How to recognize skin cancer: types of skin cancer, possible causes, symptoms and first signs of a disease, stages, treatment and prognosis of oncologists

Oncology has many varieties. One of them is skin cancer. Unfortunately, at present, the progression of pathology is observed, expressed in the growth of cases of its occurrence. And if in 1997 the number of patients on the planet with this type of cancer was 30 out of 100 thousand, then a decade later the average was already 40 people.

The highest incidence occurs in hot countries located in the tropical climate zone. Especially many patients with this diagnosis in New Zealand and Australia. The average age of the onset of pathology is considered to be 57 years. Moreover, a greater number of patients are people with white, not black skin.

What is this pathology?

Skin cancer is a malignant disease arising from the transformation of squamous cells with a high degree of polymorphism. This pathology is another confirmation of the fact that the main determining moment in the development of oncological ailments in humans is nothing more than the aggressive effect of external factors.

Human skin serves as a kind of "spacesuit" for him. It protects the body from the uncomfortable effects of the environment, while mitigating the occurrence of negative effects through sclerotic and inflammatory processes. After the depletion of compensatory mechanisms in a certain area of ​​the skin, the uncontrolled and uncontrolled growth of immature tumor cells from previously normal tissue begins. In this case, there is a tendency to the destruction of surrounding organs.

It is noted that the average person has a higher risk of skin cancer than the appearance of tumors with localization in the internal organs. The proof of this is that more than 50% of people who have survived to 70 years have one of the varieties of just such a pathology. All this is due to multiple sources of malignant tumors, which will be discussed below.

Pathology classification

When considering the structure of the skin in its structure, the epidermis and its appendages are isolated. So, the upper layer of our “spacesuit” is a flat stratified keratinizing epithelium, which is located above the basement membrane. The latter is a kind of border between the epidermis and underlying tissues.

Our “external spacesuit” also has a peculiar “buffer-shock absorber”. This is subcutaneous fat. It does not form part of the skin, despite the fact that it is located directly under the epidermis. Such a layer is located between the internal organs and the external integument.

Microscopic studies allowed scientists to distinguish the following layers of the epithelium:

• lower or basal;
• malpigian, or prickly;
• grainy;
• external or horny.

In the lowest layer of the epidermis - the basal, is melanin. This component is responsible for skin color. In the immediate vicinity of the basement membrane, on its two sides, melanocytes are located. They are the source of melanin production. There are also appendages of the skin near the membrane. These include the sebaceous and sweat glands, as well as hair follicles.

Based on tissue, malignant tumors are of three types. Among them:

• basalioma;
• squamous cell pathology;
• melanoma.

Basal cell skin cancer sources are basal cells. The tumor in this case increases at a slow pace, without metastasizing for an extended period of time. As a rule, pathology is found on the face and looks like a regular plaque. Over time, basalioma grows into the surrounding tissue and causes their destruction.

With squamous cell carcinoma, exposed areas of the body are affected. In addition, its formation occurs in scar zones and in those places where chronic chronic dermatitis is localized. This type of tumor metastases, passing through the lymphatic system.

Melanoma is the most aggressive form of skin cancer. The development of this type of pathology occurs from cells that contain the pigment melanin. Most often, the disease arises from the pigmented nevus or from a mole. The risk of this disease increases significantly with prolonged exposure to the sun.

In addition to the three main clinical forms of skin cancer, there are:

1. Adenocarcinomas. They are tumors that develop from the secreting epithelium of the sebaceous and sweat glands.
2. Mixed tumors. Manifested in several tissue sources.
3. Metastatic tumors. Such malignant neoplasms are a consequence of cancer of the internal organs.

Earlier, the classification of tumors included some of its varieties that were found in soft tissues. These are dermatosarcoma of the skin, leiomyosarcoma, angiosarcoma and some other pathologies.

Causes

It should be borne in mind that skin cancer, doctors do not belong to the most common cancer. It accounts for approximately 5% of all cases of cancer diagnosis. But at the same time, this form of pathology does not have gender differences. Skin cancer in a woman and a man can develop with the same probability, affecting people, as a rule, who have reached the age of 50. Moreover, the causes that cause its appearance are divided into external and internal. Let's consider them in more detail.

