Skin cancer is a malignant disease of the skin. This form of the tumor process is considered one of the most common in the world. Until now, specialists in the field of oncology have not established the exact causes of the pathological focus. Like many other oncological neoplasms, skin cancer is a multi-etiological disease. There are predisposing factors and precancerous diseases, the presence of which increases the possibility of developing a skin tumor process. Depending on the stage and type of cancer, appropriate treatment is selected. You can suspect the presence of skin cancer yourself by examining the skin, paying special attention to nevi. The prognosis for life and disease when a tumor of the skin surface is detected also depends on the form and stage of the process. In accordance with the international classification of diseases (ICD-10), skin cancer is coded C43-C44.
Causes of skin cancer
Currently, there is no clear answer to the question of what causes skin cancer. Like many other oncological diseases, skin tumors are considered a multi-etiological pathology. There are several predisposing factors, the presence of which increases the risk of developing a tumor focus. These include:
- Excessive exposure to ultraviolet rays on the skin. A similar situation occurs with prolonged and frequent exposure to sunlight, visiting a solarium, or working outside. Residents of the southern regions are at risk of developing skin cancer.
- Having light skin. Lack of melanin production increases the likelihood of skin tumors.
- Skin burn. A high degree of burn is accompanied by scarring of the skin. This process contributes to the emergence of latent carcinogenesis.
- Irradiation. Exposure to radioactive, ionizing rays has a detrimental effect on the skin. The risk of radiation dermatitis increases.
- Presence of skin contact with toxic substances. This group of carcinogens includes arsenic, aluminum, titanium, nickel and other heavy metals.
- Immunodeficiency. Conditions in which the body's protective functions decrease predispose to the formation of a tumor focus.
- Age. Most often, skin tumors affect people over 50 years of age.
- Concomitant systemic diseases. Doctors identify a group of pathologies in which the risk of developing skin cancer increases significantly. These include systemic lupus erythematosus, leukemia, and chronic skin diseases.
- Heredity. The presence of a skin tumor in previous generations of relatives is not a major risk factor. However, family history in combination with other predisposing conditions increases the possibility of developing skin cancer.
- Tattooing. In this case, there are two risk factors. This is a violation of the integrity of the skin and the introduction of paint with carcinogenic substances. Cheap tattoo ink may contain impurities of aluminum, titanium, and arsenic.
- A large number of nevi. Doctors urge you to monitor the condition of moles and contact a specialist if there is the slightest change. Traumatization of nevi increases the possibility of developing skin cancer.
- Excessive alcohol consumption, smoking. Chronic intoxication has a detrimental effect on the body as a whole. Against this background, the risk of tumor formation increases several times.
- Eating foods high in nitrates.
Oncologists identify several precancerous conditions, the presence of which significantly increases the risk of developing skin cancer. These include:
- Xeroderma pigmentosum.
- Bowen's disease.
- Paget's disease.
- Hyperkeratosis.
- Cutaneous horn.
- Late stage radiation sickness.
- Dermatitis and dermatoses.
Expert opinion
Author:
Alexey Andreevich Moiseev
Oncologist, chemotherapist, Ph.D.
Every year, 9,000 cases of newly diagnosed melanoma are registered in Russia. This aggressive malignant tumor is responsible for the death of 40% of patients. Such statistics indicate that the country's population is not sufficiently aware of the symptoms of melanoma. As a result, a visit to a doctor occurs in the later stages, when treatment is considered ineffective.
Doctors at the Yusupov Hospital determine the location of melanoma and prescribe treatment appropriate to the stage of tumor development. An individual approach to the problem of each patient allows us to reduce the number of deaths. A tumor detected in time is characterized by a favorable prognosis for recovery. The later melanoma is detected, the longer the treatment process will be. Its success depends on many factors. The main treatments for melanoma are surgery, radiation and chemotherapy. Depending on the condition, symptomatic therapy is carried out.
You can diagnose the presence of skin cancer yourself at home. Doctors recommend regularly examining the skin, especially nevi, for the appearance of pathological formations.
Why does melanoma develop?
There is no answer to the question of why malignant transformation of melanocytes occurs and melanoma develops. However, risk factors have been identified that increase the likelihood of developing a tumor:
- Skin phototype 1-2 are people with fair skin, blond or red hair.
- Frequent sunburn, especially in childhood and adolescence.
- Prolonged exposure to the sun.
- The presence of melanoma in close relatives.
- The presence of more than 100 moles on the body, or a large number of birthmarks (50) in people under 20 years of age.
- Dubreuil's melanosis.
- Genetic predisposition.
