What Is Skin Cancer?

Skin cancer is a disorder of the skin cells caused by mutations in the cell's DNA, which makes cell growth fast, the cell's age is longer and the cell loses its basic properties. Skin cancer commonly occurs on the skin that is often exposed to sunlight, but this condition can also occur on the skin that is not exposed to direct sunlight.

Based on the type of cells that are attacked, skin cancer is divided into three types:
  • Melanoma. This is a skin cancer that occurs in the melanocyte or skin pigment producing cells. Skin cancer melanoma is a rare, but dangerous skin cancer.
  • Non-melanoma skin cancer. It is a skin cancer that occurs in skin tissues other than melanocytes. Non-melanoma skin cancer is divided into the following two types:
    • Caesinoma S el B origin ( Basal Cell Carcinoma , BCC ), ie skin cancer that occurs at the bottom of the epidermis. Basal cell cancer is the most common type of non-melanoma cancer in humans.
    • Squamous Ca Secrhinoma S squamous ( Squamous Cell Carcinoma, SCC ), a skin cancer that occurs in the upper part of the epidermis. Squamous cell cancer is quite common, but the frequency is not as much as basal cell cancer.

Skin Cancer Symptoms
Skin cancer generally occurs in areas that are often exposed to sunlight such as on the scalp, face, lips, ears, neck, chest, arms, and legs. However, in some cases, skin cancer can also occur in areas rarely exposed to sunlight such as the palms and feet, the bottom of the fingers, even in the genital area. Skin cancer can occur to anyone, including in people who have dark skin color. The symptoms of skin cancer differ for each type. The general picture is as follows:
  • Basal cell carcinoma (BCC). BCC generally occurs in areas often exposed to sunlight such as the neck or face. Symptoms of basal cell cancer include:
    • The lump is soft and shiny on the skin.
    • Lesions are flat on dark brown or reddish-brown skin such as meat.
  • Squamous Caucasian Cells (SCC). SCC is also common in sun-exposed areas of the skin. But in dark-skinned people, squamous cell cancers often occur on the skin on the part of the body that is rarely exposed to sunlight. Symptoms of SCC in general are as follows.
    • Red lumps are hard on the skin.
    • Skin lesions are flat and scaly as crust.
  • Melanoma. Melanoma can grow in any part of the skin, either in normal skin or on an existing mole that turns malignant. In males, melanoma cancer usually appears on the face and body. Whereas in women, melanoma more often appears in the lower leg. Both in men and women, melanoma can appear in areas of skin that are not exposed to sunlight. Melanoma can be experienced by anyone regardless of skin color. In dark-skinned people, melanoma generally occurs in the palms of the hands or feet and under the fingers or toes. Symptoms of melanoma that generally occur are as follows:
    • A brown lump with black spots on the bump.
    • A mole that changes color and size or bleeds.
    • The appearance of small lesions on the skin with irregular edges, or red, white, blue, and blue-black lesions.
    • The appearance of dark-colored lesions on the palms, soles of the feet, fingertips or feet.
    • The appearance of dark-colored lesions of the mucous membranes in the mouth, nose, vagina, or anus.
The following is a list of ABCDEs about melanoma characteristics to distinguish them from ordinary moles.
  • Asymmetrical. The form of melanoma is generally asymmetrical when compared with ordinary moles.
  • Border (fringe). The edge of melanoma is generally squiggly, not round like a normal mole.
  • Color (color). The color of melanoma is a combination of two or more colors.
  • The diameter of melanoma is generally more than 6 mm.
  • Enlargement (enlargement). Melanoma will enlarge over time.

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Other Skin Cancer Cases
Here are other types of skin cancer are more rare, including:
  • Kaposi 's sarcoma Kaposi's sarcoma occurs due to a viral infection that causes mutations in endothelial cells, in the form of red or purple patches on the tissue under the skin. Kaposi sarcoma can occur in people with immune system disorders such as AIDS patients or recipients of organ transplants, infected by human herpesvirus 8 (HHV-8).
  • Cell Caucinoma Cells Merkel cells are cells located close to the nerve endings in the skin, and are related to the function of the skin as the sense of touch. Malignancy in Merkel cells is very rare, and causes the formation of a hard lump under the skin or on the hair follicle.
  • Oil gland Ka rsinoma (sebaceous glands). Cancer of the sebaceous glands is a rare, but aggressive cancer. Sebaceous gland cancer generally appears in the oil glands of the skin, then form a hard lump that does not hurt. Sebaceous cancer can occur anywhere, but it usually occurs in the eyelid and is often misdiagnosed as another eye disorder.
Not all abnormalities or protrusions of the skin are caused by cancer, but often skin cancers appear as mild skin lesions, so doctors' diagnosis is crucial in determining the cause and type of abnormality.

