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Friday, November 8, 2019
Skin Cancer Essays
Skin Cancer Essays Skin Cancer Essay Skin Cancer Essay Skin cancer is a malignant neoplasm that develops from the cells of the skin. The cancerous growth tends to spreads to the other parts of the body. Usually skin cancers develop due to exposure to high amounts of ultraviolet radiation from the sun. The lesion can take various forms including ulcers; red, black, blue or brown lesions; swellings; cystic lesions; areas of degenerated tissues; crusts; scales; etc. What causes Skin Cancer? There may be a number of etiological factors for skin cancer. However, the most common seems to be constant exposure to ultraviolet rays from the sun. Individuals who constantly develop sunburns are at a greater risk of developing skin cancers. Other risk factors for the development of skin cancers include excessive scars present on the skin (which can undergo malignant transformation), infection with the human papilloma virus, exposure to carcinogen, exposure to other forms of radiation such as infrared, X-rays, or nuclear explosions, certain individuals with genetic disorders (in which the genetic material is defected and cannot repair normal damage suffered to the skin), presence of a large number of melanocytic nevi (moles) on the skin, white skinned individuals, previous history of skin cancers, genetic susceptibility to develop skin cancers, certain skin disorders, etc. Both genetic factors coupled with the environmental factors play a very important role in the development of skin cancer. Who gets skin cancer? Many individuals are at a higher risk of developing skin cancer compared to others. Some or the individuals at a risk of developing skin cancer include:-  ·Ã‚                    Fair-skinned individuals (compared to dark)  ·Ã‚                    Individuals having a previous history of skin cancers  ·Ã‚                    Individuals having a family history of the disorder (up to 10 % of all cases have such a history)  ·Ã‚                    Europeans are at a greater risk compared to Africans and Asians  ·Ã‚                    Individuals suffering from certain immune disorders (such as HIV/AIDS) or receiving certain drugs (such as immunosuppressant)  ·Ã‚                    Individuals suffering from pre-existing skin disorders (such as actinic keratosis, xeroderma pigmentosum, senile keratosis, lupus vulgaris, burns, warts, scars eczema, and Bowen’s disease)  ·Ã‚                    Individuals having a high number of melanocytic nevi (moles) present on the surface of the skin. Moles likely to be traumatized are at a higher risk of undergoing malignant transformation  ·Ã‚                    Individuals affected with certain pre-malignant skin disorders (such as carcinoma in situ)  ·Ã‚                    Individuals whose occupation requires them to work excessively in outdoors.  ·Ã‚                    Individual who stay closer to the equator  ·Ã‚                    Older individuals (there is a general increase in the cancer occurrence with an increase in the age)  ·Ã‚                    Individuals with light-colored hair  ·Ã‚                     Individuals exposed excessively to X-rays, infrared rays and other forms of radiation (such as nuclear explosions)  ·Ã‚                    Individuals exposed to noxious chemicals such as arsenic, tars, oils and solvents Different types of skin cancer (Basal Carcinoma, Squamous Carcinoma, Malignant Melanoma) MUST INCLUDE THESE 3 TYPES Skin cancers are of three types, namely basal cell carcinoma, squamous cell carcinoma and malignant melanoma.  Basal cell carcinoma is a slow-spreading cancer of the skin that develops in areas exposed to sunlight. It arises from the basal cells of the epidermis. The condition arises from exposed portions of the skin, and is by far the most common type of skin cancer. It is also known as ‘rodent ulcer’. Squamous cell carcinoma develops from flat cells present in the outer layer of the skin, usually due to long-term exposure from ultraviolet light and also exposure to infrared and X-rays (excessively). Malignant melanoma is a skin cancer that develops from the cells that produce the pigment melanin (melanocytes). It occurs less frequently compared to basal cell carcinoma and squamous cell carcinoma, but is by far the most dangerous of all conditions (as it tends to spread rapidly to the surrounding structures, regional lymph nodes and the distan t structures of the body. It more frequently occurs in fair-individuals compared to dark. Every ten year, the incidences of malignant melanoma are doubling primarily because of the increase in the ultraviolet ray emission from the sun. The incidence rates of squamous cell carcinoma and basal cell carcinoma is about 1, 000, 000, and about 1000 individuals die from the condition each year in the US. On the other hand, about 60, 000 new cases of malignant melanoma occur every year in the US, with about 8, 000 fatal outcomes. The