- Hormonal changes - puberty, menopause.
Traumatization of moles is of great importance; in some cases, in order for melanoma to develop, it is enough to traumatize the pigmented nevus 1-2 times. It must be borne in mind that traumatization can be chronic. For example, birthmarks are often injured by clothing when they are located on the neck, in the groin folds, or on the torso.
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Symptoms and signs of skin cancer
The clinical picture of skin cancer development depends on its type. Often the first signs of a tumor are mistaken for other skin diseases. This results in untimely consultation with a doctor and the spread of the malignant process. Common signs for all types of skin cancer are:
- The appearance of a small spot or lump on the skin. The color of the formation can be pinkish, gray-yellow. It is noteworthy that the color of the neoplasm differs from moles and freckles.
- Uneven shape and asymmetric contours of the pathological focus.
- The appearance of itching and slight discomfort in the area of the tumor process. This symptom appears some time after the formation of cancer.
- Progressive growth of the tumor.
- Fatigue, weakness, sudden loss of strength.
- Decreased appetite, resulting in sudden weight loss.
- As cancer develops, regional lymph nodes are affected.
If any of the above symptoms appear, it is recommended to seek medical help. Depending on the type of skin cancer, the following symptoms are distinguished:
1. Basalioma. It is the most common form of skin tumor. It is characterized by a favorable prognosis when detected at the initial stage. Appears in the form of a nodule, painless on palpation. It has a grayish-pink color. The surface of the nodule is usually smooth. Scale formation is possible. As the tumor process spreads, the affected area increases. The neoplasm is covered with a bloody film. The predominant localization of basal cell carcinoma is the face, neck, and arm area. Basalioma does not cause a significant change in condition. This is the reason for late seeking medical help.
2. Squamous cell carcinoma. At an early stage, it looks like a dense red or brown nodule. A tumor of this type is prone to rapid decay, and therefore, as the process progresses, an ulcer forms. Its edges are heterogeneous, the ulcer often bleeds. Squamous cell carcinoma quickly grows into nearby tissues. If detected at a late stage, metastasis to regional lymph nodes or organs is possible.
3. Melanoma. Refers to an aggressive type of tumor. Most often, melanoma occurs at the site of an injured nevus, which increases in size, changes color and acquires uneven contours. A characteristic feature of this type of cancer is the asymmetric form of formation, as well as a tendency to bleed. The malignant neoplasm itches and increases in size. As the process progresses, the tumor turns into an ulcer. Melanoma progresses rapidly and often metastasizes.
4. Adenocarcinoma. At the initial stage of development, it looks like a dense nodule. It is most often localized in the armpit area, under the breast. With the development of the tumor process, adenocarcinoma grows into nearby tissues. This type of tumor is detected extremely rarely and is characterized by slow growth.
Causes of skin tumors
In rare cases, a skin tumor is caused by one reason; as a rule, there is a complex of reasons:
- ultraviolet irradiation;
- heredity;
- exposure to aggressive chemicals - arsenic, tar, resins, fuels and lubricants. The process leads to mutations in skin cells and triggers the degeneration of healthy tissues;
- exposure to radiation, which provokes the appearance of atypical cells;
- changes in scar tissue formed after burns or deep wounds;
- transformation of moles due to an excess of melanin. A minor injury or sunburn causes their accumulation to accelerate their growth and degenerate into cancer.
Some diseases are considered precancerous and in most cases develop into cancer. These include: Bowen's, Paget's, Keir's diseases, congenital hypersensitivity to ultraviolet radiation.
Some of the reasons are diseases that can become malignant under the influence of ultraviolet radiation, poor ecology, pathologies of the endocrine system, and bad habits. These include: trophic ulcers, skin manifestations of syphilis, tuberculosis, lupus erythematosus, cutaneous horn, thickening and keratinization of the skin in old age, senile keratoma.
Types of skin cancer
Depending on the type of cells from which the tumor is formed, there are several main types of skin cancer. Determining the structure of the tumor is necessary to clarify the diagnosis and carry out appropriate treatment. In addition, the speed of its spread and further prognosis depend on the type of cancer. Oncologists distinguish the following types of skin cancer:
1. Basal cell (basalioma). Basal cell carcinoma is the most common form of skin cancer. It originates from the basal cells of the epithelium. Basalioma is characterized by slow, sudden development and a relatively favorable course. Unlike other types of skin cancer, it rarely metastasizes. Basal cell carcinoma is usually localized in the area of the nose, bridge of the nose, eyebrow, upper lip and nasolabial fold. A rare location for this type of cancer is the neck and ears. There are several forms of basal cell carcinoma:
- Nodal. The most common location of nodular basal cell carcinoma is the head and neck area. At an early stage it looks like nodules up to 5 mm in size. As the tumor process develops, the nodules merge with each other. At a late stage, nodular basalioma is a deep ulcer with necrotic areas.
