Skin cancer – symptoms, signs and treatment
Among all cancers to skin cancer, perhaps, many have the most frivolous attitude. Not all people represent how dangerous he can be. But very often skin cancer can be recognized in the early stages when it is very easy to cure. Therefore, seeing unusual formations on your skin, you must immediately go to the doctor. But in what cases is there a cause for concern, and in what cases is it not?
There are many types of malignant tumors of the skin, and all of them are significantly different in nature and in the severity of the disease. Some types of skin cancer are very rare or in certain categories of the population, while others may be ill for people of different gender and age.
Unlike some other types of oncological diseases that can latently develop in the early stages without any special symptoms, skin cancer in the early stages is usually easy to notice. After all, the surface of the skin is almost always available for visual review. This means that a person is able to pay attention to the reborn tissue.
Why does cancer develop, in particular, on the skin? Medicine has no definite answer to this question. Undoubtedly, not only one unfavorable factor plays its role here, but their combination at once. Scientists believe that the following circumstances contribute most to the occurrence of tumors:
- Unhealthy Lifestyle
- lack of personal hygiene
- unhealthy diet, consumption of a large number of potentially carcinogenic foods and insufficient amounts of vitamins and fiber in the diet
- injuries and injuries of the skin surface
- hereditary factors
- racial characteristics
- prolonged exposure to solar radiation
- frequent use of tanning beds
- exposure to ionizing radiation
- prolonged contact with potentially carcinogenic substances (soot, fuel oil, benzene, coal tar, oil, etc.)
- outdoor work
- old age (over 50 years)
- long-term use of corticosteroids and immunosuppressants
- low immunity
- high incidence of other types of skin pathologies
- prolonged exposure to high temperature
- precancerous conditions of the skin (facultative and obligate)
- systemic lupus erythematosus
- chemotherapy and radiation therapy of other oncological diseases
- changes in hormonal levels (including during pregnancy)
For different types of skin cancer, the proportion of individual factors may not be the same. For example, some species can manifest themselves almost exclusively in old age. However, one way or another, almost all types of skin cancer are observed mainly in adulthood. Cases of the disease of children are relatively rare. The frequency of other types of malignant tumors varies greatly depending on racial and sexual factors.
What does skin cancer look like?
Different types of skin cancer may look different. However, no matter what kind of skin cancer a person has, the symptoms of the disease may be similar:
- burning and itching
- red border around the tumor.
Phenomena such as darkening of a previously light area of the skin, long ulceration of the surface, enlargement, and tenderness of the lymph nodes near the site of the neoplasm, compaction of the skin with its rise above the surface should also be alarming. The soreness of skin formations may indicate germination of the tumor in the deep, subcutaneous tissue layers or the accession of secondary inflammatory processes.
What to do if suspicious signs are detected? First of all, in no case should one postpone a visit to the doctor. After all, the sooner treatment is started, the greater the chances of a happy outcome.
The first signs of skin cancer on the body (initial stage)
Malignant neoplasms of the skin are diverse. Their main groups are:
- non-melanoma tumors – basal cell and squamous cell carcinomas – develop from epithelial skin cells;
- tumors of the skin appendages
- other neoplasms.
We describe the first signs of skin cancer of the most common types of malignant tumors.
Basal cell carcinoma of the skin
Basal cell carcinoma of the skin (synonyms – basal cell carcinoma, basal cell carcinoma, Krompeher basal cell carcinoma) develops from cells of the basal layer of the skin epithelium.
This type of skin cancer is most common (about 75% of cases). However, in most cases, only older people are sick (over 60 years old). Basalioma of all types of skin cancer has the slowest development and the most favorable prognosis. Basalioma is located, as a rule, on the skin of the face, most often on the following surfaces:
- the side of the nose
- brow area
- nose wings
- upper lip
- nasolabial fold
Basalioma can also occur on the ears and neck. Growing too large sizes, it can grow through the skin and underlying tissues and cause damage to them. Due to the fact that basal cell carcinoma grows slowly, patients are far from immediately referring her to the doctor.
Basalioma usually occurs suddenly, without any precursors to precancerous tumors, unlike squamous cell carcinoma of the skin. The diameter of the tumor in the beginning stage is usually 2 cm, it is easily injured and bleeds.
Unlike other types of skin tumors, basalioma extremely rarely metastasizes. In principle, this type of tumor is something between benign and malignant tumors. However, according to histological features, it still refers to malignant tumors. The prognosis for this category of skin tumors is favorable.
