Beware of skin cancer

Out of three types of this cancer, melanoma is the most dangerous, and the most common is basal cell carcinoma. Squamous cell carcinoma ranks between them in statistics, occurring three times more frequently than melanoma. If a patient starts treatment at an early stage of the disease, the cure rate can reach up to 90 percent, but when metastases appear - which happens in 1-5 percent of cases - curing becomes very difficult.

Squamous cell carcinoma arises due to uncontrolled growth of keratinocytes, the most superficial skin cells that produce a protein called keratin. It tends to flake and most commonly appears on areas with peeling spots on the skin, known as actinic keratosis or solar keratosis, which result from the harmful effects of the sun on the skin. Typical changes are hard, clearly demarcated from the surrounding skin. They can easily be mistaken for warts, which, however, are more convex. Some changes can also be soft and fleshy.

The main risk factor for skin cancer is sun exposure. In the case of melanoma, even sporadic but intense exposure to sunlight can cause the disease. As for squamous cell carcinoma, the intensity of radiation and the total amount of time spent in the sun over a longer period are more important. Like with all tumors of this type, skin color also matters. People with darker skin (African Americans, Africans, Asians) are less likely to develop squamous cell carcinoma than people of Caucasian origin. In this latter group, those with fairer skin are the most susceptible.

People who have had internal organ transplants are particularly at risk. According to European studies, the risk of developing squamous cell carcinoma among heart and kidney transplant recipients is 65 to 250 times higher than in the general population. This is likely due to the drugs taken by organ recipients. Their task is to reduce the activity of the immune system so that the body does not reject the transplanted organ, but as a side effect, they also increase susceptibility to skin cancer. Another risk factor is chronic inflammation. Squamous cell carcinoma sometimes occurs on the basis of chronic inflammation within scars and abrasions.

Cryotherapy (rapid freezing) and radiation therapy are used when changes are small and do not metastasize. Cryotherapy is a quick and inexpensive method of treatment but can leave white spots. On the other hand, radiation therapy allows for precise control and minimization of the area of healthy skin damage. However, it is expensive and involves frequent visits to the doctor, and if the disease recurs, it may require more aggressive treatment methods. When there are many changes, ointments are also used. However, they may cause the formation of spots, burning, or oozing.

The main method of treating large tumor changes is surgery, and the standard procedure - especially in the case of changes located on the face, where cosmetic effect matters - becomes the Mohs surgery. Dr. Frederic Mohs from the University of Wisconsin developed his method in the 1930s and 1940s. It involves horizontally cutting thin slices of the lesion and microscopically examining them to detect cancer cells. This technique of alternate excision of the lesion and its microscopic examination has two main advantages. Firstly, there is no need to guess how deep the change should be cut, and the risk of removing healthy tissue during surgery is minimized. Secondly, it is less likely to leave cancer cells behind, which may explain why this technique is associated with a higher cure rate than others.

Its drawbacks are time and costs. A significant part of the procedure takes place without the patient's participation, and the patient often spends hours waiting for the doctor to examine each slice. Some believe that clinics overuse this method and that its use should be limited only to high-risk cases and those where the cosmetic effect of the surgery matters most.

The best protection against skin cancer is to approach sun exposure sensibly, especially sunbathing. Avoid exposure to the sun between 11 am and 4 pm when it shines most strongly. Remember that you expose yourself to sunlight not only on the beach. According to some researchers, up to 80 percent of sun exposure occurs during everyday activities, such as walking with a child, mowing the lawn, etc. The most susceptible areas are the nose, ears, and neck, so consider covering your head with a wide-brimmed hat. A cap with a visor does not provide complete protection.

UV filters cannot be treated as a magical shield. According to the American National Cancer Institute (Bethesda, Maryland), there is still insufficient evidence that they really prevent squamous cell carcinoma (or melanoma). Some even believe that filters can do more harm, giving a false sense of protection against sunburn, which encourages people to stay in the sun for too long. If you reach for products with a filter, use those with a number of 16 (SPF 16) or higher. Make sure you apply the right amount of product as well.