Skin oncology signs. Skin cancer - the first signs, symptoms, causes and treatment of skin cancer. Types and forms of pathology

Skin cancer is a concept that unites a number of malignant skin tumors. Most often, skin cancer cancer affects exposed parts of the body, in particular the face (about 70% of all cases). In this case, on the face, most often the tumor affects the forehead, nose, temples, corners of the eyes, auricles. On the body and limbs, cancer is less common (5–10%).

Skin cancer: causes

There are several predisposing causes that contribute to the appearance of malignant skin tumors, namely:

Long-term exposure of the skin to UV rays. This can be proved by the fact that residents of the southern regions suffer from skin cancer much more often than the northern ones.
Skin exposure to radiation.
Long-term thermal effect on the skin.
Chemical impact. For example, contact with soot, various resins, tar, arsenic.
Hereditary predisposition to skin cancer.
Frequent use of drugs that suppress the immune system (anticancer, corticosteroids.
Age over 50 years. At a younger age, malignant skin diseases appear less frequently, and skin cancer in children is diagnosed even less frequently (0.3% of all cancers).
Mechanical injuries of nevi, birthmarks, scars.

In addition to the above causes of skin cancer, there are also a number of diseases that are considered precancerous. Precancerous diseases are divided into obligate and facultative precancer. Obligate precancer, as a rule, is a rare, slowly developing disease, which, however, completely turns into cancer. These include:

xeroderma pigmentosa
Paget's disease
Bowen's disease
erythroplasia of Queira

Optional precancers include all kinds of chronic skin diseases: dermatitis, inflammatory and dystrophic processes. Slow-healing wounds and skin ulcers are also considered facultative precancer.

Types of skin cancer

Types of skin cancer are, in fact, varieties of malignant skin tumors.

There are three main types of skin cancer:

Basalioma (or basal cell carcinoma). This tumor develops from the basal cells of the skin epithelium. It is the most common type of skin cancer (75% of all cases). It is characterized by slow growth without metastasis, so some researchers consider basalioma an intermediate type of tumor (between malignant and benign types).
Squamous cell skin cancer (squamous cell carcinoma). This type of cancer is much less common than basalioma, but it is characterized by very active growth and metastasis (mostly in the lymphogenous way). Metastases most often affect the lymph nodes (10% of cases), much less often the lungs are affected (in rare cases, hematogenous metastases). Squamous cell skin cancer, as a rule, is distinguished by single tumors located on any part of the body.
Malignant melanoma. This tumor develops from the two types of cancer listed above (basal cell and squamous cell). The disease develops from skin cells that produce the pigment melanin - melanocytes, which are located in the epidermis (on the top layer of the skin). Uncontrolled division of melanocytes leads to malignant melanomas. In the early stages, melanoma responds well to treatment, and when the disease is advanced, it penetrates into the deep layers of the skin, enters the blood and lymphatic system, and quickly spreads throughout the body.

Rare types of skin cancer

There are two other types of skin cancer that are extremely rare (0.5% of cases):

Merkel cell cancer is a very malignant tumor (distant and regional metastases appear in more than 50% of cases) located, usually on the skin of the face and head (in very rare cases, on other parts of the body). It occurs mainly in the elderly
skin sarcomas - appear from parts of the connective tissue of the skin and its appendages. It mainly affects the skin of the limbs and trunk. There are several types of this cancer, the most common being Kaposi's sarcoma and dermatofibrosarcoma bulging.

Skin cancer: symptoms

Those wishing to know how skin cancer manifests itself should familiarize themselves with the list of main symptoms. There are reliably identified signs of skin cancer, if found, you should immediately consult a doctor.

These include the following events:

Bleeding and long non-healing wounds or ulcers on the body (regardless of their size or location)
A persistent reddish patch that may occasionally dry out or peel off
A gradual increase in the size of the irritated skin area (regardless of the symmetry or asymmetry of its borders), which does not disappear
Any neoplasm (birthmark, bump, nodule) with a smooth texture and a shiny surface (regardless of its color, which can be pink, red, white, purple, brown or their shades)
A white, scar-like, smooth patch that is less firm than the surrounding skin
The appearance of a plaque on the skin with a depression in the middle Change in moles on the body: thickening, enlargement, inflammation, swelling, discoloration
The appearance of a dark (pigmented) spot, itching and bleeding from it

Forms of skin cancer

There are three main forms of skin cancer:

surface form. The appearance on the skin of dense nodules of a whitish and yellowish tint. These are the first signs of skin cancer, which develop over time into painless plaques with an uneven contour, inside which a depression appears (sometimes a crust appears in it, upon removal of which a drop of blood appears). This form of thicket skin cancer is seen in basal cell carcinoma.
infiltrating form. The tumor in this form looks like a deep ulceration with roller-like dense edges and bumpy crusts of dead skin cells. Such a tumor quickly grows into the surrounding tissues, becoming immobile. As a rule, this form, from the point of view of histology, is characteristic of squamous cell carcinoma.
papillary form. The rarest form of cancer, which is a tuberous tumor strewn with papillae. With this form of cancer, the tumor quickly grows in depth and outward, actively metastasizes, greatly debilitating the patient.

Skin cancer stages

Each type of skin cancer has its own characteristics of development. Summarizing, we can say that there are four stages of skin cancer:

Stage I: a mobile malignant formation (tumor or ulcer), having a size of up to 2 cm in diameter, not metastasizing;
Stage II: a malignant tumor larger than 2 cm in diameter, which has grown into the depths of the skin and metastasizes to the lymph node (closest to the site of the lesion);
Stage III has two options:

The tumor is quite large, with limited mobility, which has grown through the entire thickness of the skin, affected the soft tissues without affecting the bones and cartilage. No metastases.
A tumor of the same size (or smaller), with metastases to the lymph nodes closest to it;
A malignant formation (tumor or ulcer), which has grown extensively over the skin, penetrated into soft tissues, cartilage and bones.
A small tumor with distant metastases.

Stage IV can also be of two types:

Skin Cancer: Survival Prediction

With squamous cell skin cancer, the prognosis for survival at the first and second stages of skin cancer is 90% (that is, five years of life without recurrence), at the third or fourth stage - does not exceed 60%. With a favorable reaction of the body to treatment, relapses do not happen at all and the person lives a later life without cancer.

Especially often this happens with timely detected basal cell carcinoma.

Diagnosis of skin cancer

Diagnosis of skin cancer begins with a physician examining the patient's disturbing neoplasms. Oncologists pay attention to the following criteria:

Asymmetry of a suspicious mass, when one half of the suspicious area differs from the other half
Irregular, blurred, jagged borders of the affected area
Uneven color of the affected area, color from white and shades of tan to red brown or blue
The diameter of the neoplasm, which is more than 6 mm.

In addition to the examination, the diagnosis of skin cancer includes a biopsy and a blood test, as well as tests such as: ultrasound, X-ray, computed tomography and magnetic resonance imaging. These tests are necessary to determine the so-called Breslow index (detection of the level of tumor thickness) and to determine the degree of damage to the lymph nodes.

Naturally, in addition to the above research methods, the doctor may prescribe others, based on the individual characteristics of the patient's condition.

Skin cancer: treatment

After determining the stage of the disease, the doctor chooses the optimal method of treatment. The main treatments for skin cancer are:

Radiotherapy (irradiation). This method is used, first of all, when surgical intervention is impossible (for example, if the tumor is in a hard-to-reach place, such as in the corners of the eyes, auricles or on the nose), as well as in case of a recurrence of the disease.
Chemotherapy. It is used for repeated relapses, and in case of large tumors. This method involves the treatment of skin cancer with drugs that destroy cancer cells.
photodynamic method. It is used in cases of tumor concentration in the superficial layers of the skin. In this case, a special preparation is applied to the affected area, and then it is subjected to special light exposure. Under the influence of this light, the analyzed drug destroys cancer cells.
laser surgery. Destruction of cancer cells by a directed highly active light beam.
Fulgurative. This method of cancer treatment involves the removal of cancer cells with a special tool, followed by the treatment of the tissue with an electric current, which destroys the remaining malignant cells.
Cryosurgery. Freezing cancer cells with liquid nitrogen. This method of cancer treatment is usually used if the infiltration in the skin is not deep, and also when other methods have not been suitable for the patient.
Surgical. It involves excision of a malignant tumor 1-2 cm from its visible edge. Most often, this method is chosen for cancer of the body and limbs, as well as for the removal of metastases (provided that the underlying tumor has been cured).