- Superficial. This type of basal cell carcinoma is located on the trunk and limbs. The tumor looks like a round pink spot with ulcerations. Superficial basal cell carcinoma is considered the most favorable and non-aggressive form of skin cancer.
- Scleroderma-like. Refers to an aggressive type of cancer. Located in the deep layers of the skin. The most common location for this type of tumor is the head and neck. Basalioma has the appearance of a plaque, which in the later stages of the process has the appearance of a depressed scar.
- Cystic. A rarely detected form of basal cell carcinoma, externally similar to a cyst.
- Fibroepithelial. Located in the lumbar region. Basal cell carcinoma has the appearance of a pedunculated polyp. The fibroepithelial form is extremely rare and has a favorable course and prognosis.
2. Melanoma. Refers to an aggressive type of skin cancer that originates from melanocytes. Melanoma is characterized by rapid growth and invasion into neighboring tissues. This type of skin cancer metastasizes not only to regional lymph nodes, but also to organs. A favorable prognosis for melanoma is only possible if the tumor is diagnosed at an early stage. Women with fair skin are at risk for developing skin cancer. Often injured nevi, warts, and pigment spots degenerate into melanoma. Distinctive features of this type of tumor are its uneven shape, asymmetrical edges, pain and bleeding in the early stages of the process. Melanoma is often located on the skin of the face, chest, arms and legs.
3. Squamous. Squamous cell carcinoma is the 3rd most common type of skin cancer. It develops from the outer layers of the skin. It is characterized by slow development, which increases the possibility of detecting a tumor at an early stage. At the initial stage, squamous cell skin cancer looks like a red lump up to 2 cm in diameter. Because of this, squamous cell carcinoma is often mistaken for inflammatory diseases of the skin. It is localized in the eyes, mouth, lips, genitals and mucous membranes. Squamous cell skin cancer has a tendency to metastasize.
The above forms of skin cancer are diagnosed most often. They account for about 90% of all detected oncological processes of the skin. In addition, there is skin appendage cancer, which is extremely rare. This type of tumor includes:
- Adenocarcinoma. Comes from the sweat and sebaceous glands. Characterized by slow growth. Outwardly it looks like a dark blue node, localized in the groin and chest area. Adenocarcinoma does not tend to grow into adjacent tissues, and metastasis rarely occurs. The tumor is removed surgically.
- Verrucous carcinoma. Refers to a very rare form of squamous cell carcinoma. Outwardly it resembles a wart, so detection at an early stage is difficult. A distinctive feature of verrucous carcinoma is its bleeding.
Classification
Osteogenic sarcoma is considered the most aggressive cancer that affects the bone structure. This type of neoplasm is more common than others. Less commonly diagnosed are chondrosacroma and chondroma, which are characterized by slow development.
Malignant tumors of the skin of the hands are classified into melanoma, basal cell carcinoma and squamous cell carcinoma. The first develops due to the degeneration of cells that produce the pigment melanin. Melanomas are small spots on the surface of the skin that sometimes bleed.
Basaliomas develop in the deep layers of the epidermis. This type of cancer causes scaly plaques to appear on the surface of the skin, with ulcers forming in the center.
Squamous cell carcinoma occurs on the surface of the hands. The course of the tumor process is accompanied by ulceration of skin tissue.
What does the initial stage look like?
Symptoms of a skin tumor depend on its type. Growth rate, color, and tendency to metastasize are characteristic of each form of cancer. However, at the initial stage, several symptoms are common to all types of tumor. These include:
- The presence of a formation on the surface of the skin with unclear shapes and asymmetrical contours.
- The appearance of itching and changes in the color of the lesion as the process progresses.
- A sharp loss of strength, increased fatigue.
- Loss of appetite, sudden weight loss.
- The presence of pain in the area of the tumor.
Skin cancer develops through 4 stages. Each reflects the size of the lesion, its spread to surrounding tissues, and the presence or absence of metastases. Depending on this, the following symptoms of skin tumors are distinguished:
- First stage. At this stage of skin cancer formation, there are no specific signs. The size of the tumor focus is up to 2 mm. In this case, the general condition does not change. Detecting cancer at the first stage is possible only with a thorough self-examination of the skin.
