NON-MELANOMA SKIN CANCER

Skin cancer originates in cells, the basic unit of the organism. Normally, skin cells grow and divide to make room for new cells.

Every day, skin cells age and die and are replaced by new cells. Sometimes this systematic process goes wrong, with new cells being formed without the skin needing them, and without the aged cells dying when they should. This excess of cells can form a mass of tissue called a neoplasm or tumor.

HOW TO EXAMINE YOUR SKIN

Your doctor or nurse may recommend that you regularly check your skin for potential indicators of skin cancer, including melanoma.

The best time to do this is after taking a shower or bath. You should examine your skin in a room with lots of light, using a large mirror that allows you to see your entire body and a hand mirror. The best thing to do is to start by knowing where your moles, spots, warts and other marks are located (even the ones you were born with) and what they usually look like and feel to the touch.

Look for something new:

• New signs (that look different from the others)
• New red or dark spots that are scaly and may have some relief
• A new bulge, solid and skin-colored
• Changes to the size, shape, color or feel of existing signs
• A wound that doesn't heal
• Look at yourself from your head to your toes, don't forget your back, scalp, genital area and between your buttocks.
• Observe the face, neck, ears and scalp. You can use a comb or a dryer to brush the hair aside so you can see better.
• You can also ask a family member or friend to help you look at your scalp, as it can be difficult to do this alone.
• Look at the front and back of your body in the mirror. Then raise your arms and look at the left and right sides.
• Bend your elbows. Look closely at your fingernails, palms, forearms (including the inside), and upper arms.
• Observe the legs and the area around the genitals and between the buttocks, from different angles (back, front and side).
• Sit down and take a close look at your feet, including your nails, the soles of your feet, and the spaces between your toes.
• By observing your skin regularly, you will get to know the normal appearance of your moles or blemishes. You can also enter the dates on which you examined your skin, or even take notes about its appearance. If your doctor has taken photographs of your skin, they can compare them to your own skin to help detect changes. Consult your doctor if you notice anything out of the ordinary.

WHO IS AT RISK

We know that skin cancer is not contagious, meaning you cannot “catch” it from someone else.

Research has revealed that people with certain risk factors are more predisposed than others to developing skin cancer. A risk factor is something that can increase the likelihood of someone developing a disease.

Some studies have determined the following risk factors for skin cancer:

• Ultraviolet radiation (UV): UV radiation comes from the sun, ultraviolet lamps, horizontal or vertical sunbeds. The risk of developing skin cancer is related to exposure to UV radiation throughout life. Most skin cancers appear after age 50, although the sun begins to damage the skin at younger ages and skin cancers can develop at young ages.
• UV radiation affects us all. People with fair skin that freckles or burns easily are at increased risk. In general, these people also have red or blonde hair and light eyes. However, people with darker skin tones can also suffer from skin cancer.
• People who live in areas with a high level of UV radiation are at increased risk of developing skin cancer. Populations living in mountains are also exposed to higher levels of UV radiation.
• UV radiation is present even on cold or foggy days.
• Scars or burns to the skin
• Infection with certain human papillomaviruses (HPV)
• Exposure to arsenic in the workplace
• Chronic skin inflammation or skin ulcers
• Diseases that make the skin sensitive to the sun, such as xeroderma pigmentosum, albinism, and basal cell nevus syndrome
• Radiotherapy
• Health conditions or drugs that suppress the immune system
• History of one or more skin cancers
• Family history of skin cancer
• Actinic keratosis: manifests as a red papule or plaque, with an adherent scale, located on areas of the skin chronically exposed to the sun, especially the face and hands. Neoplasms may have a rough, reddish appearance or appear in the form of brown spots on the skin and fissures or areas of scaling on the lower lip that do not heal.
• Without treatment, a small percentage of these squamous neoplasms may progress to squamous or squamous cell carcinoma.
• Bowen's disease: Bowen's disease appears in the form of a scaly or thick patch that can develop into squamous cell carcinoma.
• If you think you may be at risk of skin cancer, you should speak to your doctor, who will be able to suggest ways to reduce your risk and develop a schedule for monitoring visits.

PREVENTION FORMS

The best way to prevent skin cancer is to protect yourself from the sun. Children, in particular, must be well protected. Doctors recommend that everyone limit the time they spend in the sun and avoid other sources of UV radiation.

• Whenever possible, you should avoid sun exposure in the middle of the day (from mid-morning to late afternoon). You must also protect yourself from UV radiation reflected by sand, water, snow and ice. UV radiation can pass through thin clothing, windshields, windows and clouds.
• Try to wear clothes with long sleeves and legs made of strong fabric, a wide-brimmed hat and sunglasses that absorb UV radiation.
• Use lotions with sunscreen. Sunscreens can help prevent skin cancer, especially broad-spectrum ones (filter UVB and UVA rays), with a sun protection factor (SPF) of at least 30. Despite using these protectors, you should avoid exposure prolonged in the sun.
• The use of ultraviolet lamps and solariums is not recommended.

TREATMENT OF NON-MELANOMA SKIN CANCER

Sometimes, during the biopsy, the entire tumor is removed. In these cases, further treatment may not be necessary. If you need further treatment, your doctor will talk to you about your options.

Skin cancer treatment depends on the type of tumor, its stage of evolution, its size and location, as well as your general health and clinical history. In most cases, the goal of treatment is to remove or completely destroy the tumor.

Before your appointment, it is helpful to make a list of the questions you want to ask. To make it easier to remember what the doctor said, you can take notes or use a recorder. Some patients prefer to be accompanied by a family member or friend when speaking to the doctor.

The doctor may refer the patient to a specialist or the patient may ask him or her to do so. The specialists who treat skin cancer are dermatologists, surgeons and radiotherapists.

Get a Second Opinion

Before starting treatment, the patient may want to get a second opinion about the diagnosis, the stage of the disease and the treatment plan. Gathering your medical test results and preparing to see another doctor can take some time. In most cases, a brief delay does not reduce the effectiveness of the treatment. To be sure, you should talk to your doctor about this delay in starting treatment. Some people with skin cancer need immediate treatment.

There are several ways to find a doctor for a second opinion:

Your doctor may refer you to one or more specialists. In oncology centers, it is common practice for different specialists to work as a team.

You may want to ask your doctor the following questions before starting treatment:

• What is the stage of evolution of the disease?
• What are my treatment options? Which one do you recommend? Why?
• What are the expected benefits of each type of treatment?
• What are the risks and possible side effects of each treatment? What can we do to control side effects?
• Will the treatment affect my appearance? If the treatment affects my appearance, can a plastic or reconstructive surgeon help me?
• How will the treatment affect my normal activity? If so, for how long?
• What is the estimated cost of the treatment? Is this treatment covered by my insurance?
• How often will I need to have review appointments?
• Will a clinical trial (research study) be appropriate for me?