Treatment of skin cancer with drugs is usually a mandatory item in combined treatment. Most often, drugs are prescribed that stimulate the immune system to actively fight cancer: 5-fluorouracil, interferon, dacarbazine, aldesleukin, imiquimod, and others. For some forms of cancer, combined treatment includes several of the above methods (eg, surgical excision of the tumor plus subsequent radiation).

Skin cancer- damage to the skin by malignant cells. This problem is widespread, especially among the elderly and accounts for 10% of all cancers.

The manifestations of skin cancer are very diverse. These are unusual moles with jagged edges, ulcers, nodules. Sometimes they cause pain and discomfort, but they can be completely painless.

Interesting facts about skin cancer

Among the victims of skin cancer are many lovers of beach holidays and solariums. It is believed that if a person received 3 sunburns in his youth, then this increases the risk of neoplasms by several times.

Skin cancer is more common in white-skinned, blond-haired, and blue-eyed people. These descendants of the Scandinavians do not have genetic protection from sunlight and, once in countries with a sunny climate, they are at great risk. But representatives of the Negroid race are 20 times less prone to skin cancer.

Some statistics

Over the past 40 years, the number of patients with skin cancer has increased 7 times.
The annual increase in incidence is 5%.
Skin cancer affects both sexes equally.
Until recently, the disease was detected mainly in people over 60, but in recent years it has become younger and affects even 18-year-olds.
In 90% of cases, skin cancer occurs on open areas of the skin, and in 70% on the face.

There are three main types of cancer: squamous cell carcinoma 11-25%, basal cell carcinoma 60-75% and skin melanoma (2.5-10%). We will dwell on them in detail in this article.

Causes of Skin Cancer

Symptoms and signs of skin cancer

Squamous cell skin cancer

Squamous cell skin cancer- a malignant neoplasm that originates from squamous epithelial cells located in the prickly layer of the skin. This tumor is very aggressive, it grows rapidly and destroys the surrounding tissue. Elderly people are more likely to suffer from it.

Squamous cell carcinoma consists of altered (atypical) cells of various sizes, which look like strands extending into the deep layers of the skin. The tumor is dangerous because it quickly metastasizes to nearby lymph nodes.

This type of skin cancer most often appears on exposed areas of the skin:

on the lower lip;
on the temples and on the forehead,
in the scalp;
on the palms;
on foot;
on the external genitalia and in the anus;
on scars after injuries and burns;
in place of chronic inflammatory processes of the skin.

Manifestations

Squamous cell carcinoma causes discomfort, soreness, and itching. From erosions on the surface of the tumor, a bloody liquid with an unpleasant odor is released.

Squamous cell carcinoma has several manifestations

Plaque- a dense flat formation, covered with small tubercles. The color is red. Often bleeds and rapidly increases in size.
Knot- a growth in the form of a cauliflower on a thick leg. The consistency is dense. The color is bright red or brown. The surface is covered with weeping erosions and crusts. Growing fast.
Ulcer- resembles a volcano crater with an uneven bottom, from which a liquid with an unpleasant odor oozes. It dries up, forming crusts. The color is rose red. Grows rapidly to the sides and deep to the bone.
On the scar seals, cracks and erosion appear. Separate areas turn red, compacted. They form tuberous outgrowths resembling warts.

Diagnostics

A malignant formation is located on the surface of the skin and this facilitates diagnosis. The doctor examines the tumor with a magnifying glass and takes a piece of the affected skin to determine if it contains cancer cells.

Histological examination for research, a piece of tissue is taken at the base of the neoplasm. In the laboratory, thin sections are made from it, stained and examined under a microscope. If it is possible to detect atypical cells, then this confirms that the tumor or ulcer is really skin cancer. The result of a planned histological examination will be ready in 5-10 days.

Cytological examination of scrapings from the surface of the ulcer. In the laboratory, using a microscope, they study the structure of the cell and its structures: nucleus, cytoplasm, organelles. Thus, it is possible to determine the degree of cell atypia, what type this neoplasm belongs to, from which cells it appeared.

Squamous cell carcinoma life threatening

Squamous cell skin cancer is aggressive and grows rapidly. But due to its superficial location, the tumor is easily treatable. If measures are taken before metastases appear, then the prognosis is favorable. More than 90% of people remain alive for at least 5 years.

But when the moment is missed, metastases appear in the lymph nodes, lungs, liver and other organs. If you start treatment at stages 3 and 4, then the five-year survival rate decreases to 25% and 45%.

Basal cell skin cancer

Basal cell skin cancer or basalioma It is the most common type of skin cancer and the most harmless. Metastases form only in 0.5% of cases, but the tumor is dangerous because it destroys surrounding tissues. Especially if it is localized on the eyelid or near the nose.

Basalioma is more prone to men, the risk of occurrence throughout life is 30%, and in women only 23%. The older the person, the higher the likelihood of a neoplasm.

The tumor often appears on open areas of the skin. But in 20% of cases it can also form on those parts of the body that are usually covered by clothing.

on the eyelids and other parts of the face;
on the neck;
on the scalp;
in men on the body;
on the legs and arms.

Manifestations

Basal cell carcinoma develops from the deepest layer of the epidermis - the basal layer. The degeneration of basal cells into cancer cells leads to the appearance of translucent "pearl" nodules 3-5 mm in size. After 1-2 years, they increase several times. A bloody crust forms in the center, and under it a bleeding ulcer. The peripheral part of the tumor is pink and vessels are translucent under the thin skin.

There are several forms of basal cell skin cancer.

Diagnostics

Cytological (cellular) examination

Previously, the surface of the tumor is cleaned of crusts using an ointment bandage. Then a glass slide is applied to its growth and a smear-imprint is obtained. This method allows you to obtain cell samples from the surface of the tumor without damaging it. In basal cell skin cancer, characteristic large and light basaloid cells are found under a microscope.

Histological examination

In order to take a sample of material for research, a biopsy is taken from the node. Thin sections are made from a small piece of the tumor with a special tool and distributed on the glass.

Confirms the presence of a basalioma: strands or nests of characteristic cells surrounded by a rim of cytoplasm. The analysis helps the doctor determine how dangerous the tumor is and choose the best treatment.

Danger to life

Basal cell skin cancer is one of the safest types of tumors. It practically does not cause metastases. The only danger is that basalioma destroys surrounding tissues. Therefore, it is very important to start treatment on time, especially if it is located in the corners of the eye, near the external auditory canal, on the nasolabial folds. Otherwise, important vessels, muscles and bones may be damaged.

skin melanoma

skin melanoma It is a malignant tumor that develops from cells that produce the pigment melanin. This neoplasm appears in place of freckles and moles (nevi). Melanoma is one of the most aggressive and malignant tumors, because it causes metastases.

Melanoma often appears in people with white skin, a large number of moles (more than 50) and freckles. And also for those who regularly go to the solarium or stay in the sun for a long time: they work in the field, are engaged in trade. The most commonly affected are the back in men and the legs in women, less often the feet, palms, mucous membranes of the mouth and genital organs. Melanoma can appear even at a young age.

Skin melanoma manifestations

Discomfort in the area of the mole.
Loss of hair from the surface of the nevus.
Change in color (darkening, lightening, uneven coloring).
The appearance of ulcers on the mole.
Bleeding.
Active growth, 2 times increase in six months.
The size of the mole is more than 7 mm.
Asymmetrical jagged edges.
Fuzzy boundaries.
The disappearance of wrinkles on the surface.
appearance of nodes.
Often melanoma is surrounded by a red inflammatory border.

Diagnosis of melanoma

At the first stage, the doctor conducts an examination using a magnifying glass or a special device - a dermatoscope.
Suspicious birthmarks are evaluated according to several criteria: asymmetry, fuzzy borders, uneven color, diameter over 6 mm. If during the examination suspicious symptoms were found, then the mole is removed.

Histological examination

The surgeon completely removes the suspicious mole and some surrounding tissue. After that, he sends the resulting material to the laboratory, where it is treated with paraffin, cut into thin plates, the sections are stained and the features of tissues are studied under a microscope. The doctor determines the depth of germination and how intensively the cells divide.