- Second stage. The growth of the tumor leads to the appearance of the first subjective signs. These include itching and pain in the area of the pathological focus. The cancer increases in size up to 4 mm.
- Third stage. The tumor focus has a diameter of more than 4 mm. At this stage of skin cancer, the process spreads to regional lymph nodes.
- Fourth stage. Late stage skin cancer is characterized by the appearance of metastases. The tumor grows into nearby tissues. The clinical picture is accompanied by the appearance of symptoms of tumor intoxication (cachexia, weakness, lack of appetite, headache).
Lack of medical care in the early stages of skin cancer leads to rapid progression of the process. As the tumor develops, nearby organs and lymph nodes are affected. The appearance of the lesion in the form of an ulcer contributes to the addition of a secondary bacterial infection. There are often deaths due to the development of sepsis.
Diagnosis of skin cancer
An integrated approach to diagnosing skin cancer is the key to timely detection of the tumor process. In order to determine the presence of skin cancer, it is necessary to conduct an examination. The first signs of skin cancer can be detected on your own. For this purpose, the ACORD principle is used.
- A – asymmetry. A lesion that has an uneven and asymmetrical shape requires close attention from a doctor.
- K – edge. A malignant neoplasm of the skin is characterized by jagged edges. The appearance of such a sign requires immediate contact with a dermatologist.
- O – coloring. Skin cancer is characterized by the appearance of a red, dark blue, or black lesion.
- R – size. The tumor process often has a diameter greater than 6 mm.
- D – dynamics. The growth of education in size requires a visit to a doctor.
The appearance of any of the above symptoms requires immediate medical attention. At the appointment, the specialist examines the formation using an epiluminescent microscope, which allows him to differentiate various skin diseases.
- Collecting anamnesis of illness and life. At the doctor's appointment, complaints are collected, the time of occurrence of the pathological formation, and the presence of predisposing factors. Precancerous diseases are determined, and the rate of development of the lesion is determined.
- General analysis of urine and blood. Laboratory diagnostics allows us to determine the presence of an inflammatory process in the body.
- Blood test for tumor markers. Specific markers for the presence of skin cancer are TA 90 and SU 100. Their determination is diagnosed already in the early stages of the tumor process.
- Tissue biopsy of pathological formation. It is one of the most important methods for diagnosing skin cancer. Histological examination makes it possible to differentiate the neoplasm, determine its stage and type. In cases where there is a metastatic lesion, a biopsy of the affected areas is performed.
- MRI and CT diagnostics. Instrumental research methods are carried out to identify metastases.
- PET-CT. This diagnostic method allows you to determine the localization of metastases. The study is carried out using a contrast agent injected into the body before tomography.
- Ultrasound. Ultrasound diagnostics helps to identify damage to the lymph nodes, as well as changes in other organs if metastases are suspected.
Detection of skin cancer at the initial stage of development allows for timely treatment and provides a favorable prognosis. Therefore, if you have the first signs of the disease, you should seek medical help. The Moscow Yusupov Hospital has modern equipment that allows you to accurately determine the type and stage of cancer, as well as the presence of metastases. Highly qualified doctors, based on the obtained diagnostic data, select individual correct treatment.
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Prevention of melanoma
- Since melanoma often develops from moles, it is recommended to conduct regular self-examination of the skin to check for changes in existing nevi and monitor the appearance of new ones.
- If you have a large number of moles, it is recommended to avoid tanning and exposure to direct sunlight.
- When tanning, you must use sunscreen.
- Avoid exposing unprotected skin to direct sunlight.
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| Diagnosis of melanoma | from 5100 rub. |
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Skin cancer treatment
The answer to the question whether skin cancer is curable or not depends on several factors. When selecting treatment, the type and stage of the tumor process are taken into account. The earlier cancer is detected, the better the prognosis. The main types of treatment for skin tumors are:
- Surgical intervention.
- Radiation therapy.
- Chemotherapy
- Cryosurgery.
- Laser therapy.
- Drug treatment.
Surgery
Surgical removal of the tumor is the most affordable method of treating skin cancer. Surgery is most effective in the early stages of cancer development due to the lack of tumor growth into nearby tissues. The surgeon removes the tumor and all affected areas. In the presence of metastatic lesions of the lymph nodes, their removal is indicated. If an aggressive form of the tumor develops, surgical intervention alone is not enough to completely get rid of the pathological focus.
A modern method of surgery to remove skin cancer is micrographic surgery using the MONS method. In this case, tumor cells are removed layer by layer under microscopic control. Each removed layer is sent for histological examination. The operation is stopped only after histological confirmation of the absence of malignant cells. Minimal cosmetic defect of the skin is an advantage of this method of surgical treatment.