Causes of Skin Cancer
Generally skin cancer is caused by exposure to ultraviolet rays resulting in DNA damage to skin tissue. The main source of ultraviolet light is sunlight which consists of three types:
  • Ultraviolet A (UVA)
  • Ultraviolet B (UVB)
  • Ultraviolet C (UVC)
Of the three types of ultraviolet light, the most harmful to the skin is UVC rays. However, UVC rays can be absorbed by the atmosphere before reaching the ground. UVA and UVB can damage skin cells, especially the pale, and potentially cause skin cancer.
Artificial UV light sources such as UV lamps and tanning beds can also cause skin cancer.

Some factors that can increase a person's risk of skin cancer are:
  • Have white skin . Everyone, regardless of skin color, can suffer from skin cancer. However, white skin has less protection against UV rays than darker skin. Darker skins have more melanin levels that provide stronger UV protection. In addition, the easy form of spots on the skin indicates the skin is more susceptible to skin cancer.
  • Often exposed to sunlight. People who are often exposed to sunlight are more at risk of skin cancer than those who are rarely exposed to sunlight. Some conditions that can increase exposure to sunlight among others
    • Living in an area that has a sunny climate.
    • Living in a higher area.
  • Mole. A person who has many moles or has an abnormal mole (larger than usual) is more at risk of skin cancer than people with fewer moles.
  • Age. People with advanced age are more susceptible to skin cancer than children or adolescents.
  • Sunburn skin ( sunburn ). Skin blistering due to sunlight makes the skin more at risk of skin cancer, especially if the skin blisters occur at the time of children or adolescents.
  • Actinic keratosis . In people with bright skin, easy exposure to sunlight results in the formation of patches of scaly skin thickening of the face, hands and head. This condition is pre-cancerous, and is potentially turned into skin cancer.
  • History of skin cancer If a person has had skin cancer and recovered, it is likely that the same condition will reappear.
  • A history of skin cancer in a family member. A person at high risk of skin cancer if you have a sibling or a parent who has had skin cancer.
  • Weakening of the immune system. People with weakened immune systems have a higher risk of skin cancer. Including people with HIV / AIDS, people taking immunosuppressant drugs, and organ transplant recipients.
  • Radiation therapy . Patients with eczema or acne given radiation therapy have a high risk of skin cancer, especially basal cell cancer.
  • Exposure to certain chemicals. Some chemicals are carcinogenic, such as arsenic, may increase the risk of skin cancer.

Diagnosis of Skin Cancer
To accurately diagnose skin cancer, the doctor will apply the following steps to the patient:
  • Physical examination of the skin. The doctor will examine the form of skin disorders, especially changes that occur in physical appearance. With this examination, the doctor will determine whether the changes are caused by cancer or other diseases.
  • Perform skin biopsy. Examination of skin tissue samples taken by biopsy in the laboratory.
After the diagnosis is done, the doctor will determine the severity of skin cancer suffered based on the stadium as follows:
  • Stage 0 , indicating that cancer tissue is still where it first appeared and has not spread (in situ).
  • Stage 1 , indicating that cancer tissue is still small and has not spread.
  • Stage 2 , indicating that cancer tissue has grown, but has not spread.
  • Stage 3 , indicating that the cancer has enlarged and has spread to surrounding tissues or to nearby lymph nodes.
  • Stage 4 , indicating that the cancer has spread to other parts of the body or has undergone metastasis.
Determination of the stage of skin cancer is done to determine the appropriate treatment. In basal cell carcinoma, cancer cells usually do not spread so skin biopsy can determine the type and stage of cancer. But in other types of skin cancers, such as squamous cell carcinoma, mercell cell carcinoma, or melanoma, doctors will perform further examination to get more accurate results. One of the more frequent follow-ups is a lymph node biopsy in the area of ​​the cancer.