It is undesirable to do a preoperative biopsy, when the doctor takes only a piece of the neoplasm for a sample. This can lead to the rapid spread of the tumor and the formation of metastases.

Is melanoma life threatening??

The danger to life depends on the degree of development of melanoma. If it has not spread to the deep layers of the skin, has not metastasized to other areas of the skin or lymph nodes, then the chances of a complete cure are excellent. But with the fourth stage of skin cancer, 15-20% of patients live longer than 5 years.

Scientists have noticed an interesting fact: if melanoma appears on the foot, palm or near the nail, then it is more life-threatening than neoplasms in other areas.

Skin cancer stages

Skin cancer goes through several stages in its development.

0 stage- cancer cells have just appeared and are located in the surface layer of the skin. At this stage, the disease is detected by chance when examining suspicious elements on the skin. Treatment efficiency 100%.

1 stage- neoplasm does not exceed 2 cm in diameter. It gradually grows into the deep layers of the epidermis. The tumor does not cause the appearance of metastases in the lymph nodes. With the right treatment, it can be completely cured.

2 stage– the diameter of the tumor is 2-5 cm. It grows into all layers of the skin. The tumor causes discomfort (pain, itching, burning). A single metastasis is formed in the lymph node. Signs of cancer on the neoplasm are visible to the naked eye. After treatment, survival is approximately 50%.

3 stage- the diameter of the tumor is more than 5 cm. It causes discomfort. Ulcers appear on its surface. Cancer affects the muscles, cartilage and bones over which it is located. The temperature rises periodically, the general condition worsens. Metastases form in the nearest (regional) lymph nodes, distant organs are not affected. About 30% of people live more than 5 years after treatment.

4 stage- the tumor is large, with uneven edges, covered with bleeding ulcers and crusts. Cancer causes severe intoxication (weight loss, weakness, nausea, headache). Metastases are formed in the vital organs of the lungs, liver, bones. The average survival after treatment is 20%.

Unlike other forms of skin cancer, basal cell carcinoma has no stages. The tumor simply grows in size, destroying the surrounding tissues.

Diagnosis of skin cancer

Diagnosis of any type of skin cancer consists of several stages.

self-examination

At least once every six months, it is necessary to carefully examine the skin in front of a mirror. Ask someone close to help you inspect hard-to-reach areas. Be sure to contact a specialist if you notice a suspicious flaky spot on the skin, a non-healing ulcer, a shiny nodule, or an asymmetrical mole with an uneven color.

Medical examination

At the appointment, the doctor carefully examines the skin with a magnifying glass or a special microscope that allows you to examine the internal structure of the neoplasm.

Biopsy

This is the taking of material from the tumor for a detailed study. There are several ways to take a biopsy:

with a special tool, similar to a hollow needle from a syringe, tissue is taken from the knots;
with a scalpel cut off the sector from the tumor;
with a sharp thin blade, the growth is cut off entirely;
remove the tumor along with the surrounding tissues.

The desired area is anesthetized and the procedure is painless. Then the obtained material is sent to the laboratory for cytological and histological examination.

Cytological examination for skin cancer

The study of the structural features of cells and their components: organelles, nuclei, cytoplasm. Particular attention is paid to the shape of the cells. The purpose of the study is to establish whether the neoplasm is benign or contains cancer cells, as well as to find out what cells the tumor consists of and determine the type of cancer. You will have to wait about 5 days for the result.

Different tumors are sensitive to different methods of treatment (surgical, radiation, chemotherapy). Therefore, cytological examination helps to choose the best way to fight cancer.

The material for cytological examination is:

biopsy samples;
prints on a glass slide from a tumor cleared of crusts.

Signs of a malignant tumor:

The cells do not look normal, which is why they are called atypical.
Cells have large dark nuclei.
Cells are not specialized, they cannot perform their function.
The cells are young and there are signs of their active division.

Histological examination in skin cancer

The material taken during the biopsy is made solid with paraffin, cut with a special apparatus and stained. The resulting sections, a few microns thick, make it possible to judge the changes that occur in the tissues. The test result will be ready in 5-7 days.

By specific signs, the doctor can judge how aggressive and dangerous the tumor is, and how to treat it.

The following signs confirm skin cancer:

Accumulations of rounded or spindle-shaped atypical cells.
The cells have large nuclei, while the rest of the organelles are small or underdeveloped.
Accumulations of cells are surrounded by a rim of the cytoplasm.

Biochemical methods for the study of skin cancer

Unfortunately, to date, scientists have not yet been able to identify substances (tumor markers) that are released into the blood precisely in skin cancer. These protein compounds could serve as an indicator that the body is prone to skin cancer and help make an early diagnosis.

At stages 3 and 4 of the disease, a biochemical blood test reveals an elevated level of the enzyme lactate dehydrogenase, over 250 U / l. This substance appears in the late stages of tumor development, after the formation of metastases. But its high values \u200b\u200bcan also speak of other diseases: heart failure, pneumonia, myopathies. Therefore, this analysis cannot confirm the diagnosis of skin cancer.

Radioisotope study of skin cancer

Positron emission tomography (PET) is the latest method based on the detection of radioisotopes of radioactive phosphorus. This substance, like a beacon, indicates where the cancer cells are located, and makes it possible to identify the smallest tumors and their metastases. The disadvantage is that complex and expensive equipment is not available in every city, and the cost of the procedure is about 20,000 rubles.

Additional studies are carried out with skin cancer of 3-4 degrees, when it is necessary to identify metastases.

X-ray of the chest;
Magnetic resonance imaging (MRI);
Ultrasound of the lymph nodes.

Features of the diagnosis of different types of skin cancer

Squamous cell skin cancer
- Dermatoscopy. The doctor examines the skin under high magnification using a special device - a dermatoscope.
- Biopsy and subsequent histological examination. Provide information about the type of tumor.
Basal cell skin cancer
- Dermatoscopy. Inspection of suspicious nodes and ulcers with a magnifying glass or dermatoscope.
- Cytological study. If the nodule is covered with skin and there are no defects on it, then a scraping or biopsy is done. If ulcers appear, then a clean, dry glass slide is applied to the cleaned surface and an imprint is obtained with samples of tumor cells.
- Histological examination. For examination under a microscope, tissue samples are taken with a scalpel or needle.
skin melanoma
- Dermoscopy is the examination of the skin with a magnifying instrument.
- Biopsy. To obtain material for study, a suspicious birthmark is completely removed.
- Cytological study. Under a microscope, the doctor examines the structure of the cells of the mole (melanocytes) and determines if they have signs of cancer.

In the event that these basic methods revealed skin cancer of 2-4 degrees, then an additional study is prescribed to find all possible metastases.

Skin Cancer Treatment

The choice of treatment method depends on the location of the tumor, its type, structure and stage of development of the disease.

Surgery or surgical excision of the tumor

Indications for surgery

Large tumor;
Deep skin lesions on the trunk or limbs;
A tumor that has arisen on the scar;
Recurrence of a tumor (relapse) after radiation treatment.

Operation technique

For stage 1-2 skin cancer, the operation is performed on an outpatient basis under local anesthesia. After an injection of an anesthetic, the doctor removes the growth with a scalpel or a loop through which an electric current passes. After that, the cut tissue is sent for examination. There, the pathologist determines whether there are malignant cells on the section. If everything is clean, then the operation is considered successful. If cancer cells are found, then deeper layers of tissue must be removed.

With skin cancer of 3-4 degrees, the subcutaneous tissue is affected, and metastases form in other organs. In this case, the operation is performed under general anesthesia. The surgeon will remove the tumor and part of the subcutaneous tissue. After that, they will perform plastic surgery so that the defect is less noticeable. The next stage of the operation is the removal of metastases in the lymph nodes and other organs.

The Moss procedure is used to treat basal cell and squamous cell skin cancer. The surgeon removes thin layers of the tumor and examines them under a microscope. The procedure is repeated until the cut is "clean". Thus, it is possible to remove all cancer cells and the minimum area of healthy tissue.

Often, you may need to undergo radiation therapy to maintain the effect of treatment and prevent the cancer from reappearing.

Efficiency

Surgical treatment of skin cancer is widely used today and is considered the most effective. It has a number of advantages:

in 1 day you can get rid of all cancer cells;
it is possible to control the quality of the operation by examining the cutoff edges;
a tumor of any size can be removed;
relatively low risk of tumor recurrence.

