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Skin Cancer :- Types, Symptoms, Causes, Diagnosis, Treatment, Prevention, General home Care of Skin Cancer

Skin cancer is the most prevalent type of cancer and is the easiest to avoid since it is mostly caused by over exposure to sun's ultraviolet rays. It was first observed in the late nineteenth century among sailors, who spent most of their day under the sun. Subsequently, farmers also showed a preponderance of skin cancer.

In human body, skin performs a number of vital functions. The most important are protection from infection, injury, heat, chemicals and sunlight. The nerve endings embedded in skin pass on messages about pain, touch, temperature, pressure and other sensations to the brain. It also controls body temperature, stores water and fat and manufactures vitamin D.

The skin consists of two layers. The outer thin layer contains 3 types of cells; basal cells, squamous cells and the deepest point, melanicytes, which produces melanin, the dark pigment that gives skin its colour and protects it from sun. On exposure to sun's ultraviolet rays the skin gets tanned. Within reasonable time to sun's exposure (about 48 hours) the melanocytes transfer melanin to non-pigment forming cells as a means of safeguarding against further injury.

The inner layer of the skin is thick and is called dermis. It is linked to a bustling control centre, where blood and lymph vessels transport their essential fluids. Sweat body temperature by excreting water, urea, and other waste products through pores. Another gland produces sebum, which keeps the skin lubricated. Hair folicies nerves and fatty tissues in the dermis.

Type of Skin Cancer

There are mainly three types of skin cancer namely:

1.BASAL-CELL CARINOMA

2.SQUAMOUS-CELL CARCINOMA

3.MELANOMA

The malignancies of the skin remain restricted in the epidermis, mostly due to invisible ultraviolet rays emitted by the sun. The ozone gas present in the air absorb most of the sun's radiation, so that only a small percentage of ultraviolet radiation of longest wave length (UVA) and ultraviolet radiation of shortest wave length (DYB) reaches the earth's surface. The UVB rays are known to burn the skin more easily and have cancer-causing potential. The disease usually occurs as a small, pearly bump on the face, neck, hands or the nose. If left untreated, the basel-cell carcinomas can crust, bleed or ulcerate. These tumors take months or years to grow_ to half an inch in diameter. They root under the skin, causing disfigurement and damage underlying bone, cartilage and muscle. It has a cure rate of better than ninety-nine per cent if detected early. A dermatologist (a physician specializing in skin diseases) can treat basal-cell carcinoma in a number of ways.

Squamous-cell carcinoma is the second most frequently caused skin cancer. It forms in the flat, scale like squamous cells and is typically found on areas of the body exposed to the sun, like face, ears, lips, mouth, neck, hands, arms and back. These tumors are similar to basal-cell carcinomas but they are raised red or pink scaly noudle in nature (it has an ulcerated centre). However, these expand rapidly and can spread to other organs. With early detection, these are about 95 per cent curable;

A third type of skin cancer is melanoma . It appears as a mole, which begins to grow asymmetrically and has irregular borders and uneven colouration. Size of the mole is usually about one quarter of an inch.

Any unusual colouration of the skin or growth on the skin should be immediately reported to the physician. Usually, dermatologists judge from the type of the skin and the amount of exposure, to determine the risk for skin cancer.

Skin Cancer Symptom

All forms of skin cancer develop according to a similar pattern. The first sign of a cancer is usually a change in the appearance of an existing mole, the presence of a new mole, or a change in the appearance of an area of the skin.

Basal cell cancer usually appears as a small lesion (wound) in the skin that lasts for at least three weeks. The lesion looks flat and waxy, with shiny, rounded edges. There may be a sore at the center of the lesion that makes it look like a dimple. The lesion slowly grows larger if it is not treated.

A squamous cell cancer generally begins as a small raised bump on the skin. The bump may have a sore at its center. It usually does not itch or cause pain.

A common symptom of melanoma is a change in an existing mole. The mole may change color, size or shape. It may become tender or itchy. If it starts to bleed, the cancer may already have begun to progress.

Specialists often recommend the ABCD rule in checking for melanomas. These letters come from the following steps:

Asymmetry. Moles are normally round. If a mole begins to take an unusual (asymmetric) shape, it may be cancerous.

Border. A normal mole has a clear-cut border with the surrounding skin. A cancerous mole has an uneven border.

Color. Normal moles are tan or brown. A cancerous mole may be any mixture of red, white, blue, brown, purple, and/or black.

Diameter. A normal mole is usually less than 5 millimeters (.25 inches) in diameter. Any mole that grows larger than that size may be cancerous.

Cause of Skin Cancer

The cause of skin cancer isn't fully understood at present. But there are certain factors that make skin cancer more likely. The main risk factor for any type of skin cancer is exposure to the intense ultraviolet light of sunshine.

Other factors that may increase your risk of skin cancer include:

Fair skin that burns easily - people with black, brown and darker olive complexions have a lower risk of skin cancer

A family history of skin cancer

Skin, which has a lot of moles

Red or fair hair and blue or green eyes

Freckles

Bad sunburn as a child

Using a snubbed

Your job - if you work outdoors you are exposed to more sunlight than if you are office-based7

Increasing age - non-melanomas such as SCC and BCC are more common in people over 60 and are rare in children

Skin Cancer Diagnosis

Your GP will examine your skin. He or she may refer you to see a specialist, such as a skin specialist (dermatologist) or a cancer specialist (oncologist) to have further tests including those listed below.

