Understanding Skin cancer

According to the 2019 Cancer Registry Report released in 2022, skin cancer is the eighth most common cancer in Taiwan. Early skin cancer, handheld dermatoscope often a painless, easy to ignore its existence, but if we do not pay attention to it, it is likely to cause deterioration. The main problems with skin cancer can be divided into 3 types, with different symptoms and degrees of malignancy. Take a look at the types, symptoms and causes of skin cancer:

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The main problems of skin cancer types can be divided into the following three categories:

Basal cell carcinoma (BCC)

This is the most common skin malignancy and usually looks bright and protrudes around the epidermis , 365nm UV Lamp presenting as a small mass of skin color and dilated microblood vessels, with occasional ulcerated wounds in the middle.

About 70% to 90% of this type of skin cancer occurs on the face and other areas where sunlight hits directly. Although basal cell carcinoma is generally less likely to metastasize, it tends to affect appearance more easily. If it is not detected early, it may invade local nerves in China or cause damage to local tissues.

Squamous cell carcinoma (SCC)

It is the second most common skin malignancy in Asians. Most of the appearance is a prominent crumb keratosis or ulcer, prone to long-term exposure to the sun, such as the ears, face, lips, and mouth, and sometimes in the legs or abdominal wall affected by chronic injury or radiation.

Squamous cell carcinoma usually develops into a large mushroom-like mass that may spread through the lymph glands, causing enlarged lymph nodes, and is more likely to metastasize to places such as the lungs, liver, brain, or bones.

Melanoma cell carcinoma (melanoma)

It is the third most common skin malignancy in Asia, with an incidence of about 1 in 100,000. This type of skin cancer is the most malignant, easily metastasized and has a high mortality rate. In Asians, melanoma often appears in the fingers, toes, palms, soles of the feet, fingernails and other limbs. It can also appear on any part of the body, including the face and mucous membranes.

According to statistics, the most common site of melanoma is football, and the prognosis is not good. Clinically, it may appear as a dark or discolored patch, or it may appear as a raised mass that must be distinguished from a benign pigmented cell nevus or mother spot (often called a birthmark).

Is there a precursor to skin cancer?

The most common warning sign of skin cancer is a change in the skin. The following three are commonly considered signs of skin cancer.

Changes in life, hair, or belt on a small scale

A red lump or a bleeding scab

Something flat, rough, dry, or scaly

However, even if the above changes in the skin occur, it does not necessarily mean skin cancer, as most skin tumors are actually related to sex. However, once the above conditions are detected on the skin, or the symptoms on the skin persist for more than a week without improvement, it is best to see a dermatologist as soon as possible for further confirmation or early examination.

What are the symptoms of skin cancer? The early symptoms of skin cancer? Late symptoms?

The symptoms of each type of skin cancer are different. Details are as follows:

Basal cell carcinoma: The early manifestation is the appearance of small, bright, almost transparent to pink, raised but hard nodules on the skin. With telangiectasia, although there is no pain or pressure pain, the skin gradually loses its normal luster. After a period of time, which can be months or years, repeated scabs, desquamation, and ulcers can form, just like insect bites.

Squamous cell carcinoma (SCC) : A red or flesh-colored tumor or ulcer that grows gradually and sometimes becomes covered with scaly skin.

Melanoma: The patient's skin usually develops new dark spots, or the original skin spots or moles gradually become larger, deformed, or discolored, which can take weeks to months to learn. Unlike normal skin spots or moles, melanomas are irregular in shape and even form a bumpy surface with no established color, which may be coffee, black, white, blue, red, gray and other colors.

What causes skin cancer?

Ultraviolet light is the biggest cause of skin cancer, so people who work in the sun for a long time are at high risk of developing skin cancer.

After years of exposure, it is easy to make the keratinocytes and melanocytes in the epidermis cancerous, leading to basal cell carcinoma, squamous cell carcinoma and malignant melanoma.

In addition, squamous cell carcinoma also has radiation exposure, prolonged wound healing, long-term exposure to chemicals and chronic arsenic poisoning and other carcinogenic factors. Severe sunburn after heavy exposure, Caucasian race, and genetic factors are other causes of malignant melanoma.

Skin cancer stage? Skin cancer stage and survival rate?

Basal cell carcinoma and squamous cell carcinoma can be divided into two stages, the local stage and the metastatic stage. Malignant melanoma can be divided into the following four stages:

Phase 1

1a: Tumor thickness ≤1mm, limited to the dermis

1b: Tumor thickness ≦ 1 mm, ulcer or confined to the subcutaneous fat layer.

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Phase 2

2a: Tumor thickness 1.01 ~ 2.0 mm with ulceration or 2.01 ~ 4.0 mm without ulceration and metastasis.

2B: The tumor thickness is between 2.01 ~ 4.0mm, with ulcers or > 4.0mm, no ulceration or lymph node metastasis

2C: tumor thickness > 4.0mm ulcer, no lymph node metastasis

Phase 3

3A: The tumor was 4.0 mm thick, ulcer-free, and had 1 to 3 lymph node metastases

3B: The tumor is 4.0 mm thick, with or without ulcers. There were 1 to 3 lymph node metastases or satellite metastases, and no lymph node metastases

3C: The tumor is 4.0 mm thick, with or without ulcers and 1 to 3 lymph node metastases, or with 4 lymph node metastases or satellite metastases with lymph node metastases

Phase 4

Tumors metastasize to other organs, such as the lungs, liver, and brain.

Once melanoma occurs, it may spread through the lymph and bloodstream to all parts of the body; If metastasis occurs, the average survival time is significantly reduced to less than one year. According to the statistics of 221 melanoma patients in Changgung Hospital in the past 10 years, the 10-year survival rate of patients with first and second stage is as high as 70%. However, the survival time of patients with local lymph nodes in stage III was significantly shortened, with an average of 3 years. Patients with stage 4 had the shortest survival, with an average of about one year.