Radiation therapy for skin cancer

Radiation therapy for skin cancer is used as an independent method of treatment or in combination with surgical removal of the tumor. For therapeutic purposes, X-rays, gamma, beta, neuron radiation are used.

Schemes have been specially developed that allow minimizing the exposure of healthy cells. And in cancer cells, molecules are destroyed and they either lose the ability to multiply or die.

Indications

general anesthesia is contraindicated for the patient and the operation cannot be performed;
for the treatment of recurrent skin cancer;
it is necessary to achieve a good cosmetic effect;
large tumor size;
the tumor is located in hard-to-reach places for surgery;
remoteness of the tumor from important organs and large vessels.

Methodology

Treatment of skin cancer is carried out by the contact method, which is the most effective and safe for surrounding tissues. The doctor individually sets the dose of radiation, the duration of the procedure and the number of sessions.

You sit on the couch and try to lie still. The emitter is applied directly to the tumor and a radiotherapy session is performed, which lasts up to 10 minutes. During the procedure, you will not experience pain or other discomfort. After the session, it is advisable to rest for 20-30 minutes and you can go home.

During treatment, radiation does not accumulate in the body. Therefore, after the procedure, you can communicate with people without fear of irradiating them.

Efficiency

In terms of effectiveness, radiation therapy is comparable to the surgical method, but less traumatic. In the initial stages, this method provides a recovery of 95%. Radiation therapy is used alone, after surgery, or in combination with chemotherapy. The best results are observed in the treatment of basal cell and squamous cell skin cancer.

Chemotherapy

Chemotherapy is a method of treating skin cancer using poisons or toxins that damage cancer cells and prevent them from multiplying.

Indications

small tumors are treated with ointments;
recurrence in basal cell carcinoma;
large tumors that cannot be operated on (are treated with intravenous chemotherapy);
skin cancer grades 3 and 4 with multiple relapses;
patient refusal from surgery.

Methodology

For the treatment of stages 1 and 2, 30% prospidin ointment or fluorouracil emulsion is used. These funds are applied in the form of applications under bandages for 3-4 weeks.

In the event that metastases have arisen, then chemotherapy drugs are administered intravenously. Cisplatin is used - 25 mgm2 from the 1st to the 5th day of treatment. Methotrexate 15mgm2 is administered on the 1st, 8th and 15th day of treatment. The interval between courses is 3 weeks. The duration of treatment depends on the stage of the disease.

Efficiency

Chemotherapy quite effectively complements surgery and radiation therapy. But as an independent method, it is not often used. The reason is that chemotherapy treatment is long and causes many side effects.

Gentle treatments

Used for skin cancer 1 and 2 degrees, if the tumor is small.

Cryotherapy - freezing of the tumor using liquid nitrogen at a temperature of -190 degrees.
Laser destruction - burning the tumor with a laser. As a result, water is evaporated from malignant cells, and they dry out.
Local drug treatment . Using electrophoresis, cytostatics are injected into the skin - drugs that stop the growth of cancer cells: Prospidin, Bleomycin, Cyclophosphamide, Methotrexate.

In conclusion: Skin cancer is a malignant tumor that is diagnosed more easily than other oncological pathologies. You can get rid of it in the initial stages in one day. In order not to miss the moment, it is enough just to be attentive to your health and consult a doctor about all suspicious nodes, ulcers and birthmarks.

A responsible approach to one's health helps a person to prevent the occurrence of many dangerous diseases, including skin cancers.

Even with the external stability of the situation, you should pay attention to the number of moles on the body - if their number has increased in a short period of time - this is a serious signal to be examined.

The presence of a zero stage of skin cancer may be indicated by red or brown formations that have a bumpy surface, as well as wounds, abrasions and cuts that do not heal for too long. Often, the modification of moles indicates the beginning of the development of pathology. All this does not diagnose cancer, but it makes you think.

Malignant skin neoplasms are cancerous lesions that develop in the surface cells of the epithelium. The disease has no risk groups, age categories and does not occur by gender.

Specialists in the field of oncology highlight a certain sequence - the disease often affects pale-faced elderly people not properly exposing themselves to solar radiation.

General manifestations

The sooner skin cancer is diagnosed, the greater the patient's chances for a full recovery and return to a full life. If a person is immediately examined and the disease is detected, the formation won't be able to transform to deadly proportions avoid metastasis and global damage to other important systems and organs.

To avoid a critical situation, when only a miracle can help, it is worth considering in more detail the possible common primary manifestations of a terrible disease.

squamous

In oncological practice, squamous cell carcinoma is treated as one of the initial types of tumor lesions that can appear on any part of the skin. Formation and distribution throughout the body metastases with this type of oncology - extremely a rare event diagnosed in one out of ten cases.

More often there is the introduction of a tumor, and its germination in the deep layers of soft tissues. The main cause of the disease is rapidly deteriorating environmental situation in most regions of Russia.

There are the following forms and varieties of squamous cell skin cancer:

plaque- this type of pathology looks like a brightly colored area in the form of a tubercle. It has a rough structure, is clearly visible on the body with the naked eye. Over time, it becomes denser and quickly increases in size.

As the disease progresses, a deep penetration of the formation into neighboring soft tissues is observed, which at the initial stage is accompanied by unpleasant sensations and discomfort when in contact with the lesion, and subsequently by the appearance of a pronounced pain syndrome and spontaneous bleeding from the tumor localization site;

nodal- with external touch, it looks like a multiple accumulation of nodular formations of various sizes, it is associated with a cauliflower inflorescence. Firmer texture than plaque cancer, larger at the base.

The shade is dark brown - closer to brown. The surface has a rough layer. As a rule, the nodular form of pathology appears at the site of wounds, old scars (especially poorly, unevenly fused), old mechanical injuries of the skin.

Initially, squamous cell oncology finds its manifestation in the form cracks that do not heal for a long time and causing pain. Then there will be first nodules, initially preserving immobility. A little later, they will grow, start to hurt. This process is rather short.

Provoking factors:

declining age;
excessive being in the sun;
harmful working conditions;
undertreated diseases and inflammatory processes of the outer skin;
weak immunity;
genetic disposition.

The only and main symptom that allows you to accurately diagnose this particular type of cancer is specific smell from the lesion, when pressed on which starts ooze blood.

Basal cell (basalioma)

Basalioma of the skin in some way, a unique type of oncological pathology, characterized by a very slow growth education and 100% absence of metastasis. Doctors are still arguing - what is the nature of the tumor: benign or malignant? Often doctors agree that this is a kind of intermediate stage between these two conditions.

Diagnosed in 3 out of 4 cases of skin cancer. Most affected by this disease - residents of the southern regions of the country.

Children and young people almost never get this form of cancer. Provoking factors:

genetics;
weak body defenses;
bad ecology;
skin diseases.

Initial symptoms:

appearance micronodules of delicate white, pinkish or yellow edema, reminiscent little pearl;
formations most often appear in the hairline area and cause discomfort;
proliferate not wide but in depth;
characteristic crust, which when removed, it reappears soon after.

Tumor options:

nodular - ulcerative;
cylindrical;
perforating;
pigmented;
warty;
nodular;
atrophic.

Adenocarcinoma

It is another proof that cancerous skin formations are the result of the negative impact of external factors on the human body.

A symptom characteristic of this form of the disease must necessarily alert - unexplained large rash, which appeared on the upper layers of the epithelium, accompanied by constant itching and mild pain.

However, in general physical condition patient at this, the initial stage of the course of the disease, this is a manifestation not reflected at all- health is not a cause for concern.

A fairly rare anomaly. Appears near the sebaceous and sweat glands, in armpits and groin. prone to relapse. Poorly diagnosed in the early stages. Able to grow up to 10 cm.

The root causes of the disease:

Negative influence x-ray radiation high concentration;
heredity;
chemical toxins;
chronic papillomavirus.

Common early symptoms:

natural darkening of the skin in previously healthy places, tending to grow rapidly;
humidity on the surface of spontaneously arisen anomalies;
structure seal and change in the color of the formations;
sometimes general weakness, fatigue and drowsiness;
small but uncontrolled rise in body temperature;
slow tumor growth.

Sometimes it can grow into the deeper layers of muscles and tendons, which is very rare.