Chemotherapy
It is carried out both as an independent method of treatment and in combination with surgical intervention. Prescribing chemotherapy before surgery is intended to reduce the pathological focus. The purpose of this method of treating skin cancer after surgery is designed to completely destroy cancer cells. The disadvantage of this method is the inability to exclude the effects of drugs on healthy cells. The question of the need for chemotherapy is decided by the attending physician based on the individual characteristics of the development of the tumor process.
Radiation therapy
This treatment method is used in cases of ineffectiveness of a surgical operation, in combination with it, and also when surgical intervention is impossible. The positive effect of radiation therapy occurs at the initial stages of cancer formation. The method is based on the effect of ionizing radiation on cancer cells. The disadvantage of this treatment is the detrimental effect of ionization on the entire body.
Cryosurgery
This treatment method is most often used when cancer is localized in the facial area. The tumor is cauterized using liquid nitrogen. After this, it is removed without severe trauma to the skin. Cryodestruction is effective in the early stages of the tumor process. In the case of a late stage, as well as in the presence of aggressive forms of cancer, this method of treatment is not used.
Laser therapy
This method was developed relatively recently. The feasibility of using radiation therapy without prior surgery is still being debated. The treatment method is based on the impact on the pathological focus using a laser beam. Before this, photosensitization is performed, thereby increasing the sensitivity of cancer cells to light.
Drug treatment
As the tumor process progresses, corresponding clinical symptoms appear. The main ones include pain and itching. To symptomatically combat these symptoms, non-steroidal anti-inflammatory drugs are prescribed to relieve pain due to skin cancer.
| Stage | TNM | Treatment method |
| 1 | T1-4N0M0 | At the initial stage of the tumor process, treatment consists of surgery with excision of the pathological focus. |
| 2 | T1-4N0M0 | At this stage, the tumor does not metastasize or grow into nearby tissues. Therefore, surgical intervention is considered sufficient treatment. |
| 3 | рTN1-3M0 | The stage is characterized by growth into nearby tissues and damage to regional lymph nodes. Therefore, the scope of treatment is:
|
| 4 | pTрNM1 | The spread of the tumor process affects the lymph nodes and organs. The fourth stage is characterized by multiple metastases. The volume of therapy depends on the general condition and is selected strictly individually. Treatment is as follows:
|
Forecast
The average life expectancy of patients diagnosed with skin cancer depends on several factors. These include the type of cancer, its stage, and the presence or absence of metastases. Detection of a tumor focus at the initial stage contributes to timely treatment and minimal risk of complications. In addition, each type of cancer has its own prognosis. Squamous cell and basal cell carcinomas are characterized by a favorable course and prognosis. Melanoma is an aggressive type of tumor that tends to grow rapidly and metastasize. The average five-year survival rate after skin cancer is diagnosed is:
- 80-100% when skin surface cancer is detected in the first stages.
- Up to 50% when skin cancer is detected at a late stage.
- Up to 25% in the presence of metastases in regional lymph nodes and other organs.
In order to minimize the risk of developing a tumor, it is necessary to prevent skin cancer. It is recommended to limit the time spent under ultraviolet rays and avoid excessive consumption of alcohol and nicotine. If there is an occupational hazard, it is required to undergo an annual medical examination to detect pathology at an early stage. In addition, it is necessary to wear protective suits that limit skin contact with carcinogenic substances. One of the cancer prevention measures is self-examination of the skin. Any changes require immediate medical attention to diagnose the disease.
How is the disease diagnosed?
After examining the patient, the dermato-oncologist prescribes studies and tests to diagnose skin cancer and determine the extent of tissue damage:
- cytological examination of a smear from the surface of the ulcer;
- tumor biopsy for histological examination of the affected tissue;
- lymph node biopsy according to indications;
- Ultrasound of the area where the tumor is located, as well as internal organs;
- X-ray of the lungs;
- computed tomography, etc.
Examinations of internal organs are necessary to ensure that there are no neoplasms or metastases in them.
How is skin cancer treated?
The Moscow Yusupov Hospital has been diagnosing and treating skin tumors for many years. Thanks to modern equipment, skin cancer can be detected in the shortest possible time, and its type and stage can be accurately determined. This is necessary to determine further treatment tactics. Highly qualified doctors of the medical institution select individual therapy, taking into account the obtained diagnostic data. In their work, specialists at the Yusupov Hospital use current recommendations for the treatment of skin cancer. You can make an appointment with an oncodermatologist and learn more about prices by phone.
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