Skin Cancer Treatment
Handling depends on the type and stage of skin cancer. The main skin cancer treatment is surgery to remove cancer cells, especially in the type of melanoma.
In skin cancer melanoma type, treatment is adjusted to the stage of cancer. An overview of treatment for each stage of cancer is as follows:
  • Stage 1 and 2 melanomas can be treated by surgery to remove healthy cancerous and skin tissue around the tissue. This surgery is known as an excision surgery. If the excision surgery is expected to leave a large scar, this procedure can be combined with skin grafting . Surgical excision has a fairly good success in patients with stage 1 and 2 melanoma cancer, which is about 80-90 percent. After surgery, the patient will be intensively monitored by health care workers.
  • Stage 3 melanoma can be treated by excision surgery on cancer tissue. To keep the cancer from spreading to other organs, lymph node biopsy may be performed. If the lymph node biopsy results indicate the cancer has spread to the gland, it can be surgical removal of lymph nodes to prevent the spread of cancer further.
  • Stage 4 melanoma occurs when cancer tissue has spread to other organs (metastasis). The goal of stage 4 cancer treatment is no longer to kill cancer cells, but to prolong patient life expectancy, slow the growth of cancer, and reduce the symptoms that arise. Treatment, among others, through radiotherapy or immunotherapy.

In non-melanoma skin cancer, treatment can be done through the following methods:
  • Surgical excision combined with skin grafts. The goal is to remove cancer cells and prevent them from spreading.
  • Mohs micrographic surgery (MMS ) surgery . This method is used if cancer cells are feared to have spread or occur on a very important part of the skin, such as the eye or nose area. In MMS surgery, the edge of cancer tissue is examined microscopically to make sure all cancer cells are completely removed. If cancerous tissue still exists, surgery is done again.
  • Curettage. This method of treatment is applied to non-melanoma cancers of very small size. Here the doctor will perform cancer cancer network until the remaining healthy network, then do the burning (cauterization). The procedure of curettage method can be done several times to make sure no cancer cells are left.
  • Krioterapi. This cancer treatment method is done by using cold temperature to kill cancer cells in the early stages. In cryotherapy, patients will be given liquid nitrogen to freeze the cancerous tissue that causes the formation of scabs in the area. After a few weeks, the ulcer that contains cancerous tissue will then be released by itself.
  • Anti-cancer Creams Anti-cancer cream is used for the treatment of cancerous tissue found only in the upper layers of the skin, such as basal cell cancer or Bowen disease. There are two types of anti-cancer cream that is:
    • Chemotherapy cream
    • Immune-stimulating cream
  • Photodynamic therapy. This therapy is used to treat basal cell cancer, Bowen's disease, and keratose asitinik. This therapy uses certain creams to make skin cancer more sensitive to light. After the cream is used, the skin is irradiated with strong intensity light to kill cancer cells.
  • Radiotherapy . That is the treatment through radiation methods. This therapy is done if surgery can not be done or cancer has spread widely.
  • Electrochemotherapy. This is a more complicated, but more effective, method of chemotherapy. Electrochemotherapy is applied if surgical methods, radiotherapy, and chemotherapy do not work effectively in removing cancer. Electrochemotherapy is performed by giving intravenous chemotherapy to patients, followed by shock delivery of electrode to the cancerous tissue. The flow of electricity will facilitate chemotherapy drugs to enter into cancer cells so that cancer cells become more easily damaged. This method is usually carried out using total anesthesia to the patient, although in some cases, the patient is only given local anesthesia. Electroemotherapy procedures usually last for several hours and the results can be seen in six weeks.
Prevention of Skin Cancer
Here are some ways you can do to prevent the occurrence of skin cancer:
  • Avoid the sun at noon. This step can be done by arranging an outdoor activity schedule during the day. UV accumulation of the skin in the long term can damage the skin and cause cancer. By avoiding sunlight during daylight, the accumulation of UV light can be reduced.
  • Use sunscreen on a regular basis. Sunscreen or sunscreen can not absorb all types of harmful UV radiation, but can reduce adverse effects and damage to the skin caused by sunlight.
  • Use clothes that can protect from the sun. Because sunscreens can not absorb UV radiation entirely, using clothes that cover the body, including the arms and legs, can provide additional protection against the harmful effects of sunlight. In addition, hats and sunglasses can provide more protection for the head and eyes of solar radiation, especially UVA and UVB.
  • Avoid the use of tanning beds . Tanning beds used to darken skin tone emit UV radiation that can be harmful to the skin.
  • Be careful in using drugs with side effects on the skin. Some drugs like antibiotics increase the sensitivity of skin to light. If taking the drug with these side effects, should reduce the activity outside the room, especially at noon.
  • Perform routine skin checks and consult skin changes that are considered unusual to the doctor.

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