Melanoma

If the patient suffers from melanoma, drug therapy is prescribed on an emergency basis - if it is on the surface of the skin layer and has not had time to grow deep, it is very easily removed and, as a rule, does not cause a relapse.

Five years is a borderline period of time allotted to a person for her treatment. Then - a difficult, and often, losing struggle with malignant multiple, uncontrolled formations.

It is considered the most dangerous type of skin cancer. More often than others, it metastasizes and multiplies rapidly. Sometimes from the initial stage diseases to its final all you need a few months.

Developing from the squamous epithelium, the disease spares neither children nor adults. It mainly originates from pigmented areas, where the epithelium is already initially modified and birthmarks. The main risk group is women of the middle age group.

Localization of the anomaly is different - back, face, chest, limbs. In 80% of cases, it does not lend itself to any of the methods known to medicine treatment.

In addition to the causes typical for all groups of skin cancer, melanoma can be provoked by:

ionizing rays;
the negative impact of solarium;
dysfunction of the endocrine system;
hormonal disruptions;
immune diseases.

Often the nature of the pathology cannot be determined. Its symptoms vary practically undetectable in the early stages. Since incubation anomaly instantly starts to progress.

Common initial symptoms when age spots or a mole begin to transform into a malignant nature:

too fast pigmentation of a mole;
uneven color staining of its upper part;
inflammation and redness of the halo framing a mole;
chaotic appearance of small papillomas in the area of \u200b\u200bthe mole;
itching, burning, pain syndrome in the focus of the formation of malignant pathology;
occurrence of bleeding even with the slightest injury to the surface of the formation;
general fatigue and weakness;
frequent headaches, poorly stopped by painkillers;
swollen lymph nodes if oncology is located in the zone of their proximity;
when pressing on the mole, it is palpable internal seal;
loss of hair, if there were any before;

If the size of the tumor became more than 6-7 mm- this is also a characteristic primary symptom of skin cancer. In its diagnosis, it is important to understand that all moles, birthmarks and other "distinctive features" end their appearance on the human body at the moment when puberty is completed. Everything that appeared later is a reason to visit a doctor and be carefully examined.

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20.10.2018

Skin cancer is a malignant tumor that develops from the epithelial cells of the skin.

The disease is a serious problem of mankind, characterized by high mortality and severity.

Skin cancer can appear in anyone, regardless of gender and age, but due to reasons, the disease develops only in a certain group of people. This risk group includes the elderly, fair-skinned and sun-exposed people.

Types of skin cancer

Cellular cancer. This type of disease arises from melonocytes and rarely metastasizes. It can release processes and with the help of them penetrate into the circulatory and lymphatic systems. If this happens, then melanoma (cellular cancer) can spread throughout the organs, and the survival period will not exceed one year.
Basal skin cancer. This type of disease occurs more often than others, in approximately seventy percent of cases. It has a tendency to relapse but does not metastasize. The neoplasm is characterized by a slow growth rate. It is localized mainly on the scalp or epidermis. A malignant tumor of the skin is a protruding formation above the skin of a round shape, having a dark red or pinkish tint.
Squamous cell carcinoma. This type of malignant neoplasm can be located on any part of the skin, but sometimes it is localized on the open area and the lower lip. This type of cancer is not gender selective, but prefers the elderly. Squamous cell oncology is a nodular formation. Then the neoplasm becomes bleeding and loses mobility.
Skin sarcoma. It is a rare type of cancer and develops mainly on the trunk and limbs. Formed from tissue particles of the epidermis.
Merkel cell oncology. This type of tumor is localized on the head or face in elderly patients. In many cases, it can metastasize.

Forms of skin cancer

papillary- is the rarest form of skin oncology, is a tuberous neoplasm, which is covered with many papillae. This form of tumor can metastasize and grow inside the human body, because of this, rapid depletion occurs.
Infiltrating form- ulceration with dense edges and a bumpy crust. A similar form of neoplasm is characterized by germination in neighboring tissues, making them immobilized.
superficial- a form that manifests itself as dense nodular formations that have a yellow-white tint. Over time, they degenerate into uneven plaques with a depression in the center.

Causes of Skin Cancer

There are many predisposing factors that can cause skin cancer.

Excessive exposure to solar radiation and ultraviolet radiation. This factor is especially dangerous for fair-skinned and fair-haired people.
Professions that involve prolonged exposure to the sun.
Chemical carcinogens (fuel oil, arsenic, oil and others).
Prolonged thermal effect on specific areas of the skin. An example is "kangri cancer", it is common among the people of the mountainous regions of Nepal and India. This type of cancer develops on the skin of the abdomen, in those areas where pots of hot coal are placed for warming.
Precancerous skin diseases (Bowen's disease, Paget's disease, xeroderma pigmentosa, Queyre's erythroplasia and benign neoplasms that are subject to constant traumatization).

Other causes of skin cancer include:

Smoking.
Contact radiation and chemotherapy. These methods, which were used to treat oncological diseases of other localization, can also cause skin cancer.
Reduced immunity due to the influence of various factors. These factors may include: AIDS, the use of immunosuppressants and glucocorticoids after organ transplantation and in the treatment of autoimmune diseases.
genetic predisposition.
Sexual features. For example, melanomas, which occur mainly in women.

Oncology symptoms

The ability to detect skin cancer in the early stages is an important feature of the clinic of malignant neoplasms. The first signs of skin cancer that should alert:

A change in the appearance of the skin, accompanied by itching and discomfort, in places where there are scars, papillomas, moles and trophic ulcers.
The appearance of a large rash. It should not be accompanied by changes in the general condition of the body, unlike allergic and infectious diseases.
Darkening of a specific area of the skin that was previously normal.
Ulceration that does not heal for a long time, with a moist surface.
A hardened area of skin with a change in color, raised above the general surface.

Different histological forms of this disease have their manifestations:

Squamous cell carcinoma. It looks like a scaly red plaque with clear boundaries, is easily injured and does not heal. The ulcerative defect is distinguished by a sharp unpleasant odor. There is no definite and characteristic localization, but more often than others it can develop on the face and limbs. A sign of squamous cell oncology can be uncontrollable pain in the area of skin manifestations of skin cancer. With metastases to regional lymph nodes, the symptom may be an increase in the lymph nodes themselves, while remaining painless and mobile. But they are fixed to the skin and sharply become painful.
Basal cell carcinoma. Initially, it looks like a flat single or confluent neoplasm, having a rich dark pink color. The tumor grows rather slowly and rarely spreads outside the primary focus. Unlike other types of skin cancer, basal cell oncology preserves the entire surface for a long time. Over time, the plaque may take the form of a skin ulcer with raised edges. The bottom of the ulcer is partially covered with a dry crust. And non-ulcerated areas have a whitish luster. The bottom of the ulcer expands and deepens, and also grows into deep tissues. It can destroy everything in its path, even bones and muscles. Treatment of skin cancer with folk remedies is impossible. If the localization of basalioma (basal cell carcinoma) is on the face or auricles, then there is a possibility of its germination in the eyeballs, nasal cavity, bone structure of the inner ear, up to the brain.
Adenocarcinoma. Skin cancer develops in places richest in sweat and sebaceous glands: in the armpits, inguinal areas, under the mammary glands. In these areas, a single small knot becomes noticeable, a couple of millimeters in size, the name is a bluish-violet hue. This node grows slowly, and quite rarely reaches a large size (up to ten centimeters). There are cases, albeit rare, of germination in deep intermuscular spaces and deep muscles. This form of cancer can metastasize. Basically, the tumor is found in pain due to an attached secondary infection.
Melanoma. It is localized mainly on the face, anterior surface of the chest, limbs. With this form of cancer, the existing mole changes into a red color or its discoloration. The edges of the birthmark are blurred, turn into uneven and asymmetric. The first symptoms of skin cancer are a manifestation of pain and itching in the area of the birthmark. Its increase in size and swelling. Many pigment spots that bleed and itch can appear on the nearest areas of the skin. Over time, the hairline disappears from the mole. Metastases can be found in the meninges, bones, lungs, and liver. Unfortunately, it is impossible to predict the path of metastasis.

In the last stages, melanoma takes on a sign of general intoxication. On the manifestations of metastasis can speak: an increase in lymph nodes, especially in the armpits; sudden unexplained weight loss; staining of the entire skin in a dark gray color; nausea and headaches; loss of consciousness and convulsions.