Dangerous with this type of skin cancer are cases where the localization of the pathology occurs around the eyes, in the folds above the lip, around the external auditory canal, in the posterior sulcus of the auricle. In these places, the tumor grows deep, damaging the bone tissue, muscles, brain.
However, with early detection, timely treatment and removal of the tumor, the patient can get rid of this disease without consequences.
There are about 20 types of malignant cells of basal cell skin cancer. The most common clinical forms are:
The symptoms and signs of each type of basal cancer vary. And most often in one patient forms are combined. Diagnosis requires a clinical examination by a specialist doctor.
Nodular (nodular, solid) basalioma
Appears on the scalp, neck. This initial skin cancer is characterized by the appearance of dense small nodules (2-5 mm), which gradually merge with each other. The tumor grows slowly, then disintegrates, forming a deep ulcer with roller-like edges, covered with purulent-necrotic crusts.
Pigment tumor cells can be translucent and can vary from slightly brown to black.
Usually located on the torso, arms, and legs. Looks like a rounded pink spot. At the initial stage, it peels off, and when developed, papilloma growths and ulcerations appear on its surface.
This skin cancer is not aggressive and most favorable according to the forecast: the defeat of the skin develops very slowly, for decades.
Scleroderma-like (flat, morphe-like, sclerosing) basalioma
Rare, but rather aggressive skin cancer. The tumor is deep in the layers of the skin and by volume, it is much larger than the external signs on the surface. Cases of disease recurrence are many.
Most symptoms of this type of skin cancer are found on the head and neck. At the initial stage, a pale pink plaque with raised edges and mother-of-pearl shade appears on the skin. In the later stages of development, the lesion has the appearance of a depressed scar or patch.
The form is called cystic because it looks like a skin cancer of this type of translucent nodule (like a cyst). Detected by chance if a biopsy is performed.
Fibroepithelial basalioma (Pincus fibroepithelioma)
Signs of skin cancer of this type are usually found on the lower back. Looks like a fibrous polyp on a flat or hemispherical leg. This is a rare tumor formation. It has a favorable outlook.
Squamous cell carcinoma
Squamous cell carcinoma of the skin (synonyms – squamous cell carcinoma, squamous epithelioma, epidermoid carcinoma, spinocellular carcinoma) develops from skin keratinocytes.
This type of skin cancer is the third most common after basal cell carcinoma and melanoma. They can suffer people of any age, both adults and elderly, both men and women.
Externally, the tumor in squamous cancer resembles a small sore, sometimes bleeding. Very often, the tumor is confused with the manifestation of some inflammatory skin diseases, dermatitis, burns. However, unlike these formations, the tumor does not decrease in size and grows.
This formation can be located on different parts of the body but is most often found at the junction of various skin surfaces – the corners of the eyes, mouth, lips, mucous membranes, genitals (Keir’s disease), etc. Over time, the tumor may form metastases. However, they are most often observed on the skin near the primary tumor on the skin or in the lymph nodes. For tumors located on the face, damage to the lymphatic system is most common. Signs of lymph nodes are their increase in size, their mobility, and soreness. In the future, their decay is possible with simultaneous ulceration of the nearest skin. Metastases affect distant organs only in advanced cases of the disease.
A tumor is usually distinguished by slow development, which increases the chances that it can be recognized and cured in a timely manner. However, at a late stage of development of the disease, the percentage of patient survival is small.
At the initial stage, squamous cell carcinoma of the skin is a formation in the form of a red induration, an ulcer or bumps with a diameter of approximately 2 cm. This formation can easily be injured. The trigger for the beginning of its development can serve as various factors, first of all, the intense irradiation of the skin by the sun’s rays. On the site of the appearance of education can be as a healthy area of the skin, and scars from burns, chronic ulcers, inflammation.
Squamous cell carcinoma is easily treatable in its early stages. For this purpose, using surgical methods, radiation therapy, chemotherapy. However, chemotherapy in most cases is auxiliary.
As a variety of squamous cell carcinoma of the skin, you can specify a highly differentiated cancer. The predecessor of this disease is such pathological structures as actinic keratosis and Bowen’s disease.
With highly differentiated skin cancer, the tumor grows long. It has a high density, horny growths, and crusts on the surface. However, this skin tumor is similar to warts, solar keratosis, which can make it difficult to diagnose the disease.
Low-differentiated squamous cell carcinoma, unlike well-differentiated, has a high growth rate and an aggressive course. This is a soft formation that looks like a bump or an ulcer. May bleed or ache.
Five-year survival with timely removal of cancer cells is more than 50%, but with the formation of metastases, it decreases to 30%.
