SKIN HEALTH
Most skin cancers will resemble one of the following:
- A spot or sore that does not heal within four weeks
- A spot or sore that itches, hurts, is scabbed or crusty, or bleeds for more than four weeks
- Areas where the skin has broken down (an ulcer) and doesn’t heal within four weeks, and you can’t think of a reason for this change
Basal cell skin cancers look like a small, slow growing, shiny, pink or red lump. They can also look like red scaly patches. If left, basal cell skin cancers tend to become crusty, bleed, or develop into an ulcer. They are commonest on the face, scalp, ears, hands, shoulders and back.
Squamous cell skin cancers are usually pink lumps, which may have hard or scaly skin on the surface. They are often tender, but not always, and can often develop into an ulcer (ie, where the skin has broken down). Squamous cell skin cancers are commonest on the face, neck, lips, ears, hands, shoulders, arms and legs.
Symptoms of non-melanoma skin cancer can be recognised quite easily, particularly since they tend to develop most often on skin that is exposed to the sun.
DIAGNOSIS
As with any cancer, the earlier a skin cancer is picked up, the easier it is to treat it, so a patient should always present to their GP as soon as any potential symptoms are noticed.
A GP will be able to ascertain whether or not a patient needs to be referred to specialists, although, if they think
that a patient has squamous cell cancer or a rare type of skin cancer, they’ll often make an urgent referral to a specialist.
At the follow-up appointment, the specialist will closely examine the abnormal area of skin and may use a dermatoscope (with resembles a magnifying glass) to assist in the initial diagnosis. Due to the appearance of some basal cell cancers, it can be very clear to a specialist what it is, and they can then plan treatment.
This isn’t always possible, however, so in the event that the specialist can’t determine a diagnosis immediately, he or she will take a sample of the skin and send it to the lab for examination. This is called a biopsy and is usually carried out under a local anaesthetic.
PROGNOSIS FOR SKIN CANCERS
The cure rates for non-melanoma skin cancers are very high, with more than 90 per cent of people with basal cell skin cancer cured. In a small percentage of people, it can come back in the same area and requires further treatment.
A similar amount of people (90 per cent) with squamous cell skin cancer
are also cured, and the cure rate for squamous cell skin cancer diagnosed at an early stage may be even higher.
SURGERY
Most basal cell and squamous cell skin cancers can be successfully treated with surgery and, in most cases, the surgery is minor. The affected area is completely removed and the procedure is generally carried out under local anaesthetic.
If the cancer is larger, then a general anaesthetic will be required and a skin graft may have to be done. Alternatively, the skin can be replaced by a skin flap, which is a thicker piece of skin tissue taken from an area of skin nearby and then stitched in place over the wound.
RADIOTHERAPY
Radiotherapy can also be used to treat basal cell or squamous cell skin cancers. In most cases radiotherapy will be an option if:
* The cancer covers a wide area
* It’s in an area that is difficult to operate on
* Surgery is not suitable for the patient, if, for example, they are elderly or have other health problems.
If there is a risk that cancer cells may have been left behind, radiotherapy may be used after surgery. This is called adjuvant treatment and is designed to reduce the risk of the cancer coming back in the future. •
SUMMARY STATISTICS FOR MALIGNANT MELANOMA OF THE SKIN IN SCOTLAND Scotland
Males
Rank - incidence (2013) Rank - mortality (2014)
Percentage frequency of all cancers - incidence (2013) Percentage frequency of all cancers - mortality (2014) Number of new cases diagnosed in 2013 Number of deaths recorded in 2014 Change in incidence from 2003 to 2013 Change in mortality from 2004 to 2014
1 year relative survival for patients diagnosed between 2007 and 2011 5 year relative survival for patients diagnosed between 2007 and 2011 ISD Scotland
6 16
3.9% 1.2% 585 100
+38.5% -4.5% 97.7% 89.8%
5 18
3.7% 1.0% 587 76
+22.2% +15.5% 99.1% 96.4%
Females 6 18
3.8% 1.1% 1,172 176
+30.3% +2.3% 98.5% 94.0%
SCOTTISH PHARMACIST - 45 Persons
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