Diagnosis of skin cancer

To identify neoplasms on the skin, the specialist examines and probes the entire surface of the skin. Including natural cavities, folds, the vulva area and the scalp.

Next, an epiluminescent microscopy of the altered skin area is performed using a dermatoscope. The state of all lymph nodes available for examination and palpation is determined. If tumor-like formations are found, then a smear-imprint is taken for cytological examination.

For the diagnosis of melanoma, a radioisotope method is additionally used. Also, the presence of melanoma is indicated by thermography data, the temperature of the neoplasm is several degrees higher than the temperature of healthy skin. An alternative diagnostic method can be specially trained dogs that are able to detect malignancy even before visual signs on the skin.

When skin cancer is detected, an X-ray examination of the chest organs is performed to determine the presence or absence of metastases. Ultrasound diagnostics of regional lymph nodes is carried out. If the lymph nodes are enlarged, CT or MRI is prescribed.

To determine distant metastases, osteoscintigraphy is additionally performed. A complex of laboratory tests is being carried out: a general analysis of urine and blood; a serological test for syphilis; biochemical blood test.

Skin Cancer Treatment

Most skin growths are benign. In their treatment, they are limited to mechanical removal with the obligatory subsequent dispatch for histological examination. Such operations are carried out at outpatient stages.

How to treat skin cancer? New surgical techniques that are used when removing a tumor without prior cytological examination, unfortunately, do not provide an opportunity for an accurate study of the removed material. This is precisely what leads to a huge risk of "losing" the patient out of sight until he himself seeks help from specialists with a relapse or signs of metastases.

Many people ask the question: is skin cancer treated or not? And how is the treatment going? If the question of the presence of melanoma is not raised, then the treatment of any form of diagnosed skin cancer is standard - removal. Surgical intervention has its own characteristics:

If the size of malignant skin tumors is less than two centimeters, then the neoplasm is cut out two centimeters from the edge on the sides and in depth.
If the neoplasm is more than two sentiments, then in addition to its removal, the scar and surrounding tissue are irradiated along with the nearest regional lymph nodes. The answer to the question: is it possible to cure skin cancer, is positive if the disease has not gone too far.
If metastases are detected, then lymph node dissection is additionally performed.
When distant metastases are detected, skin cancer treatment becomes complex: chemotherapy is added to the above methods. The number of radiation courses, as well as the volume of surgical intervention, is determined on an individual basis.

Can skin cancer be treated and what is the prognosis for survival?

With treatment in the first and second stages, the survival rate is 80-100%.
When metastases are detected in the regional lymph nodes with the germination of a malignant neoplasm in the underlying organs and tissues, the survival rate is 25%.

Skin cancer is a disease in which skin cells start to develop into malignant tumors. Skin cancer, the symptoms of which appear as a result of exposure to certain risk factors, can manifest itself in several main varieties, being basal cell carcinoma, squamous cell skin cancer, adnexal skin cancer or melanoma. Each of the listed variants of skin cancer is characterized by its own characteristics, while the most dangerous type is melanoma.

general description

Skin cancer is a fairly common form of a malignant type of tumors, in which both women and men are affected almost equally, their age is mainly from 50 years or more, although the likelihood of developing the disease in one form or another in more than one form is not ruled out. young patients. The area of the lesion is, as a rule, areas of the skin that are open to one or another effect. The development of skin cancer is noted in 5% of the total number of cases of cancer as such.

Causes of Skin Cancer

When considering the causes that provoke the development of skin cancer, there are two main types of factors that are directly related to the process. In particular, these are exogenous factors, as well as endogenous factors, we will consider them in more detail.

Exogenous factors

Otherwise, they can be defined as external factors. The most important of these factors can be distinguished ultraviolet radiation and the sun's rays in particular. Remarkably, the development of squamous cell and basal cell carcinoma is provided by chronic damage to the skin obtained when exposed to UV radiation, but the development of melanoma occurs mainly as a result of periodic intense exposure to sunlight. Moreover, in the latter version, even a single exposure is sufficient for this.

Confirmation of this statement lies in the fact that melanoma predominantly appears within those areas that are hidden by clothing. On top of this, it has been established that melanoma predominantly occurs in people who are mostly indoors and only occasionally exposed to ultraviolet radiation (which implies normal outdoor sunlight). Skin cancer, on the contrary, can also occur in areas of the body that remain unprotected. There is an assumption that the incidence of skin cancer is increasing as a result of the destruction that the ozone layer of the stratosphere undergoes and provides the retention of most of the ultraviolet radiation.

In addition to ultraviolet radiation, an important and fairly common factor in the etiological type of melanoma development is injury to pigmented nevi through abrasions, bumps, etc. Pigmented nevi can otherwise be defined as a nevoid tumor or birthmark - that is, a formation on the skin, consisting of pigment (or nevus) cells .

In addition, the possibility of exposure to lighting devices (fluorescent lamps), certain chemical carcinogens (for example, hair dye), intense electromagnetic fields and ionizing radiation is not excluded.

Endogenous factors

The incidence of skin cancer is determined based on ethnic factors. So, for example, the greatest spread of tumors is observed in fair-skinned people, while representatives of the Negroid race encounter them much less frequently.

Also, most often in such factors, a small amount of pigment is released in the tissues of some individuals, as a result of which sensitivity to the effects of ultraviolet rays on their skin is exacerbated. Such persons in particular include people with blond hair, skin, eyes. If we take into account hair color in combination with skin in this regard, then for blondes the risk of a possible development of cancer increases by 1.6 times, while for people with fair skin this risk doubles, and for red-haired people - three times. times.

Not the last role, especially in recent years, is played by immune factors, as a result of which skin cancer can also develop. In particular, the risk of its occurrence increases in immunodeficient states, as well as in immunosuppressive states. In addition, endocrine factors also play an important role. For example, it is known that pregnancy is a stimulating factor for the process of malignant transformation of pigmented nevi.

Age, anatomical localization of the tumor formation and gender also affect the development of the disease. Remarkably, these factors are closely related to each other. A disease such as melanoma is observed up to two times more often among women, while the peak incidence is within the age range of 41 to 50 years. Most often, melanoma is affected by the fifth decade of their life. As for the concentration of the tumor formation, it is most often noted in the face, legs and buttocks. If we are talking about men, then in this case, the concentration of the tumor formation is noted mainly within the lateral and anterior surfaces of the skin of the chest wall, as well as bones, thighs, fingers on the foot and heel area.

Some hereditary skin diseases also lead to the development of cancer, in particular, it can be Paget's disease, Bowen's disease, xeroderma pigmentosum, etc.

As for the varieties of the disease, the types of skin cancer, we repeat, are the following: basalioma (basal cell carcinoma), squamous cell carcinoma, cancer of the skin appendages and melanoma.

Skin cancer: symptoms

In general, the appearance of cancer is preceded by certain types of pathological processes and precancerous diseases, which are usually defined as precancers. Precancers, in turn, can be obligate or facultative.

Obligate precancers in almost all cases, they are transformed into a malignant process. Precancers include such types of diseases as:

erythroplasia of Queyra;
Paget's disease;
Bowen's disease;
xeroderma pigmentosa.

Facultative precancers can be transformed into cancer under a certain combination of adverse factors from the impact of internal or external environments on the body. In particular, they include:

senile keratoma or senile keratosis;
skin horn;
radiation ulcers (late);
keratoacanthoma;
scarring;
trophic ulcers;
skin lesions noted in syphilis, systemic lupus erythematosus, tuberculosis;
arsenic keratoses.

The following signs are distinguished, indicating the malignant nature of the degeneration of a nevus (that is, a mole):

vertical growth relative to surrounding tissues;
partial or complete change in color, the formation of areas of depigmentation of the associated type;
irregular outlines, asymmetric edges (in other words, a change in the shape of the nevus);
burning, itching;
the formation of pronounced ulceration over the mole;
wetting surface (wetting) or bleeding;
disappearance of the hairline from the surface of the nevus (its loss or absence);
the appearance of inflammation in the area of \u200b\u200bthe mole, as well as the tissues surrounding it;
peeling of the surface, the appearance of dry crusts;
the formation of additional formations on the skin around the mole (pink or pigmented shade);
loosening or softening of a mole (that is, a change in its inherent consistency);
disappearance from the surface of the nevus of the previously characteristic skin pattern;
the formation of a glossy and shiny surface.