Melanoma skin cancer
This tumor develops on the basis of the pigment cells of the skin – melanocytes. This type of cancer is relatively rare compared with the basal cell (15% of all skin cancer cases). However, he still takes second place after it, and if you take all cancers, more than 1% of them fall on melanoma. Most often, women suffer from the disease, although the proportion of sick men is quite large. The probability of getting this type of skin cancer in people over the age of 50 also increases dramatically.
Despite the relatively low probability of developing this type of cancer, it is among the most aggressive types of skin cancer, and cancer in general. For reasons that are not completely understood by science, the body’s immune system reacts very poorly to melanoma, allowing tumors to develop quite quickly — within weeks, and sometimes several days, the tumor goes from cancer in the initial stage to the life-threatening stage. Also, the tumor is characterized by rapid metastasis in the early stages, and metastases can penetrate not only the adjacent skin areas but also the lymph nodes, as well as organs distant from the tumor.
The prognosis for this type of tumor is extremely poor. Only in the first stage of the disease can radical removal lead to a cure. Also, the tumor tends to grow deep into the skin, going beyond its boundaries and penetrating into other tissues – muscles and cartilage. Melanoma mortality accounts for approximately 80% of all skin cancer deaths.
Outwardly, melanoma looks like a small speck of an uneven shape with a width of just a few millimeters. The signs that make it possible to determine a tumor at an early stage are its soreness and bleeding. The color of the formation is usually black or dark blue, less often red. It may contain inclusions of another color, for example, white. The tumor also protrudes slightly above the surface of the skin, often ulcerated. Sometimes there is a melanoma with a whitish-colored surface, such tumors are particularly difficult to diagnose at an early stage.
The size of the tumor can be different – from 2 mm to several cms. A characteristic symptom for identifying the malignancy of a neoplasm is rather its shape, color, and associated symptoms – pain, bleeding.
Often, the tumor is formed on a completely clean skin. However, pigment spots on the skin are usually transformed into melanoma, warts, and moles – nevi. In this pigment spots can change their color, shape, and size, become asymmetrical, acquire uneven or blurred edges. Also, a nevus may become red, darker, or, conversely, discolor. Other nevuses may appear with a similar structure. Such mechanisms as injury to benign skin tumors, exposure of the skin to a large dose of sunlight, skin interaction with carcinogenic chemicals can serve as trigger mechanisms for this transformation.
Melanoma develops on some surfaces of the skin more often than on others. These places include the face, chest, and limbs. Less commonly, melanoma occurs on the skin of the feet and toes, palms. The occurrence of a tumor on the mucous membranes – the conjunctiva of the eyes, the mucous membrane of the mouth, even in the vagina and anus is possible (is it worth saying that such localization of the tumor is extremely unlikely to be detected).
A type of melanoma is lentigo-melanoma. It has been growing for a relatively long time, but in appearance, it resembles solar lentigo, seborrheic keratosis, pigmented actinic keratosis and lichen planus. The appearance of black nodules in the formations of this type indicates their transition to the next stage.
Most often, this type of tumor is found in people with fair skin, with a small amount of melanin, especially if they live in the southern regions, where there is a lot of bright suns. Caucasians suffer from melanoma much more often than the indigenous people of the African continent.
Treatment of melanoma, like other malignant skin tumors, is usually surgical. Chemotherapy and radiotherapy can also be used.
In oncology, the following classification of melanoma stages is used:
|Stage||Disease development||five-year survival|
|Stage 0||the tumor is localized in the surface layer of the epidermis||95%|
|Stage 1||tumor diameter less than 2 mm, it affects all layers of the skin, no metastases||90%|
|Stage 2||tumor diameter up to 4 mm, no metastases||50%|
|Stage 3||lymph node metastasis observed||thirty%|
|Stage 4||there is metastasis to the internal organs, the general intoxication of the body||ten%|
Tumors of the skin appendages
Other types of skin cancer are much less common, and make up a fraction of a percent of all skin cancers. These can be sweat and sebaceous gland tumors (adenocarcinoma), tumors from the tissues that make up the follicles, and skin metastases from other tumors. To determine the type of tumor in these cases is possible only with the help of diagnostic procedures – MRI, computed tomography and biopsy.
Adenocarcinoma is a rare type of skin cancer. Develops from glandular cells (sweat and sebaceous glands), grows slowly. It looks like a tight nodule of blue-violet color or a papule towering above the skin. It forms in the axillary region, in the groin, under the breasts in women.
