December 2009 Archives

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High-frequency ultrasound with elastography will be a great technology to help the diagnosis and treatment of skin cancer. Here is the news to follow.
clipped from www.medicalnewstoday.com

Special Ultrasound Accurately Identifies Skin Cancer

High-frequency ultrasound with elastography can help differentiate between cancerous and benign skin conditions, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).

Elastography was found to distinguish between benign and malignant lesions not by their visible appearance but by measuring their elasticity or stiffness. Since malignancies are stiffer than benign growths, elastography, when added to high-frequency ultrasound imaging of the skin, has potential to improve the accuracy of traditional clinical diagnosis of skin cancers and, in some cases, eliminate unnecessary biopsies of benign skin lesions. The procedure is noninvasive, convenient and inexpensive.
Source

Radiological Society of North America
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Approximately 90% of all skin cancers are believed to come from exposure to the sun’s ultra-violet rays.  These are the invisible rays and are part of the many forms of solar radiation.

Ultra-violet ray spectrum covers a range from about 4 to 380 nanometers (nm).  A nanometer is one billionth of a meter.  The whole spectrum is made up of three sections:  UVC rays from about 100 to 280nm, UVB rays from about 280 to 320nm, and UVA from about 320 to 400nm.

Only UVB and UVA reach the earth’s surface and are therefore the ones that have a strong bearing to our overall skin health.

UVB has longed been regarded as the tanning ray and is the strongest in the summer months.  In moderation, these rays help to induce tanning.  As a result, the skin is protected from too much exposure to the sun by thickening the epidermis (outer layer of skin).  However, more often than not, people are suffering from sunburn because of prolonged exposure to these rays.

UVA was regarded in the 80’s as the safe ray.  As a result, the use of UVA was widely promoted in tanning beds and tanning salons.  We now understand that UVA is not better off than UVB.  Indeed these rays can penetrate the skin more deeply, causing skin wrinkling and leathering. They can result in more permanent damages to the skin cells called keratinocytes in the basal layer of the epidermis, inevitably enhancing the chance of such damaged cells to becoming cancerous.

In order than we can effectively protect our body from UVA and UVB damages, using sunscreen products with a SPF of at least 15+ is highly recommended.

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People need to be reminded that the use of tanning beds and the like is closely relating to melanoma, and that this deadly cancer can be a build up from uv damages from young age.
clipped from professional.cancerconsultants.com
Tanning Beds Classified as “Carcinogenic to Humans”
The International Agency for Research on Cancer (IARC) now classifies tanning beds and other UV-emitting tanning devices as Group 1 carcinogens, meaning that there is sufficient evidence to conclude that these devices cause cancer in humans.[1] Use of tanning beds has been linked with an increased risk of melanoma, the most deadly type of skin cancer.
The strongest evidence for a link between indoor tanning and melanoma is found among individuals who were first exposed to indoor tanning at a young age. In a combined analysis of previously published studies, individuals who had their first exposure to indoor tanning before the age of 30 were 75% more likely to develop melanoma than individuals who had no exposure to indoor tanning. Exposure to indoor tanning was linked with a more than twofold increased risk of squamous cell carcinoma of the skin.[7]
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Basal Cell Carcinoma (BCC) is the most common form of all skin cancers. It accounts for about 75 percent of all skin cancers diagnosed in the US. Almost one out of five fair-skinned Americans would have at least one BCC in his or her lifetime.

Though it is generally found in Caucasian people, it has also been diagnosed in people with more pigmentation, including those of Asian or Mediterranean decent.

BCC develops from the basal cell layer of the epidermis. It usually grows very slowly and remains unchanged for years. It is labeled as non-melanoma because it rarely metastasizes or spreads to other parts of the body. However, if left untreated, all BCC can bleed or ulcerate.

They might appear as a small, shiny bump on the skin, in places that are often exposed to the sun, for instance, on the head, neck, arms, hands, and face.

Statistics show that there is a tendency of re-occurrence. 20 percent of people with a single BCC could develop a second one at another site within year, and 50 percent within three years. If there are two BCC at presentation, there is a 40 percent chance of developing a new one within a year.

Given this rate of re-occurrence, patients are advised to see their doctor twice a year for the first three years after treatment of the skin cancer, and then followed by yearly visits.

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This information from the Skin Cancer Foundation of Australia should prove to be helpful in identifying basal cell carcinomas.

clipped from www.skincancer.org

The Five Warning Signs of Basal Cell Carcinoma

An open sore that bleeds, oozes, or crusts and remains open for a few weeks only to heal up and then bleed again. A persistent, non –healing sore is a very common sign of an early basal cell carcinoma.
A Reddish Patch or irritated area, frequently occurring on the face, chest, shoulders, arms or legs. Sometimes the patch crusts, and it may also itch or hurt.

A Shiny Bump or nodule that is pearly or translucent and is often pink, red or white. The bump can also be tan, black or brown, especially in dark-haired people, and can be confused with a mole.
A Pink Growth with a slightly elevated rolled border and a crusted indentation in the center.
A Scar-Like Area which is white, yellow or waxy, and often has poorly defined borders. The skin itself appears shiny and taut.
If you observe any of the warning signs or some other worrisome change in your skin, consult your physician immediately.
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The following are the main causes of skin cancer.

1/ Ultra-violet rays from the sun – the two associated with skin cancer are UVA (ultra-violet A) and UVB (ultra-violet B) rays. UVB rays are the shorter-wave solar rays and are more unlikely to cause skin reddening and sunburn. UVA rays, however, would have more permanent damages to the skin as they penetrate much deeper to the skin. Latest studies show that UVA not only increases UVB’s cancer-causing effects, but may also directly cause some skin cancers, including melanomas.