Basal cell skin cancer (basalioma): symptoms

Basal cell carcinoma, also referred to as basal cell epithelioma, basal cell carcinoma, or skin carcinoid, is a type of skin cancer that typically affects the skin of the neck and face, and in some cases the nose or eyelids. . The name of the disease determines the area of the lesion - that is, here cancer cells are formed from the basal layer of the skin, which is the deepest in humans.

This type of cancer is most commonly diagnosed in men. As for age-related susceptibility, it can also be traced here - basal cell skin cancer occurs after the age of forty. In this variant of the disease, as in general when considering skin cancer, representatives of the Mongoloid and Negroid races almost face it.

Quite often, basal cancer is characterized by a virtual absence of symptoms, although manifestations in the form of ulceration in combination with bleeding are not excluded. In particular, patients seek medical advice due to the appearance of an ulcer or tumor formation, which is gradually increasing. At the same time, the formation that is relevant in this situation can increase over a period of several months to several years, soreness, as a rule, is absent, in some cases itching is possible.

Basaliomas can manifest in such forms as nodular basalioma, superficial basalioma, ulcerative basalioma and cicatricial basalioma. As for the clinic of its manifestations, it is determined based on the location of the tumor formation and its specific form.

Nodular form of basalioma. This option is the most common in terms of frequency of manifestation. It is a hemispherical node of a mother-of-pearl pink hue, it has a smooth surface and a dense texture. In the very center of this node, the presence of a recess is noted, it itself gradually increases, reaching a diameter of about 5-10 mm. Quite often, the presence of telangiectasias on the surface of this node is noted (which, most likely, are more known to the reader as "spider veins", which they are). Outwardly, the knot is similar to a pearl.

Superficial form of basalioma. Outwardly, it resembles a plaque with characteristic dense, somewhat raised and clear edges. In diameter, the center of this formation of red-brown color is about 1-30 mm, its contours have a rounded or irregular appearance. A characteristic feature of this form is its slow growth, as well as a benign course.

Cicatricial form of basalioma. This formation has the appearance of a dense and flat pink-gray scar, concentrated slightly below the skin surrounding it. At the edges of the focus of education, clear and raised contours. Along its periphery, within the border with healthy skin, one or several erosive formations are concentrated, a brown-pink crust is noted on them.

Subsequently, one part of the erosive formations heals, and the other begins to spread to healthy areas of the skin. The development of this variant of the basalioma form determines the periods during which scars predominate, while erosive formations are either small or completely absent. In addition, there may also be flat and extensive erosive formations in combination with small scars, covered with crusts and concentrated along the periphery of the focus.

Ulcerative basalioma. It is characterized by the destructive growth of basalioma, during which the destruction of the surrounding bones and soft tissues occurs. The shape of the ulcer in this case is irregular or round, its bottom has a gray-black crust, it is also bumpy and greasy.

In general, basal cell carcinoma is characterized by slow invasive growth with predominant localization in the region of the primary focus (that is, the place of initial appearance). Metastasis in this case is observed only in the order of about 0.1% of cases of the disease. As for the depth of the actual invasion (the ability of the cells that make up the malignant formation to separate from it with subsequent penetration into the surrounding tissues), as well as the risk of future relapses, everything here is determined based on the location of the tumor formation, its size, as well as the inherent histological characteristics. In addition, the determining factors in considering this item are the duration of the disease, the general state of immunity and other features of the state of the body.

The central facial part, that is, the skin in the area of the eyes and mouth, the skin in the area of the nasolabial folds and nose, is determined as the most dangerous area of localization.

With a pigmented and superficial form of the considered type of cancer, as well as with a nodular-ulcerative form, there is every reason to assert the effectiveness of treatment, which is important if these forms of cancer appear in the form of small and non-ulcerated nodules. As for other forms of basal cell carcinoma (especially if it is a scleroderma-like form), they themselves are quite dangerous for the patient.

Squamous cell skin cancer: symptoms

Squamous cell skin cancer, also referred to as squamous epithelioma or spinocellular carcinoma, is a malignant type of tumor that develops on the basis of keratinocytes (squamous skin cells). Keratinocytes act as structural elements concentrated within the epidermis (that is, the outer layer of the skin). This type of cancer develops mainly in those areas of the skin that are usually open to exposure to sunlight, but its occurrence in those areas that are completely hidden from it (mouth, vulva, perianal area) is not excluded. etc.).

The difference in the clinical course of this type of cancer is that patients in this case (unlike basalioma) complain of a rapid increase in the size of the tumor or ulcerative formation. An extensive lesion of the skin in combination with deep-lying tissues, when inflammation is attached to them, due to infection, subsequently leads to pain.

Squamous cell carcinoma develops along the path of formation of the corresponding formation (plaque, node or ulcer).
For ulcerative the form of this type of cancer is characterized by a pronounced density and elevation of the edges of the formation, surrounding it from different sides like a roller. The downturned edges give the formation the appearance of a crater. Actual allocation of serous-bloody exudate, which subsequently dries up with crusts. A characteristic feature of education against the background of the processes occurring with it is an unpleasant odor emanating from it. Its initial increase is noted in size both in relation to length/width and depth.

Outwardly cancerous node determines the resemblance to a mushroom or cauliflower with a wide base. The color of the tumor is bright red or brown, the consistency of the node and its base are dense. The growth of education, as in other cases, is rapid.

With a cancerous tumor that manifests itself in this form of cancer in the form of plaques, the surface is predominantly small-hilly and bleeding, the color is red. Spread along the surface of the skin occurs quickly, subsequently, the formation also affects the underlying tissues.

For cancer that develops on the scar its compaction occurs with the formation of cracks and ulcerations directly on the surface; the tuberous type of growth is not excluded.

Areas of regional metastasis, concentrated on the neck, in the armpit, as well as in the groin, can subsequently acquire a mobile type of lymph nodes, characterized by increased density, mobility and severe soreness. Their mobility is subsequently lost, soreness remains, in addition, their soldering with the skin is noted during subsequent decay, during which ulcerated infiltrates are formed.

Cancer of the skin appendages: symptoms

This form of cancer is extremely rare. Its characteristic clinical picture determines the absence of differences from the previous form of cancer, its diagnosis can be made on the basis of a histological examination.

The form of cancer considered in this case can manifest itself, in turn, in one of two varieties, in particular, cancer of the sweat glands and cancer of the sebaceous glands. In addition, the development of this type of cancer can occur directly from the hair follicles. Its peculiarity lies in the tendency to hemato- and lymphogenous metastasis. According to the frequency of occurrence, metastases are noted in the order of 2-5% of cases, mainly it occurs to regional lymph nodes.

Melanoma: symptoms

Melanoma (also known as melanosarcoma, melanocarcinoma or malignant melanoma) is one of the most malignant tumor formations relevant to humans. Melanoma develops regardless of the compliance with a specific age category, and therefore the possibility of its occurrence in both young people and aged people is not excluded. Notably, melanoma is more common in women than in men. Over the past decades, there has been a sharp increase in the total number of cases of melanoma.

As a rule, melanoma develops in the open areas of the skin, although, as in the previous variants of the disease we are considering, its formation in the mucous membranes (conjunctiva, oral cavity, genitals) is not excluded. The risk factors contributing to its development include, first of all, the above-mentioned exposure to ultraviolet radiation, in addition, the factor of heredity in terms of predisposition to this disease is not excluded. Additional factors include the following:

red hair, fair skin;
a large number of moles on the body (more than 50);
the presence of many freckles, as well as their rapid appearance;
the occurrence of sunburn in the past.

In any case, it is important to consider that skin melanoma can appear in a person belonging to any race and with any skin color, even if this is true for a smaller ratio of cases. Given this, we note that melanoma is not limited to the defeat of the category of people with fair skin and in accordance with their listed factors.

It is noteworthy that hairy nevi (moles) never become malignant, and therefore, if there is hair on a pigmented tumor formation, it should not be classified as a malignant formation.

Melanoma is formed in about 70% of the total number of cases of morbidity from a birthmark pigment spot (moles, nevus). Predominantly, the concentration of a malignant formation is determined in the neck, limbs or scalp. Melanoma in men mainly appears in the chest and back, again, in the extremities (upper). Melanoma in women, in turn, focuses on the lower extremities and chest.

