Skin cancer: Get informed

The skin is an essential organ of the body that completely covers each individual. This organ is a natural defense barrier and helps protect the body from external elements, such as pollutants and chemicals.

The skin allows an individual to experience the sensation of touch, including detecting pressure, and variations in temperature, all of which aids in the perception of pain and other sensations of contact.

The skin consists of three layers:

- Epidermis: the most superficial part of the skin that acts as a barrier against external elements, such as UV rays or any other external force. Keratinocytes represent 80% of the cellular population of the epidermis.

- Dermis: located below the epidermis; ensures the hydration and nutrition of the skin. The dermis also protects the body against foreign bodies.

- Hypodermis: the deepest layer of the skin; contains the adipocytes (fat cells). Its role is essentially to insulate the body so that the body stays warm.

The Different Forms of Skin Cancer

Skin Carcinoma

Skin carcinomas occur most often after the age of 50 and are the most common form of skin cancer. Each year 200,000 new cases are discovered. Slowly progressing, these cancers are found on the superficial part of the skin, the epidermis. They often occur in areas affected by sunburn, such as the arms, shoulders, neck, back, and hands.

In general they are benign and easily treatable if detected in time.

Skin Melanoma

The second form of skin cancer, which is much more aggressive, is skin melanoma. It can affect both young people and adults and has no specific location. Its evolution can be very rapid.
It can be recognized by the development of a pigmented spot on the skin that looks like a mole. In nearly 80% of melanoma cases, an abnormal mole (bright color, irregular shape and contours, increasing in size) is present.

A change in color and shape of an existing mole can be a sign of skin melanoma. Bleeding and brightly colored lesions appear and persist. With regard to the hands and nails, melanoma is characterized by the presence of a new brown band under the nail.

Women generally are diagnosed earlier (58 years old compared to 60 for men), but their 5-year survival rate is better than that of men: 89% compared to 83%. It should also be noted that melanoma is a cancer whose incidence rate is constantly increasing.

Causes of Skin Cancer

Skin cancer has several factors that contribute to its onset, including:

- Ultraviolet Rays,whether artificial or natural (sun): protect yourself with sunscreen, avoid exposure to the sun during the hottest hours of the day and do not use tanning beds.

- Melanoma Genetic History: A family background can predispose someone to skin cancer, as well as a personal history of melanoma.

- Total Number of Moles: The more moles an idividual has, the greater the risk of developing melanoma. One should monitor their moles and consult a dermatologist or health professional immediately upon development of heterogeneous color, irregular edges, and a diameter of more than 5 millimeters.

- Skin Type (Phototype). The lighter the skin and hair, the greater the risk of developing melanoma.

People who understand these risk factors are advised to discuss them with their doctor. The doctor will then assess whether or not it is necessary to take specific preventive measures or undergo specific care. A dermatological consultation may, for example, be prescribed. Prevention is also a way to limit the extent of risk factors. It is sometimes recommended to have regular medical check-ups and self-monitor.

Skin Cancer Treatments

The choice of treatment for skin cancer depends on the stage of melanoma development, the location, and the patient's health status (age, physical condition, etc.). In addition, patient input and multidisciplinary discussion among health professionals are fully integrated into the treatment choice process.

The eradication of melanoma, stopping its proliferation, reducing the likelihood of relapse, and reducing skin cancer pain and symptoms to ensure better comfort for patients are all different goals that skin cancer treatments offer.

Surgery is the main option for treating skin cancer. It allows for the melanoma to be surgically removed from its location. As a complementary treatment, immunotherapy is proposed to limit the probability of relapse. These two combined treatments are proposed in stages I and II of skin cancer.

Stage III corresponds to an extensive skin melanoma with similar metastases. For treatment, surgery is first performed. As an adjuvant treatment, immunotherapy is proposed. It is done by alpha interferons and its objective is to reduce the risk of recurrence as much as possible. External radiotherapy is another complementary treatment to surgery.

If it is impossible to perform surgery to remove the melanoma, chemotherapy is an option available.

If melanoma is spread with distant metastases (stage IV), available treatments are surgery, immunotherapy, and chemotherapy. In particular, external radiotherapy and chemotherapy are proposed as palliative treatments. This means that their objective is to limit the development of skin cancer; reduce/relieve related symptoms, such as pain; and improve quality of life.

More rarely, the following treatments can be proposed:

- Destruction of metastases by radiofrequency: the destruction of cancer cells by the application of waves that emit very high heat.

- Cryosurgery of liver metastases: this local treatment of metastases is limited to the introduction of needles that will freeze the tumor in intense cold.

- Chemotherapy on an isolated limb.

Published Apr 29, 2019