skin cancer diagnosis

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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.

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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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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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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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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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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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Melanoma (meaning black tumor) is not only the most malignant of all skin cancers, but it is also among the most malignant of all cancers. It can spread to nearly every organ and tissue in the body and can lead to death within a year after it recurs in distant sites.

According to the American Cancer Society, the most recent estimates show that America alone has over 68,000 new cases of melanoma every year, and more than 8,500 deaths annually directly attributable to this type of skin cancer. The lifetime risk of getting melanoma is about 1 in 50 for whites, 1 in 1000 for blacks, and 1 in 200 for Hispanics.

Melanoma is a malignant tumor that originates in melanocytes located in the epidermis. These melanocytes are cells that produce melanin, the pigment that colors the skin, and protects it from harmful ultra-violet rays.

The majority of melanomas are brown or black. However, some are in the same color as the skin, or pink, red, purple, blue, or white. The usual sites of melanoma in white people include the head, neck, trunk, and limbs. In the black people, there is a good likelihood to show up on the palms of the hands, soles of the feet, and mucous membranes.

These tumors can also show up in somewhat unusual locations, such as under the nail of a finger or toe and on the mucosa lining inside of the mouth, vagina, or anus.

There are two phases of growth of melanoma – radially (outwardly on the surface of the skin) and vertically (deeply into the layers of the skin). Once the melanoma has penetrated deeply into the dermis of the skin, and has reached the lymphatic and blood vessels, the melanoma can utilize the lymphatics and bloodstream to spread to distant locations, most commonly to the lungs, liver, and brain. It is said to metastasize.

For patients with a melanoma less than 1mm thick, the likelihood of death due to the disease is only about 10%. However, this would rise to about 30% for a tumor with a thickness of 3mm.

Though we come across melanoma as a deadly skin cancer, there is a lot of hope for a 100 percent cure if it is detected and treated early. As a matter of fact, more than 90% of patients are alive for five years or more following their first diagnosis of melanoma.

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Skin cancer is amongst the most common forms of cancer found these days. It is also highly preventable and very curable if it is caught early enough.

There are three different types of skin cancers that can be found on your skin.

The first form of skin cancer to emerge is squamous cell carcinoma. These neoplasms typically develop in areas which have been exposed to too much sun, more often than not  the face and the ears. A lump or a swelling is often the first manifestation of squamous cell carcinoma, a type of skin cancer. If left untreated, it ulcerates into an unhealing open sore which continues to grow in size. In the later stages it can also spread to other parts of the body.

Basal cell carcinoma is another one of the types of skin cancers. These are generally found on the face, hands and neck and are as many as seventy five percent of all skin cancers that are diagnosed. Basal cell carcinoma is very treatable and can be cured quite easily if it is found early enough. The symptoms of basal cell carcinoma are a sore that bleeds and is irritated. It may also resemble a fresh scar.

The third type of skin cancer is the most dangerous of all of them. It is melanoma and it can be found on any area of the body. It is usually found on the arms and legs in the beginning. It will look like a mole or freckle that has recently appeared on the skin. It can also be from an existing mole that has recently changed its size, shape or color. The border of the melanoma will be indistinguishable and it may have more than one color.

It is imperative that the melanoma type of skin cancer be found and eradicated early to prevent the problems that will come with the later stages of this skin cancer.

There are many steps you can take to prevent skin cancer. Most importantly, try protect your skin from the sun whenever you are outside. It is a good idea to always wear sunscreen no matter what time of year it is.  Have enough clothing to keep the skin from over-exposure to the sun.  Have a hat handy to keep your face and head in shade.

In a nutshell, if you can keep an eye on your skin and be mindful of  early symptoms of cancer development, you would likely keep yourself out of trouble.

As always, your best chance is from prevention and awareness.