The most dangerous of the options is the so-called borderline nevus (epidermal nevus), which mainly appears on the soles, palms or on the skin in the scrotum. The main signs indicating that the formation is becoming malignant:

resizing (respectively, their increase);
change in color (it either becomes more noticeable or weakens in the severity of color);
bleeding;
infiltration in the area around the nevus or under its base (that is, its abnormal seepage to the indicated areas).

As for the type of melanoma, it is a tumor nodule of a dense consistency of pronounced black color (in some cases with a slight blue tint). Somewhat less often in practice, “pigmentless” nodules of the type of melanoma are noted - in this case they have a pinkish tint, without pigment. The dimensions of the tumor formation in diameter can be about 0.5-3 cm. Often it has a bleeding and eroded surface in combination with a compacted base.

Based on the listed signs, it is already possible to make a diagnosis during a routine examination by a doctor (this is done exclusively using a magnifying glass). Meanwhile, it is important to note that the early stages of the process, in which a mole is transformed into a malignant formation, are accompanied by its completely harmless appearance, therefore, the specialist who makes the diagnosis must have considerable experience that will distinguish a malignant formation from a formation that is really harmless and benign in its own way. essence.

Melanoma can manifest itself in the following varieties:

malignant lentigo;
melanoma superficially spreading;
nodular melanoma.

In addition to the above options, when melanoma is localized in the scrotum, sole or palms, it is defined as a separate clinical and morphological form, which, in turn, is defined as acral melanoma.

Melanoma, superficially spreading appears in persons corresponding to a younger age (average - about 44 years). The development of the tumor occurs with the same frequency of occurrence both within the open areas of the skin and within the closed areas. Basically, the area of concentration is noted in women - on the lower extremities, in men - along the upper back. The plaque configuration in this case is irregular, with uneven edges, mosaic color, with discolored foci and keratosis along the surface (i.e. with thickening, excessive keratinization). After a few years (about 4-5 years), a node is formed on the plaque, which indicates the relevance of the transition of the formation growth from horizontal to vertical.

Melanoma nodular defined as the most aggressive of the possible tumor variants. The average age of patients is 53 years, while the incidence ratio for men and women is approximately 60:40. Most often, localization is determined within the head and neck, skin on the back and limbs. The node increases quite quickly - as a rule, patients indicate a period of about several months, while the process is accompanied by its ulceration in combination with bleeding.

Malignant lentigo It is characterized by the duration of the phase in which horizontal growth is noted (it can be from 5 to 20 years, or even longer). Typical cases of the appearance of a tumor formation indicate its relevance for the elderly. Concentration - in the neck and skin of the face, appearance - in the form of spots or plaques, color - brown-black.

Melanoma as a whole does not exclude the possibility of recurrence, which occurs due to non-radical surgery. This type of cases are accompanied by the detection of distant metastasis with the simultaneous detection of a relapse in its process, and sometimes even before its immediate appearance.

Pure chemotherapy in the treatment is used in the prevalence of forms of melanoma, as well as the relevance for the patient of distant metastasis. This implies the use of drugs in various combinations. Regression in this case is achieved in about 20-40% of cases.

Separately, I would like to dwell on metastasis. Melanoma as a whole can be characterized by a very pronounced degree of the course of this process, not only by the lymphogenous route, but also by the hematogenous one. Predominantly metastases affect the brain, liver and lungs, while dissemination (spread) of malignant nodules along the skin of the entire trunk or limb is often noted, depending on the location of the lesion and the characteristics of the course of the process.

It is also important not to exclude such an option, in which the peculiarities of the course of the process lead the patient to seek medical help based only on an increase in his lymph nodes in any of the areas. Meanwhile, a thorough questioning allows us to determine, for example, that some time ago a “wart” was removed from the patient. Such an innocent, at first glance, formation, like a wart, in fact, often turns out to be malignant melanoma, which is already determined on the basis of subsequent confirmation based on a histological examination.

If we consider the prognosis for malignant melanoma, then in general it is quite severe, and it is directly determined based on its timely detection. After its removal, a number of factors are evaluated for the forecast, on the basis of which it, in fact, can be made. It is noteworthy that the early stages of melanoma determine a five-year survival rate of the order of 80% of cases. In addition to the degree of invasion taken into account in this case, it also takes into account, as we noted earlier, the location of the tumor formation, the presence of metastasis, etc.

The vast majority of patients with metastases do not live up to a five-year period, and a long road to recovery allows achieving a result in about 30% of cases. With visceral or distant metastases, patients die within a year.

Diagnosis

Diagnosis of skin cancer occurs with a thorough examination using a magnifying glass in it, which is enough to determine the pathology. As a confirmatory measure, a radioisotope study is used, during which the amount of accumulated phosphorus with radioactive properties is detected (in the case of the relevance of cancer, its composition can be increased up to 400% in comparison with the healthy area of the patient's skin).

The main method for determining skin cancer is a biopsy, in which a sector-shaped excision of a site is performed with the capture of healthy tissues. The relevance of metastases to internal organs is determined on the basis of ultrasound, computed tomography and radiography.

Skin cancer: how to recognize?

Of course, a doctor's consultation is necessary in any case of suspicion of pathological manifestations relating to the skin. Nevertheless, it is important to systematically conduct an independent examination for their presence. So, let's consider the main recommendations that are necessary in this case.

The best time to do a self-examination is after a bath or shower. You will need two mirrors, one of which should be full-length and the other with a handle. In this combination, it will not be difficult for you to see any parts of the body. In addition, you will need a comb or comb and a hair dryer - all this is already used to conduct an examination of the head within the hairline. You can also additionally attach a flashlight to the above for additional highlighting of the desired areas.

During the inspection, it is important to pay attention to the following:

newly appeared moles (different from the rest);
non-healing wounds;
newly appeared formations of a dark or red color, somewhat elevated above the level of the skin;
change in the state of the mole (color, shape, size).

Now let's move on to action.

Examine your face while standing in front of a full-length mirror. Examine the area of the lips, skin near the eyes and ears (use a second mirror where necessary). Examine the oral cavity, highlighting the examination area with a flashlight, in the same way examine the auricles, nostrils, go to the examination of the chest, shoulders and neck.
Examine, using a second mirror, the area of the upper back and neck. Next, using a comb and hair dryer, inspect the scalp in a consistent manner, if you have difficulty viewing, ask people close to you for help in this.
Examine the skin of the flanks and abdomen. In particular, pay attention to the back, because it is there that malignant tumors are often localized. Also check the area of the buttocks and genitals.
Further, being in front of a large mirror, raise your hands up and look at them from different sides, not missing the area under the armpits and between the fingers.
To examine the legs, it is better to eat. Next, bend your leg, and then, using a small mirror, inspect each area, not missing the feet and toes. The action, as can be understood, is performed in relation to both limbs.

Skin cancer, the signs of which are detected at an early stage during self-examination, will help to maximize the impact on the course of this disease, minimizing its further consequences and achieving more favorable results in general.

Skin Cancer Treatment

Treatment of the disease is based on taking into account a number of factors that accompany its course (type of cancer, stage, condition of the patient as a whole, etc.). The main methods of treatment are the following options:

Surgery. It implies the removal of a tumor formation, which is one of the most common methods used in the treatment of skin cancer. In this case, the tumor formation itself is excised, as well as the lymph nodes (in case they were subject to a corresponding lesion). Additionally, radiotherapy or drug therapy may be prescribed after the operation.
Radiotherapy. It consists in irradiating the area in which the tumor has developed. With this method of treatment, it is possible to remove those tumor cells that were not removed during surgery.
Drug therapy consists of taking drugs aimed at destroying cancer cells or increasing immune activity to fight the body against the disease.

As for such an issue as the prevention of skin cancer, it consists, first of all, in preventing the main influencing factor that can lead to this disease - exposure to ultraviolet radiation. Accordingly, this implies the need to reduce the time spent in direct sunlight.

It should be remembered that the most dangerous time of exposure to sunlight is defined for the time period from 10 am to 4 pm. During these hours, it is important to ensure proper skin protection from the sun, at least with sunscreen (creams, sprays) and clothing. To avoid skin cancer, it is also not recommended to use the services of solariums.

If the symptoms are relevant, which may indicate the appearance of skin cancer, it is necessary to consult a dermatologist, and an oncologist may additionally be consulted.