The node is characterized by slow growth, but in some cases, it can reach large sizes (8-10 cm). Germination in depth beyond the skin tissue and the identification of metastases is rarely observed. After removal, a tumor may recur in the same place.
Verrucous carcinoma of the skin is a rare type of tumor, a type of squamous cell carcinoma. Appears on the skin of the hands, looks like a wart, making it difficult to correctly diagnose the early stages of the disease. However, these formations can bleed, which allows time to pay attention to them.
Pre-cancerous conditions of the skin
There are obligate precancerous skin diseases – those that are converted into malignant tumors with a 100% probability (the question is only in time),
- Paget’s disease
- Bowen’s disease
- erythroplasia Keira,
- pigment xeroderma.
The optional forms of precancerous skin diseases are those that often turn into malignant, but not always.
- chronic dermatitis of various etiologies
- senile dyskeratosis
- chronic trophic ulcers
- postburn scars
- giant nevus
- complex pigment nevus
- nevus otta
- dysplastic nevus;
- birthmarks, papillomas, and warts provided they are permanently traumatized.
Bowen disease is initial cancer in which tumor cells do not germinate through the epidermis. Externally, the disease looks like scaly red crusts covered with crusts. May resemble eczema or psoriasis, a fungal infection of the skin. The size of the formation in the initial stage is about 2 cm.
Paget’s disease looks like Bowen’s disease. Tumors of this type are most often located near the nipples and on the genitals.
Cutaneous horn – a pathological process that almost always goes into squamous cell cancer. Skin cancer, its initial stage has the appearance of a small red spot or bumps with horny scales. Over time, a yellow-colored growth of the skin may begin to form, which gradually becomes higher. However, this type of tumor on the skin occurs infrequently, mainly in the elderly.
Keratoacanthoma is considered to be a precancerous condition that can often be transformed into a squamous type of skin cancer. It has a hemispherical shape with a diameter of 0.5 to 2 cm. It can appear and grow to large sizes in a few weeks. This swelling of the skin is dense and rough, and may also have a yellow growth.
Actinic (solar) keratosis is a precancerous skin disease, which is 20% of cases turn into a malignant squamous cell tumor. Usually, tumors in this form of the disease are located in groups, which increases the chances of their malignancy (transformation into malignant tumors). Externally, they look like flat, red, scaly patches on the skin, often covered with yellow crusts. They are easily confused with senile keratomas. They are usually found on the head, neck, or hands.
A dysplastic nevus is a benign skin lesion, which has a high risk of becoming malignant. The signs of a dysplastic nevus that distinguishes it from ordinary moles are the lack of symmetry in its shape, uneven edges, etc. The larger the size of the nevus, the more likely its degeneration. Particularly dangerous nevi with dark patches.
Diagnosis of the disease
Determining the type of tumor on the skin and the characteristics of its development is not an easy task. It is also necessary to establish how strongly neighboring organs are involved in the pathological process. Of course, analysis of the patient’s complaints and history will not be enough.
The most important diagnostic method is biopsy – taking a piece of tissue for analysis, followed by microscopic examination. In the event that not only the skin is affected, but also the lymph nodes, it is necessary to take biological material from and to the study. In many cases, informative radioisotope methods, thermography.
Also, such procedures as radiography of the lungs, urography, abdominal ultrasound, MRI or CT of the brain and kidneys, general blood and urine tests are done. All this is necessary to determine the stage of the disease.
Skin cancer treatment
The treatment plan is determined for each patient individually. In 9 cases out of 10, the therapy is effective. The following options are possible:
- surgery for skin cancer – the main method of treatment. During surgery, the neoplasm itself is removed along with the adjacent visually healthy area. In this way, the risk of leaving separate cancer cells in the suture zone, which will form a new tumor, is reduced. With extensive surgery, skin grafts may be necessary.
A type of surgical treatment is Mohs micrographic surgery: the tumor is removed in layers. Each of them is examined under a microscope. Layers are removed until pathologically altered tissues are observed in the samples;
- radiation therapy (radiotherapy) – is used when the area of the lesion is very large or is not amenable to surgical treatment. Sometimes radiotherapy is performed after surgery. Its goal is to destroy the remaining cancer cells (adjuvant radiotherapy);
- modern methods: cryodestruction, laser coagulation, and photodynamic therapy, in which a special cream is applied, which increases the sensitivity of tumor cells to light;
- drugs prescribed only for cancer, which affects the upper layers of the skin. There are two types of anti-cancer creams: chemotherapy and immunostimulating.
The so-called traditional methods of treating skin cancer is a reliable path to complications and advanced cases of the disease. Therefore, it is not necessary to resort to them.