Which is the largest organ in the human body? Most people get this answer wrong. The answer is skin. Most people do not think of skin as a organ in true sense like liver or kidney.
In quite similar fashion, skin cancers are also underestimated. Skin cancer is one of the most common cancers with the incidence being much higher than other cancers like breast and lung. The reason it does not get much attention is because quite a few skin cancers are harmless and patients may carry it on throughout their life. This is particularly true of a variety of skin cancer called basal cell carcinoma. This makes it difficult to give maintain a database and give clear statistics about skin cancer.
In many ways skin cancer has many paradoxes. While on one hand we have skin cancers which are very slow growing, on the other hand we have cancers which are very aggressive and progress from diagnoses to metastases within a matter of months. This can happen in a variety of cancer known as melanomas. There is a wide variation in the behaviour of skin cancers having the same name. Most basal cell carcinomas are indolent while few others may behave aggressively. Treatment also varies from wait and watch to simple excisions and radical surgery.
Most of us have some spots or moles in different parts of our body. The key question is which of these are harmful. It is important for us to know about the various spots on our body and keep track of them occasionally.
Certain changes in the spots should raise red flags and prompt you to seek medical attention, These are :
- Rapid growth in the size of a spot or mole
- Bleeding from these lesions
- Lesion suddenly starts becoming itchy
- Lesion becomes painful
- Appearance of new lesions
While most of these signs may end up as not cancer it should warrant seeking medical attention.
Most people visit their dermatologist and if the doctor finds the lesion suspicious, they may order a biopsy. Skin biopsy is usually a very simple procedure under local anaesthesia. The biopsy specimen is then sent to a pathologist for confirmation if there is a cancer or not.
Certain type of people are more susceptible to get skin cancer. These include :
- People who go out in the sun very often
- Aged people
- Those who are immunosuppressed especially post organ transplantation
- Family history does play a role in certain skin cancers
- Preexisting conditions like certain keratoses can increase the risk
Broadly there are three types of skin cancers :
- Squamous carcinoma
- Basal cell carcinoma
- Melanomas
Treatment will depend on where the cancer is located, its type and the extent of spread in terms of depth and spread to lymph nodes.
In most cancers which are small and superficial just burning the lesion using cryotherapy may suffice.
Mohs surgery is a particular variety of surgery done for cancer in cosmetically sensitive areas like face. Here the cancer is sliced layer by layer like a loaf of bread so that the bare essential removal is done
Few cancers which are more aggressive and penetrate deep require wide excision with possible plastic surgery.
Radiation in used in certain types of skin cancers; Chemotherapy is used in certain aggressive cancers like melanomas.
Prevention of skin cancer is by not going out too much in the sun and using protective garments and sunscreen lotions.
Dr Anil Kamath is a senior consultant surgical oncologist with expertise in treating Gall Bladder cancers. He is available for consultation at Apollo Hospital, Bannerghatta Rod and Healius cancer clinic. For appointment call +91 9900613143