More sun, more trouble
We naturally wear far fewer clothes in these scorching hot summer
months than we do in the middle of winter. And this comes with an
advantage: we can see more of our skin, and therefore take the opportunity
to check out the ageing process.
Such an examination is depressing when the wrinkles associated with
age remind us of better times, but sun spots and early skin cancers
can be found in time to prevent death and destruction.
Looking at the face and arms is a good place to start, as these areas
receive more sun exposure than others. Naturally, sun damage and the
risk of cancer are directly proportional to the amount of sun one’s
skin receives.
While this seems obvious, it is important to remember that, if you
are a high-risk person in terms of sun cancer, more sun means more
trouble for you. A low-risk person can eventually turn his or her
skin into a cancer risk by UV exposure.
The trick is also to remember that there is no safe way of getting
UV radiation on the skin without increasing the risk of damaging it.
As the radiation injures the growing part of the skin, genetic damage
increases the likelihood of the cells growing out of control. Out-of-control
skin cell growth is cancer and varies from the often deadly malignant
melanoma to the more common basal cell cancer, which can cause nasty
ulcerations and painful sores (also known as the rodent ulcer).
New treatments for sun-damaged skin are around and offer some hope
of alternative treatments, besides surgery. The application of anticancer
(chemotherapy) cream to the skin can kill the abnormal cells and fix
the cancer. In the situation of wide-spread sun damage, there may
be an advantage in using this type of treatment.
Increasingly, we see people who suffered sunburn when they were younger.
Widespread damage from UV light will damage the skin and eventually
cause cancer, but in between times there may be rough skin.
Solar hyperkeratosis is a precursor to cancer. To remove a large
area of skin may need a skin graft, so the application of a cream
is a good option. There are also trials currently underway in the
use of a cream that stimulates the immune system. There has been success
at treating some skin cancers because the immune system killed the
abnormal cells and eliminated the cancer.
If surgery is needed, there exists a likelihood that the cancer
will recur if it is not completely removed. One approach is to remove
a large margin of normal skin around a cancer and check that all of
the tumour is removed.
Another option – used in Adelaide – is the procedure of removing
the cancer, checking under the microscope, removing more, checking
again, and so on. This continues until there is proof that all the
cancer is removed, before fixing the hole left by the removal of the
cancer. Although this takes a long time, it guarantees removal.
New treatment for malignant melanoma has developed around tracking
how the tumour spreads. It is absolutely still the best option to
get a melanoma at a very small and early stage. But, if a melanoma
is found, a new procedure will trace the likely spread of the tumour
through the lymph nodes, and remove all of the tissue through which
the melanoma might track. This appears to be a major advance in the
treatment of this very aggressive cancer, and has application for
a lot of other cancers.
The most common growths and tumours (and tumour simply means swelling)
seen as we get older are non-cancer. Oil on the skin often causes
a warty growth known as seborrhoic keratosis (hardening), or sometimes
referred to as senile (meaning old) warts.
These can be removed by CO2 or nitrogen burning, but do not cause
or turn into cancer. Many other shaped bumps and growths exist, and
it is best to get anything checked out when you see your doctor, or
even make a special trip to get your spots examined.
Men are particularly bad at going for health checks, so it may be
worth going to places dedicated to photographing and recording skin
moles.
If there is doubt about a mole or growth, a biopsy is recommended.
This can be done by removing the whole mole (excision biopsy), taking
out a small round portion of the mole (punch biopsy), or shaving off
the top of the mole (shave biopsy).
The important part is sending the tissue to a pathologist, who can
look under a microscope and tell the doctor exactly what is causing
the mole and how it should be treated. Remember, however, prevention
is better than cure, and early treatment is always more successful
than later treatment. If in doubt, check it out.
