Skin Cancer ( Non- Melanoma )

Skin Cancer (Non-Melanoma)

The skin is the largest organ in the human body. It serves several critical functions:

• Protects the body from infections and injuries.

• Regulates body temperature.

• Stores water and fat.

• Produces Vitamin D.

Layers of the Skin:

1. Epidermis: Outermost layer.

2. Dermis: Middle layer.

3. Hypodermis: Innermost layer composed of fat.

What is Skin Cancer?

Skin cancer occurs when healthy skin cells grow uncontrollably to form a tumor. Tumors can be benign (non-cancerous) or malignant (cancerous).

Types of Skin Cancer

1. Basal Cell Carcinoma:

• Starts in the basal cells of the lower epidermis.

• Accounts for 80% of skin cancers.

• Often occurs on the head and neck due to sun exposure.

• Slow-growing and rarely spreads to other parts.

2. Squamous Cell Carcinoma:

• Forms in the squamous cells of the epidermis.

• Represents 20% of skin cancers.

• Sun exposure is a major cause.

• Common on the lips, scars, mouth, anus, and vagina.

• 2-5% may spread to other areas.

3. Merkel Cell Carcinoma:

• A rare but aggressive cancer that grows rapidly.

• Begins in hormone-producing cells, mostly on the head and neck.

4. Melanoma (Although not included under non-melanoma, for reference):

• Starts in the melanocytes, which give skin its color.

• The most aggressive form of skin cancer.

Risk Factors for Skin Cancer

Factors that increase the risk of developing skin cancer include:

• Sun exposure: Ultraviolet (UV) rays, especially UVB radiation, are the primary cause.

• Weakened immune system: Individuals with conditions like AIDS or those who underwent organ transplants are more prone to skin cancer.

• Indoor tanning: Use of tanning beds or sunlamps increases the risk of skin cancers, including melanoma.

• Fair skin: Individuals with lighter skin tones are at higher risk.

• Previous skin cancer or pre-cancerous conditions.

• Exposure to chemicals: Prolonged contact with arsenic.

• Human Papilloma Virus (HPV) or Merkel cell polyomavirus (MCV) infections.

• Prior radiation therapy.

Prevention of Skin Cancer

• Minimize sun exposure between 10 AM and 4 PM.

• Use sunscreens with SPF 30 or higher. Reapply every two hours.

• Avoid indoor tanning using tanning beds or sunlamps.

Symptoms of Skin Cancer

Basal Cell Carcinoma:

• Persistent open sores that bleed or ooze.

• Raised red patches.

• Shiny pink, red, or white bumps.

• Pink growths with raised borders.

Squamous Cell Carcinoma:

• Wart-like growths.

• Red patches with irregular borders that may bleed.

• Open sores that persist for weeks.

• Rough or scaly growths with a central depression.

Merkel Cell Carcinoma:

• Painless, shiny lumps or nodules.

• May appear in red, pink, or blue hues.

Diagnosis of Skin Cancer

• Biopsy: A sample of suspicious tissue is taken and examined under a microscope to confirm cancer.

Treatment Options for Skin Cancer

1. Surgery

• The tumor and surrounding healthy tissue are removed.

• Types of surgeries:

• Curettage and electrodesiccation

• Mohs micrographic surgery

• Wide excision

• Reconstructive surgery

2. Radiation Therapy

• High-energy rays destroy cancer cells.

• Used for areas difficult to operate, like the eyelids, nose, or ears.

• Radiation is also used after surgery if the cancer has spread to the lymph nodes.

3. Chemotherapy

• Drugs are used to kill cancer cells.

• Topical chemotherapy involves applying medication directly to the skin for early-stage cancers.

• Common drugs:

• Diclofenac (Solaraze)

• Fluorouracil (5-FU)

• Ingenol mebutate (Picato)

• Imiquimod (Aldara, Zyclara) for small basal cell cancers.

4. Targeted Therapy

• Focuses on specific genes or proteins in cancer cells.

• Drugs used for large or inoperable basal cell carcinoma:

• Vismodegib (Erivedge)

• Sonidegib (Odomzo)

5. Immunotherapy

• Boosts the immune system to fight cancer cells.

• Drugs used for non-melanoma skin cancers:

• Cemiplimab (Libtayo)

• Pembrolizumab (Keytruda)

• Avelumab (Bavencio)

Follow-up Care

Regular follow-ups are essential to:

• Monitor for recurrence.

• Manage any side effects from treatment.

• Include physical exams, blood tests, and imaging tests.

Non-melanoma skin cancers, when detected early, have excellent treatment outcomes. Consistent sun protection and regular check-ups are vital to prevent recurrence and manage side effects effectively.

‍