External causes

Among the main risk factors for developing skin cancer are:

1. Irradiation with UV rays (exposure to sunlight). This explains that the development of skin cancer usually occurs in open areas of the body, namely on the forehead, nose, ears, corners of the eyes and other parts of the head. After all, the areas of their location are most exposed to the rays of the sun. On the skin of the legs, arms and body, malignant neoplasms are quite rare. Their probability relative to all cases of detection of the disease does not exceed 10%. Can provoke the development of cancer, not only prolonged, but also a single, but at the same time intense exposure to UV rays. Especially often this is the cause of the development of melanoma. Often, those people who are irregularly exposed to the scorching sun get sick with this form of skin cancer, but only occasionally. An example of this is the situation when an office worker spends his holidays on the beach. Recently, the impact of this factor has become major. This is affected by the increase in the destruction of the ozone layer, which is the protection of our planet from ultraviolet rays. Often, skin cancer also affects bronze tanning enthusiasts visiting tanning salons.
2. Mechanical skin injuries. They can cause the appearance of a malignant formation if the areas on which the birthmarks are located (pigmented nevi) are damaged.
3. Irradiation with ionizing (gamma and x-ray) radiation. Such an effect contributes to the development of radiation dermatitis of an early or late type.
4. Irradiation with infrared rays. As a rule, this factor is present in the metallurgical and glass-blowing industries.
5. Prolonged or regular contact with certain substances that can have a carcinogenic effect. These include petroleum products, coal, herbicides, insecticides and mineral oils. The development of pathology is possible with frequent use of hair dye.
6. Intoxication of arsenic species.
7. Thermal burns. They are especially dangerous when repeated.

Internal causes

Such predisposing factors for the development of skin cancer include:

1. Race. The greatest predisposition to the development of skin oncology are blondes and people of the Caucasian race. Among representatives of the black race, patients with this disease are extremely rare.
2. Weak immunity. It also predisposes to skin cancer. A certain danger in this regard is the period of pregnancy, during which all conditions are created for the degeneration of moles or pigmented nevi.
3. Heredity.
4. Human infection with certain types of papilloma virus (HPV).
5. Inflammatory processes of a chronic nature of various etiologies that capture not only the skin, but also the underlying tissues. These include deep mycosis and fistulas, trophic ulcers and the gummous form of syphilis, systemic lupus erythematosus, and other types of similar pathologies.

Disease development

When exposed to ultraviolet radiation, as well as other causal factors, in most cases, skin cells are damaged directly. This causes an effect on DNA. Destruction of the cell membranes is not detected. With partial destruction of nucleic acids, a mutation occurs, leading to a change in membrane lipids, as well as in key protein molecules. In this case, damage is noted in the epithelial basal cells.

However, HPV and various types of exposure cause not only a mutagenic effect. The body develops immune deficiency. A similar process is explained by the death of dermal cells, as well as the irreversibility of the destruction of certain membrane antigens necessary for the activation of lymphocytes. As a result, the cellular immune link fails and the antitumor defense mechanisms are suppressed.

Common symptoms

How to recognize skin cancer? At the earliest stages, the volume of malignant tissue is still quite small. Changes affect the body at the cellular level. In the subsequent period, a solid intradermal and cutaneous formation appears. This process is due to a progressive increase in the number of tumor cells. In addition, pigmented spots or ulcers with an infiltrated base appear on the skin. The symptoms of skin cancer (see the pathology photo below) do not include pruritus at the site of the neoplasm.

In other words, whether the spot appears to scratch or not, this is not a diagnostic sign of skin cancer. The progression of the tumor can be suggested by pain cider in the place of its localization.

How to recognize skin cancer? Among the possible symptoms of pathology, there are:

• the formation in the thickness of the skin of a dense nodule with a pearl white, reddish or dark color, which has a tendency to increase and grow into adjacent tissues;
• the presence of a spot of irregular shape, which is characterized by uneven peripheral growth;
• the formation of a pigmented seal, with a tendency to progressive central ulceration;
• the detection of a tuberous, slightly protruding above the surface of the skin integument of a dense formation, which has a heterogeneous color and areas of erosion and peeling;
• warty formation of a papillary type, prone to uneven softening, after which the formation of decay sites occurs;
• a change in the size and color of the nevi existing on the body with the appearance of a red corolla around them;
• pain that is disturbing in the area of ​​scars and skin formations, indicating a deep lesion of the dermis.

Skin cancer (the photo, what the pathology looks like, is given below), as a rule, manifests itself in open areas of the body and on the face, as well as in places that are rubbed with clothes or often injured for one reason or another.

In most cases, such neoplasms are single. However, cases of the appearance of several tumors at once are not an exception.

Stages of the disease

How to recognize skin cancer? At the initial stage of the pathology, only local symptoms appear. The tumor size is within 2 mm, without going beyond the epidermis. This is a visible formation that can move with the movement of the skin. In the study, it turns out that the pathological process covers not only the upper, but also the lower layers of the epidermis. The patient's condition does not cause any alarm. The prognosis for his recovery is quite favorable.

