Skin cancers

NON-MELANOMA SKIN CANCERS 

Basal cell or basocellular carcinoma (BCC)

A basocellular carcinoma resembles a shiny pimple that grows slowly, or a small, painless wound that does not heal, sometimes surrounded by a fold of fat. It can resemble a small, whitish zone, similar to a spontaneous scar, which grows gradually. The BCC is the most frequent, non malignant, skin cancer that usually develops on the face (nose, cheeks, temples, forehead, auricles) but can develop anywhere on the body.

Although these lesions are classified among the skin cancers, the malignancy of a BCC is very limited and it only concerns a locally (at the level of the skin) destructive cancer without risk of metastasis. However, if left untreated, they can ulcerate or overgrow neighbouring areas from their starting point. Of course, that collateral damage becomes more difficult to deal with as it spreads. Late diagnosis can also lead to more extensive surgery, which can sometimes result in mutilating scars.​

Spinocellular carcinoma (SCC)

A spinocellular carcinoma usually looks like a pimply crust, which eventually starts to bleed. It can arise from an untreated actinic keratosis. Unlike basal cell carcinomas, spinocellular carcinomas can metastasize, but generally they are not very aggressive tumors and metastases are very rare. When they metastasize, they usually do so to the nearest lymph nodes. A SCC can cause significant damage if left untreated.

The choice of treatment depends on the cancer type (confirmed by microscopic analysis after a skin biopsy), the size of the tumor, the location, the age of the patient and his general condition. Minor lesions are usually surgically removed under local anaesthesia. If the type, size and location of the lesion permits, the intervention takes place within our practice. If the treatment requires a larger infrastructure, the patient will be referred to a hospital.

 Photodynamic therapy is a possible treatment in certain types of minor SCC.

After appropriate treatment, the chances of a cure are very high. People with a skin carcinoma must have regular check-ups with the dermatologist for the rest of their lives. A skin cancer means that the skin is globally damaged by UV. Therefore, there is a chance that a second skin cancer will develop, different from the first.

 

Melanoma

Melanoma is a potentially very dangerous skin cancer that develops in the pigment cells of the skin (the melanocytes). It can develop in a birthmark or pigmentation, but that is not always the case. Melanomas can develop anywhere in the skin. In women it is slightly more common on the legs, in men on the trunk. Melanoma is the most aggressive form of skin cancer. It is often curable if the tumor is discovered at an early stage. However, some melanomas grow quickly and can also spread fairly early. Usually that first happens to the lymph nodes near the tumor. Sometimes the malignant tumor spreads through the blood to other organs, and/or metastasizes elsewhere in the skin.

It is important that every change in a pigmentation spot as well as every new pigmentation spot, especially if it is irregular in color and shape, grows quickly and develops after the age of 40, is shown to a doctor and preferably a dermatologist.

If the dermatologist suspects melanoma, the suspected injury is treated by full surgical resection. The injury will then be examined microscopically to confirm the diagnosis. The rest of the treatment depends on the size and thickness of the melanoma. A thorough clinical examination of the entire skin and adjacent lymph nodes should be performed, as well as other investigations, including, for example, an ultrasound of the liver, a lung x-ray. Sometimes scans are also taken. Early diagnosis is essential as melanoma has a very favorable prognosis in the initial phase. With further evolution, there is a risk of the malignant cells spreading to the depth, resulting in metastasis. The prognosis is much less favorable in that phase.

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  • Dr Cathy Dermato
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