2/ Family History – recent research confirms that the risk of melanoma is more than double in people with a family history of skin cancer. Though having someone in the family with skin cancer does not necessarily mean that you will get it too, it certainly warrants some extra attention because of the higher risk factor.

3/ Chemical Exposure – some chemicals might cause harm when they come into contact with your skin. Insecticides, for instance, often contain substances like arsenic that are dangerous to the skin. They can increase the risk of non-melanoma skin cancer. Nevertheless, people working in environments in regular contact with chemicals and industrial materials (such as petroleum derivatives, arsenicals, and coal tar) are more likely to develop some type of skin cancer.

4/ Smoking — whilst it is common knowledge that smoking is linked to other types of cancer such as mouth and lung cancers, the tobacco used in cigarettes etc could be a cause to developing skin cancer too.

5/ Radiation Exposure
– there are concerns that radiation therapy that some children undergo for other cancer treatments may increase the risk of developing a non-melanoma skin cancer. Also, people working with X-rays, including medical, nursing and radiographic personnels are subject to higher risks.

6/ Skin Condition and Geography
– certain skin conditions can increase a person’s risk of developing skin cancer. For instance, people with light to fair skin living in tropical or subtropical climates, such as the American Southwest, equatorial Africa, Hawaii, and Australia, generally have very high incidences of skin cancer. Serious injuries to the skin, if not healed in time, could raise the chance for non-melanoma skin cancer. Likewise for scars from very bad burns.

7/ Weak Immune System – the immune system is part of the body’s defense against bacteria and cancerous formations. When the immune system is strong, the antibodies and immune cells are better able to do their job in neutralizing the free radicals and getting rid of the harmful elements from the body. Conversely, a weak immune system would open up a lot of possibilities as cancerous cells could spread out fast and divide in ways that are hard to predict.

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Squamous Cell Carcinoma (SCC) is the second most common form of skin cancer. It is affecting around 200,000 Americans each year. Though it is also labelled as a non-melanoma type skin cancer (alongside Basal Cell Carcinoma), it can turn nasty and become fatal as 1-2 percent of cases will metastasize.

Metastasis is a key criterion for malignancy. When the cancerous tumor manages to penetrate from the epidermis layer into the dermis layer of the skin, it could spread out very fast, to lymph nodes, blood vessels, and so to distant sites inside the body.

Squamous Cell Carcinoma (SCC) and basal cell carcinoma share many common characteristics. For instance, it is usually found in the sun-exposed areas of the body. The commonest sites would include the head, the nose, temples, rim of the ear and lip, as well as the side and back of the neck, and the dorsal surfaces of the hand and forearm. SCC also occurs in sites of previous burns, scars, or chronic ulcers; or on the mucous membranes of the mouth.

It would normally appear as a red, scaling, well-defined plaque and may gradually develop into an ulcer, a scaly crust, or a wartlike surface. Eventually, it can spread into the deeper or surrounding tissues. They may become itchy or painful, and the lesion may start to bleed or ulcerate.

Reoccurrence is quite common amongst people who have had their SCC removed before. Typically, a reoccurrence might happen in the first two years of the previous removal and is likely to appear in the same skin area as to the previous presentation.

Sunlight, X-ray exposure, arsenic ingestion, and occupational carcinogens are all key contributing factors to this skin cancer. As such, getting to know about these causes and building the knowledge of defence would surely be the most meaningful strategy.

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For many years since the 80’s, people have been taking tanning salons, or tanning beds as a safe alternative to basking under the sun. These machines were said to produce UVA rays and not UVB rays which are the cause of most sunburns.

Researchers have since found that tanning beds do produce UVB rays as well. Besides, UVA rays are not as safe as once thought. These rays can penetrate deeper into the skin and cause damages to the dermis, the true skin.

Articles from the Skin Cancer Foundation reveal that the high pressure sunlamps used in tanning salons emit doses of UVA as much as 12 times that of the sun. As a result, people frequent tanning salons are 2.5 times more likely to develop squamous cell carcinoma, and 1.5 times more likely to develop basal cell carcinoma. In terms of the risk of developing melanoma, it is almost twice as often as other people. For youth exposing to tanning beds, the likelihood of melanoma happening in the latter part of their life could be as high as 75%.

The idea of using tanning beds to create a safe “base tan” first before exposing to the natural sun has proved false as well. It does nothing to prevent sunburn.

Getting your tan by way of the machine or directly from the natural sun is equally dangerous. The more we know about these ultra-violet rays, the more we have to ask ourselves the question: is the tan worth the risk?

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Actinic Keratosis (AK) is also known as solar keratosis.  Technically, it is not a skin cancer. It is considered non-malignant or pre-malignant.  However, it is still a concern because like moles, it can develop into skin cancer as well.

AK usually appears as a small crusty, scaly, or crumbly bump on the skin surface.  It can be hard to locate because it may be light or dark, tan, pink, red, or a combination of the above.  It can even be in the same color as the skin.  Because the scale or crust is dry and rough, in which case spotting them through touch is quite effective.

Occasionally, you might find AK bleeding, or having surrounding skin swollen with different shades of red.

They generally grow very slowly into a size of about a quarter inch in length. The usual places that they would appear include the face, lips, ears, scalp, neck, backs of the hands and forearms, shoulders, and back.  The one found on the lips, called actinic cheilitis, could evolve into a type of squamous cell skin cancer that can spread rapidly to other parts of the body.

Sun damage remains the key factor giving rise to AK’s.

The AK lesions can be eliminated quite easily if treated early.  It is safe as they haven’t developed into skin cancers yet.  However, if left untreated, about 10% may progress to squamous cell carcinoma.