In a biopsy, your doctor will surgically remove a suspicious skin lesion or collect a small sample of tissue with a needle. The sample will be sent to a laboratory for examination to find out if it is a cancer and what type it is.

X-rays and CT will tell your doctor how far the cancer has spread (if at all).

CT scan

In a sentinel node biopsy, your doctor will remove the closest lymph node that a melanoma skin cancer would drain into and examine it to see if cancer is present.

Skin Cancer Treatment

If the tissue is cancerous the doctor considers a number of factors to determine the best treatment for skin cancer, such as the location of the cancer, its size, and whether or not the cancer has spread beyond the skin. There are three basic surgical techniques available to remove the cancerous growth - curettage and electrodesiccation, conventional surgery and Mohs' surgery.

Curettage and electrodesiccation scrapes the cancerous skin with a curette, an instrument with a sharp, spoon-shaped end. The area then is generally treated by electrodesiccation. Electrodesiccation is an electric current from a special machine that is used to control bleeding and kill any cancer cells remaining around the edge of the wound.

Conventional surgery cuts the cancer from the skin along with some of the healthy tissue around it.

Mohs' technique shaves off one thin layer of skin at a time until the entire tumor is removed.

Doctors may opt for other non-surgical techniques such as cryosurgery (freezing the tumor), laser therapy (uses a narrow beam of light to remove or destroy cancer cells), radiation therapy (uses high-energy rays to damage cancer cells and stop them from growing), or topical chemotherapy (anticancer drugs in cream or lotion form that are applied to the skin).

For treatment of actinic keratosis, the doctor has many options available. Topical chemotherapy, cryosurgery, curettage and electrodesiccation, laser therapy, dermabrasion (removing the top layer of skin with a special machine) or shave excision (shaving the very top layer of skin) have all been successful in the treatment of this condition.

Skin Cancer Prevention

Minimizing sun exposure is the best way to prevent skin damage, including many types of skin cancer:

Protect your skin from the sun when you can -- wear protective clothing such as hats, long-sleeved shirts, long skirts, or pants.

Try to avoid exposure during midday, when the sun is most intense.

Use sunscreen with an SPF of at least 15. Apply sunscreen at least one-half hour before sun exposure, and reapply frequently.

Apply sunscreen during winter months as well.

RISK FACTORS

People over 40 years of age

Hereditary risk factors

Fair complexion; blond or red hair; blue, green or grey eyes

Family history of xeroderma pigmentosum, albinism

Family history of melanoma

Personal health history of risk factors.

Exposure to medical X-rays or treatments utilizing artificial UV radiation

Personal history of skin cancer

Environmental risk factors

Working with chemicals such as arsenic acid and polycyclic aromatic hydrocarbons.

Working out doors

Exposure to industrial radiation

Proximity to the equator and other geographical factors

It is advised to consult a physician in case of any of the above factors are observed.

Self Skin-examination

You can visually examine (or inspect) your body for signs of skin cancer. You should get to know your skin. All you need is a brightly lit room, a full-length mirror and a hand­held mirror. You should examine all the skin, the scalp, inside the mouth, between the toes, the bottom of the feet ­everywhere. Proceed in the following way:

Begin by looking at yourself in a full-length mirror. If you spot any lesions, analyze their appearances whether light or dark. Do not

get upset. Only note down.

Check your back.

Raise your arms and look at your right and left sides.

Bend your elbows. Carefully check your forearms, upper arms, underarms and palms of your hand.

Sit on the floor and look at the back of your legs and feet, the soles and between your toes.

Pick up a hand-held mirror. Examine the back of your neck and your scalp. Part your hair with your fingers, a brush or a blow dryer.

Finally, check your buttocks and your back once again using the hand mirror.

Repeat the examination every 3 or 4 months. Check for any moles on the body, whether they are of the same size or different.

Any suspicious growth or findings should be reported to a dermatologist. The dermatologist may like to examine the body in your birthday suit and then do skin biopsy before deciding on the future course of the treatment.

GENERAL HOME CARE

Look for unusual moles, spots or bumps

Pay special attention to the area that gets a lot of sun-exposure; hands, arms, chest, neck, face, ear etc.

Examine your skin with a mirror or another person's help.

CALL THE DOCTOR NOW

If your moles do not change over me, there is little cause for concern. If you have a family history of malignant melanoma, let your doc­tor know. You may be at higher risk. Call your doctor if you notice any of the following changes:

Asymmetrical shape: One half does not match the other half.

Border irregularity: The edges are ragged, notched, or blurred.

Color: The color is not uniform. Watch for shades of red and black, or a red, white, and blue mottled appearance.

Diameter: The mole is larger than a pencil eraser. (Harmless moles are usually smaller than this.)

Scaliness, oozing, bleeding, or spreading of pigment into sur­rounding skin.

Appearance of a bump or nodule on the mole, or any change in appearance of the mole.

Itching, tenderness, or pain.

Unusual skin changes or growths, especially if they bleed and keep growing.



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