Full boarded in Plastic and Reconstructive Surgery
Of all the cancers, skin cancer is the most frequent. Even though it can occur anywhere on the body, the areas most affected are the most exposed ones (face and hands).
The first cause of skin cancer is due to exposure to ultra-violet rays, therefore, prolonged exposure to the sun, and also to artificial sources, such as sunbeds and tanning lamps. In the past, it was referred to as the farmer's or fisherman's disease who, for work reasons, were more exposed than others to the damaging effects of the sun's rays.
Skin cancers can hit anybody, independently of their phototype, race, sex or age. However, the risks are higher if the subject:
- has a fair complexion
- has red hair
- is continually exposed to the sun
- has a high number of moles and freckles
- has undergone radiotherapy treatment
- lives near the equator
The most common skin cancer is Basal Cell Carcinoma. Fortunately, it is also the least dangerous and aggressive. It spreads slowly and only in exceptional cases does it become metastatic. It's aggressivity is only local and its surgical removal is enough to fully resolve the problem without resorting to any other treatment.
The second most common skin cancer is Squamous Cell Carcinoma. It often occurs on the face and lips. It is more aggressive than Basal Cell Carcinoma, and spreads much more quickly in tissues and can eventually become metastasic. It is a dangerous lesion if not treated quickly.
The third type of skin cancer is Malignant Melanoma. Unfortunately, it has been steadily increasing in frequency and is certainly the most dangerous of the skin cancers. If diagnosed early and treated in time it can be completely cured, but, if not, it can be extremely dangerous as it tends to develop into metastasis and spread to the internal organs, often with mortal consequences.
The two types of benign skin cancers are moles and keratoses. The first occurs in different shapes, colours and sizes all over the human body. They can be flat or raised and sometimes can change over time into a Melanoma. The second can occur due to sun exposure or ageing and takes the form of actinic keratoses and seborrhoeic (age-related) keratoses. These can also sometimes change and become Basal and Squamous Cell Carcinomas.
Skin cancers can appear in different forms. Therefore, it is advisable to consult a specialist in Plastic Surgery or Dermatology if you are worried if a lesion appears or a mole changes. Many people have a very high number of moles which makes it difficult for an untrained eye to carry out a self-examination and it is advisable for them to do a mole mapping by a specialist.
The general advice I can give you is that if you notice the appearance of a new lesion or change in a mole on your body you should immediately consult a specialist.
The final diagnosis of a skin lesion is done by a biopsy and histopathological exam under a microscope.
Skin cancer treatment depends on different factors - the type of lesion, size, location.
It can involve a simple excision and immediate wound closing under a local anaesthesia and immediate dismissal, or a more serious operation with a larger excision and skin reconstruction in the area to be carried out and,consequently, under a general anaesthesia and hospitalization.
Depending on the type of lesion removed, a follow-up clinic for the patient could be necessary.
There is no possibility to avoid a relapse and it needs to be underlined that a patient who has developed any type of skin cancer can, over time, develop others. The best solution is to have regular checkups so as to intervene as early as possible if new lesions appear.
It could be also advisable to change one's lifestyle and habits avoiding, for example, excessive exposure to the sun.