problems with skin canceretc Squamous cell carcinoma is the second most common skin cancer after basal cell carcinoma. The tumor tends to spread to other parts of the body. The tumor appears as a scaly, crusted, growing swelling, or a non healing ulcer. It usually appears red in color and the borders appear rolled-out or indurated, suggesting the spreading nature of the tumor. The base of the lesion contains granulation tissue. It usually develops on the portions of the skin that are usually exposed to the sunlight such as the scalp, face, lips, nose, neck, upper limbs ears. Rarely, it can develop in other portions of the body such as the oral cavity, genitals, etc. The tumor tends to spread to the surrounding tissues and destroys them (locally invasive). More than 2, 500 individuals in the US die from squamous cell carcinoma every year. The tumor does not cause any pain or tenderness during the early stages of the disorder. The regional lymph nodes may be enlarged. Th e diagnosis of squamous cell carcinoma is confirmed through a biopsy of the lesion. The treatment varies depending on the size of the tumor, spread to various parts of the body, involvement of the lymph nodes and individual factors. The entire tumor, along with a margin of the healthy tissue and the involved lymph nodes are removed through surgery. Radiotherapy is recommended for superficial tumors and to reduce the chances of recurrence in those that cannot be completely removed through surgery (American Academy of Dermatology, 2006). The incidences of basal cell carcinoma are increasing each year by about 10 % due to increasing levels of ultraviolet rays. Most of the tumors occur on the head, face and the neck region, whereas less often it occurs on the upper limbs, intra-orally and the genitals. In women, the condition frequently occurs on the breasts. During the initial stages of the disease, the tumor appears translucent and pearly. The rodent ulcer variety is characterized by rolled out borders with an ulcer that does not heal. The tumor tends to spread very slowly, and invaded the local tissues. As it grows, the tumor tends to furrow in and degenerate the tissues. The individual may not develop pain, but a slight itch may be present. The regional lymph nodes are usually not involved. The tumor may also be nodular, cystic, pigmented, or morphoeic. The morphoeic variety is an aggressive version of the tumor that has irregular borders and spreads to other parts of the body ve ry quickly. The metastasis rates of basal cell carcinoma are as low as 0.0028% to 0.55%. The diagnosis of basal cell carcinoma is confirmed with the help of a biopsy. Superficial lesions can be treated with radiotherapy, whereas surgery can result in higher success and five-year survival rates. Several other techniques such as cryotherapy, Laser surgery, Grafting, curettage, local chemotherapy and photodynamic therapy may also help in the treatment of basal cell carcinoma. The outcome of basal cell carcinoma is much better than squamous cell carcinoma and malignant melanoma (C S M Wong. 2003). Malignant melanoma usually arises from normal skin (exposed to sunlight) or from moles. The lesion appears blue or bluish black. In a mole, the color changes and/or the size increases suggesting malignant transformation. The tumor can be present as a skin lesion, an ulcer, swelling, etc. The borders of the tumor appear irregular and it has a light halo surrounding it. The regional lymph nodes may be involved. Pain is usually present, but sometimes an itch develops. Frequently, the ABCDE criteria (Asymmetry, irregular Borders, Color appears different, Diameter below or above 6 mm, and Elevation) is utilized to assess the tumor. Melanomas can be classified into 4 types, including the superficial spreading type (flat, brown to black in color, frequent), nodular melanoma (blackish-blue or bluish-red raised lesion), Lentigo maligna melanoma (large, flat lesion), and Acral lentiginous melanoma (common in Blacks, Chinese and Japanese, and present in the hands and feet). Very rarely are systemic features (such as low-grade fever, anemia, weight loss, breathing difficulties, malaise, loss of appetite, etc) present. The tumor tends to invade the deeper tissues, spreads to the lymph nodes, and also to distant parts of the body resulting in distant metastasis. The diagnosis of malignant melanoma is made using excisional biopsy. Frequently, a biopsy of the regional lymph nodes and other tissues of the body may be required to detect involvement. The treatment of melanoma varies depending dimensions of the tumor, involvement of lymph nodes, neighboring structures and distant structures, and the individual factors (such as age, medical condition, etc). Small tumors are usually treated by excision of the lesion and a huge potion of the surrounding tissues. Several other treatment modalities such as chemotherapy, radiotherapy, immunotherapy, etc, may also be needed (NCI. 2003).
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