pinkish, purple or red macules in Kaposi’s sarcoma.
Mucous (mouth, anus…) Can also be affected.
To benefit from appropriate care, it is essential to consult a doctor.
Prevention tip (s)
Prevention skin cancer, it is necessary to respect some rules:
– do not expose young children to the sun;
– avoid prolonged exposure to the sun, especially between noon and 4 pm;
– apply sunscreen regularly in the event of exposure;
– wear, especially if you have fair skin, a hat or cap, sunglasses and light covering clothing;
– do not tan in a UV cabin ;
– regularly screen for precancerous lesions or skin cancer;
– limit, in summer, the use of photosensitizing drugs (anti-inflammatory) because the skin is then more sensitive to the sun’s rays.
The ABCDE rule for spotting a suspicious mole
It is essential to be vigilant in everything change (size, shape, color, etc.) of a mole. Check your skin regularly for any changes. Help yourself to rule “ABCDE : A for asymmetry; B as jagged edges; C as an inhomogeneous color; D as diameter; E as evolution.
Diagnosis and examinations
In the event of the appearance of a small brown spot on the skin or of a modification of a mole, medical advice is essential.
During the consultation, the dermatologist examines the entire skin and identifies suspicious spots or moles. If a cancerous lesion is suspected, he removes it, most often under local anesthesia, to have it analyzed.
If the diagnosis of skin cancer is confirmed, additional examinations (CT scan, MRI, etc.) can be performed to assess the extent of the lesion and to check whether other organs have been affected.
Carcinoma, melanoma: what treatments?
Treatment for skin cancer depends on its form and course.
The standard treatment for first-line skin cancer is surgery : The tumor is usually removed under local anesthesia.
The early detection is decisive in the cure of skin cancer, especially melanoma. Detected early enough, squamous cell carcinoma and basal cell carcinoma are well treated, with cure rates of 90% and 100%, respectively. Cured early, melanoma is one of the cancers with the best 80% five-year survival, says the National Union of Dermatologists.
In a large number of cases of carcinoma or melanoma without metastases, no other treatment is started.
When cancer is found at a later stage, treatment consists of surgery (removal of the tumor) which may be followed by immunotherapy, chemotherapy, or radiotherapy, depending on the patient’s profile or the stage of cancer.
Important therapeutic advances have taken place in recent years, with the availability of new molecules of targeted therapies: ipilimumab and vemurafenib. So, ipilimumab, a monoclonal antibody, acts on the immune system by stimulating it to help destroy cancer cells.
In order to monitor the possible appearance of a recurrence or new skin cancers, long-term medical supervision is essential.