What does skin cancer look like in the second stage? An increase in the size of the tumor indicates the progression of the disease. It reaches 4 mm in diameter, while capturing the deep layers of the dermis. In this case, the patient complains of the appearance of pain or itching. Sometimes one of the nearby lymph nodes is involved in the pathological process or a secondary one appears on the periphery of the main focus. Metastases in the second stage of skin cancer are usually absent. However, in rare cases, one of them may still occur. If the pathology is detected in a timely manner, then the doctors give a comforting prognosis to their patients. Based on statistical data, 50% of patients live with proper treatment for 5 years.

What happens in the third stage of the disease? With its further progression, malignant cells spread through the lymphatic stream. At the same time, they carry a package defeat of distant and regional lymph nodes. At this stage, the main symptoms of skin cancer (photo below) are scaly or lumpy painful neoplasms.

Due to the fact that such foci of pathology sprout to the subcutaneous tissue, they have limitations in movement. Metastases spread through the lymphatic system without affecting the internal organs. The prognosis for patients at this stage is relatively comforting. Based on the available data, the survival rate is 30%.

In the last, fourth stage, the disease leads to multiple hematogenous and lymphogenous metastasis. What does skin cancer look like at this stage? New tumorous formations appear on the body. And they are not only on the skin. Tumors are located in various organs, leading to an increase in general exhaustion, called "cancer cachexia." At this stage, patients complain of high soreness. After all, the pathological process begins to capture the cartilage and bone tissue. Often, a tumor bleeds, spreading pathological cells throughout the body and poisoning it. The forecast at this stage is disappointing. Only less than 20% of all patients survive.

Basalioma

How to recognize skin cancer at the initial stage? A photo of basal cell carcinoma, when it occurs, makes it clear to us that on the skin such a formation looks like a nodule or flat plaque. At this point, pathology is quite difficult to determine, since the tumor has not yet formed completely.

At the first stage, the neoplasm reaches a diameter of 2 cm. It is limited to dermis and does not pass into tissue adjacent to the focus of the pathology.

In the second stage of the disease, basilioma increases in diameter, reaching 5 cm. It covers the entire thickness of the skin, but does not extend to the layers of subcutaneous tissue.

In the third stage, the tumor becomes more than 5 cm in diameter. The lesion focus begins to constitute an ulcerated surface. The destruction of subcutaneous fatty tissue occurs, after which tendons, muscles and soft tissues are damaged.

The fourth stage of basal cell carcinoma is indicated by a tumor that has spread so much that, in addition to damage and ulceration of the soft tissues, it has managed to destroy bones and cartilage.

Symptoms and signs of skin cancer of this type can be determined by a simplified classification. It implies the division of basal cell carcinoma into the following stages:

• initial;
• detailed;
• terminal.

What does skin cancer look like at the initial stage (photo below)? When basal cell carcinoma occurs, it can be determined by small nodules with a diameter of less than 2 cm, on which there are no ulcerations.

How to recognize skin cancer at the advanced stage? This is the period when the tumor becomes larger, growing in diameter to 5 or more centimeters. In this case, primary ulceration occurs on the skin and soft tissue lesions occur.

How to recognize skin cancer at the thermal stage? Pathology is a tumor that has grown to 10 cm or more, which has grown in the underlying organs and tissues. At the thermal stage, the patient, as a rule, develops multiple complications caused by the destruction of organs.

There are several varieties of basal cell carcinoma, each of which has its own external signs:

1. Nodal With the development of this type of skin cancer, the initial stage of the pathology manifests itself in the form of the formation of a dense nodule that has a pearly pink color. It rises above the surface and has a recess in the center. When injured, such a nodule is easily damaged and begins to bleed.
2. Superficial.In this type of skin cancer, the initial stage is detected when plaques of irregular or round shape occur that have a red-brown color. Such neoplasms have slightly waxy shiny edges raised above the surrounding skin. Sometimes the patient immediately has several such foci that grow quite slowly and only in rare cases deepen into the skin.
3. Cicatricial. How to recognize skin cancer? At an early stage of occurrence, cicatricial basal cell carcinoma is a recess with raised waxy edges. At the bottom of this formation is dense tissue. With the development of pathology in the periphery, ulcerations begin to appear periodically. Over time, they scar and merge with the primary focus.

Squamous cell carcinoma

We proceed to consider the main signs of this type of pathology. How to recognize skin cancer at an early stage in this case? The initial manifestations of the pathology have many options, each of which depends on the form of cancer, morphology, as well as the localization of the focus of the malignant process.

With squamous oncology, changes can develop on various parts of the body. These are the soles of the feet, palms, perianal region, facial skin or scalp. Such cancer has several forms. One of them is plaque. How to recognize skin cancer (photo can be seen below)? With this form of oncology, a colored area appears on a certain part of the body, over which a tubercle appears. To the touch, this pathological zone is rough and dense.

