Cancer of skin and other skin lesions

Skin cancer is a cancer that is well known and researched. Unfortunately, it is becoming more common. In addition to the congenital risk factors that cannot be controled, there is one that we can and is the most well-known cause of skin cancer – exposure to ultraviolet (UV) radiation. Prevention is of paramount importance , which consists of avoiding excessive exposure to these rays as well as protection from them (creams and covers). It is very important not to ignore the changes we notice on the skin. If we still get skin cancer, it is extremely important to start treatment as soon as possible.

ETIOLOGY OF CANCER OF THE SKIN AND OTHER LESIONS

Skin cancer and various other skin and subcutaneous leions can include many possible changes and diagnoses.

The incidence of skin cancer and the changes that precede it (precancerous lesions) are taking on real epidemic proportions in recent times. Generally speaking, skin cancer occurs in the epidermis (the outer layer of the skin), making it visible to the eye. It mainly occurs on parts of the body exposed to the sun, including the scalp, face, lips, ears, neck, chest, arms, palms, but also the skin on the feet. The most common warning sign of existence is a newly formed lesion that does not heal. The most important risk factors are:

  • naturally lighter skin complexion,
  • family risk,
  • previously treated skin cancer in the same person,
  • excessive sun exposure (as part of an occupation, but also a hobby),
  • suffered burns in childhood or adolescence,
  • skin type that is slightly red or burns, spots or becomes painful when exposed to the sun,
  • light eye color (blue, green), blonde or red hair,
  • certain types of moles and their excessive number.

The best known cause of skin cancer is ultraviolet (UV) radiation present in the sun’s rays and commercial tanning devices (quartz lamps). It should be noted that both UVA and UVB contribute to the development of skin cancer. The best way to prevent this is to protect yourself from the sun.

HOW TO RECOGNIZE A SUSPICIOUS CHANGE?

The most common warning sign of possible skin cancer is a new change that does not heal. Cancer can occur as a small, smooth, shiny, pale, or protruding lump. It can also occur as a reddish change. Occasionally there is a small spot of bleeding or scab. It can also occur as a new formation at the same level of the skin, as a reddish, rough, rough stain, dry consistency. There is also the so-called actinic keratosis, a change that looks like a rough, reddish, or brownish spot of various sizes that sometimes results in cancer. Characteristic of actinic keratosis is that it occurs in places exposed to the sun, but also elsewhere on the skin. It should be noted that changes in the skin do not necessarily mean the development of cancer. We recommend a clinical examination for all changes lasting more than a month.

TYPES OF SKIN CANCER

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There are basically three types of skin cancer:

  • Basal cell carcinoma (BCC) accounts for approximately 70-75% of all cases. It usually spreads aggressively only locally, around the site of origin and grows very slowly
  • Squamous cell carcinoma (SCC) accounts for about 25% of all cases, and may be more aggressive and rarely spreads to local lymph nodes (metastases)
  • Malignant melanoma (MM), 1-5% of cases. This tumor can be very dangerous, with frequent development of regional and/or distant metastases

Other, less common tumors arise from structures under the skin (subcutaneous fat, hair follicles, sebaceous glands, sweat glands, blood and lymph vessels, and nerves).

WHAT ARE TREATMENT OPTIONS?

If your doctor recommends, surgical removal of the entire change (or slightly less often part of it) is performed. This procedure is called a biopsy. The sent tissue sample is sent for pathohistological analysis (PHD) where the pathologist checks what kind of change it is, ie. whether the removed change corresponds to the cancer.

We emphasize that biopsy and pathohistological analysis (PHD) of a sample of altered skin is the only way to know with certainty whether it is cancer. It should be noted that the standard treatment of skin growths is complete surgical removal, i.e. excision. Only a completely removed tumor guarantees a complete cure. In this sense, the surgeon’s task is to ensure safe (healthy) surgical edges. Of course, the aesthetics of the scar is certainly important, but not with the compromise of the residual (rest) tumor.

The ideal type of removal may depend on the appearance and size of the cancer, the risk of scarring (the patient’s proneness), age, and general health. There are several removal options:

  • Surgical removal is the main and safest treatment. The tumor is removed with a secure healthy border that is typically a few millimeters. The resulting defect is closed by suturing of the wound edges together or can be closed by “borrowing” tissue from the surrounding area, ie. so called flap. Sometimes (in large lesions) a free transplant of healthy skin taken from another part of the body is sutured into the resulting defect. There is also the possibility that the wound does not need to be primarliy closed at all, but that it heals with so-called secondary type of healing. For some regions on the face it is a very convenient way for the final appearance of the scar.
  • Excochleation and cauterization – under local anesthesia, the cancer is removed with a sharp instrument, and the surrounding tissue is treated with a special instrument (electrocautery) to control bleeding and destroy any remnants of lesion around the edge of the wound. Most patients develop a flat, whitish scar upon completion of healing, no larger than the removed lesion.
  • So called cryosurgery (freezing with liquid nitrogen) for very small changes or actinic keratosis
  • Laser removal is sometimes used for tumors that affect very superficial parts of the skin. In similar cases, dermabrasion can be used.
  • Radiotherapy (radiation), a method used somewhat less frequently, in special cases and in places more difficult to access surgery
  • Topical chemotherapy with cream or lotion

AFTER THERAPY

Postoperative controls are mandatory for all skin cancers. It is good to know a statistic that says there is a 50% chance of a second skin cancer appearing after the first one is removed. Therefore, the recommended time for regular check-ups is approximately 3-5 years after removal of the first tumor.

SKIN CANCER PREVENTION

Put simply, there are 5 most important ways to protect against skin cancer:

  • avoiding excessive sun exposure. Staying in the shade, especially at noon (10 h -16 h) when UV rays are strongest and most harmful,
  • covering the skin with clothes and shoes,
  • wearing a head covering (hat, scarf) or eyeshadow, head, ears and neck,
  • umbrellas that provide approximately 100% UVA and UVB protection,
  • applying sunscreen or oil (SPF) 15 or higher.

PRICES

Prices vary depending on many factors.

  • Surgical removal of a skin lesion with primary reconstruction – 800 – 1000 HRK
  • Removal of skin lesion with local lobe reconstruction or
    free skin graft –
    1000 – 2000 HRK
  • Removal of another growth on the face or neck under local anesthesia
    (lipomas, etc.) –
    1000 – 3000 HRK
  • Pathohistological analysis of the preparation (PHD) – 400 HRK