Another form of squamous cell carcinoma is nodular. In this case, the initial stage of skin cancer (photo is presented below) represents the areas where there is an accumulation of different sized nodules, which looks like cauliflower. Such formations are brown and dense to the touch. At an early stage of development of this form of cancer, painful cracks appear on the skin. Gradually, nodules begin to form in them, which eventually grow and condense.

The next form of squamous oncology is ulcerative. In this skin cancer, the initial stage (in the photo below) is a pathological process in the form of ulcers in the upper layer of the epidermis.

The foci of the tumor rise slightly above the skin, deepening in the center. The edges of such an ulcer have borders in the form of a roller. Another symptom of this form of skin oncology is a characteristic odor.

Squamous cell cancer in its structure is divided into keratinizing and non-keratinizing, as well as differentiated and undifferentiated. Consider these forms of pathology. Thus, keratinizing cancer develops from certain cell structures in which the keratinization process has passed. Doctors say that this form is the most benign due to the fact that it progresses rather slowly and gradually infiltrates into the layers of underlying tissues. This form of cancer is difficult to diagnose due to the lack of color in a malignant tumor. To suspect the development of oncology is possible only with the appearance of keratinization on the surface of varicose ulcers and scars.

A large malignant process is the non-cornified form. Indeed, in this case, the foci of pathology infiltrate with high speed, reaching the lower layers of the skin. The main feature of this form of oncology is fleshy granulation, which has a soft consistency. The initial manifestations of this pathology are an education that affects only the upper layer of the skin. When you click on it, the patient does not feel pain. Over time, the formation begins to grow, its structure becomes denser, which leads to the appearance of a plaque that rises above the surface of the skin. The neoplasm continues to develop, and its color changes from a slight reddening to a wide variety of shades of brown. Then, upon palpation, pain begins to arise, and from the lesion there appears a blood or purulent exudate. Following this, a dense crust appears on the upper part of the formation.

Melanoma

This malignant tumor is the most aggressive. Moreover, it affects not only the skin. Its negative effects sometimes extend to the spinal cord or brain, eyes and internal organs. Moreover, changes are not only in the lesion focus. Skin cancer metastases can be found in many other organs. It is important to know the main feature of melanoma. When metastases occur, the primary tumor, as a rule, stops growing and even goes through the stages of reverse development. The establishment of the diagnosis itself becomes possible only after the detection of damage to internal organs.

How does it manifest itself in the initial stage of melanoma? Skin cancer may be suspected:

1. When tingling, burning and itching in the area of ​​pigmentation. Such symptoms are due to the active process of cell division.
2. In case of hair loss on the surface of the nevus. This process is due to the degeneration of melanocytes. They turn into tumor cells, which causes the destruction of follicles.
3. When darker areas appear on the pigmented formation or an increase in its general color. A similar process provokes the degeneration of melanocyte into a tumor cell and the loss of its processes by it. Pigment due to the inability to leave the cell begins to accumulate.
4. With enlightenment of the pigment formation due to the loss by the cells of the ability to produce melanin. Color changes sometimes occur unevenly. Pigmented formation can darken or lighten from only one edge, and sometimes in the middle.
5. In case of increase in size. A similar phenomenon indicates an active process of cell division, which occurs in the structure of pigment formation.
6. When cracks or ulcers, moisture or bleeding. Such phenomena are due to the process of destruction of normal skin cells by a tumor. The upper layer of the epidermis bursts, exposing its lower layers. That is why even the smallest injury is enough for the tumor to “explode” and its contents spill out. In this case, cancer cells enter healthy areas of the skin and invade their layers.

Treatment

What actions will be taken to rid the patient of skin cancer will directly depend on the stage, type, and also on the prevalence of processes.

1. Surgical removal. This method involves the elimination of the tumor focus up to the limits of healthy tissues. It is used in the absence of infiltrative growth of education and screenings in the lymph nodes, that is, in the first stages of cancer. With a significant development of pathology, chemotherapy and radiation therapy are first performed. Surgical removal of the tumor focus is used at the final stage of treatment.
2. Radiation therapy. This method is used both independently and for the prevention of deterioration of the patient after surgical treatment. Irradiate patients with small doses, conducting multiple procedures. Most often, this type of therapy is used to detect oncology on the skin of women.
3. Chemotherapy. Use this method in the case of metastatic and disseminated skin cancer, when there are multiple lesions in various parts of the body. Sometimes chemotherapy is combined with radiation, prescribing such procedures before removing tumor foci by surgery.

The prognosis for skin cancer is far from unambiguous. The result of treatment will depend on the type of neoplasm and how soon after the onset of the development of the pathology the patient consulted a doctor. So, after skin cancer detected at an early stage, about 85-95% of patients recover. With advanced cases, the success rate of treatment is significantly reduced.