Skin cancer: the key questions and answers

Woman - skin cancer

There are several types of skin cancer, white (or light) and black. The latter is referred to in technical jargon with the collective term "malignant melanoma". Because of its propensity for metastasis, melanoma is particularly dangerous - and is known to most people as a skin cancer. Only the early and complete removal of this tumor can lead to healing. At the same time, this is the good news: With the help of self-regulation and medical skin cancer screening, you can resist the onset before the cancer spreads. Negligent or anxious waiting on the other hand worsens the healing prospects as seriously as unnecessary.

The incidence of skin cancer has increased significantly

Nevertheless, the skin cancer numbers have risen sharply in the last two decades, and the trend continues to rise. Nearly 20,000 people in Germany contracted malignant melanoma in 2010, and more than 2,700 people died as a result. Overall, the skin cancer is much more common: The epidemiologists expect about 235,000 new cases per year. The share of bears is attributable to the white skin cancer forms. More than half of the cases are basal cell carcinoma (basal cell carcinoma) and almost one third are squamous cell carcinoma (spinalioma).

The available numbers are estimated, extrapolated and partly different. With the reliable and nationwide uniform coverage of skin cancer cases it still lacks. National cancer incidence statistics often only include malignant melanoma. Actually amazing, given the quantitative dimensions. Presumably, it is because the white skin cancer rarely scatters and is therefore usually not life-threatening. However, he also breaks the tissue area affected by him.

A major risk factor: UV radiation

In contrast to other types of cancer, one of the main causes of skin cancer has been identified: ultraviolet radiation, which can damage DNA in the nucleus and degenerate skin cells. Of course we expose ourselves to UV radiation in sunlight and artificially in the solarium. The accumulation of the radiation dose over the years of life increases the risk of cancer. For white skin cancer, this relationship is considered secure and clear. He also prefers to appear in old age and sun-drenched areas of the skin such as the face.

Black skin cancer develops from melanocytes

Melanomas, on the other hand, are found preferentially on the back of men and on the legs of women. But they can also occur on the mucous membranes or in the eye. They do not originate from the actual skin cells, but from the melanocytes, which provide the pigment melanin in the skin.

Melanoma can also occur independently of sunlight exposure, much as lung cancer is not only found in smokers. Nevertheless, the extent of UV irradiation (similar to smoking in lung cancer) is a relevant risk factor. Other factors include hereditary predisposition, skin type, previous sunburns, the number of skin spots present and the weakening of the immune system (for example, in the case of HIV infection or after transplantation). In part, the melanomas develop from existing birthmarks, but in the majority they re-form on previously unaltered skin.

Keep an eye on your skin regularly ...

In both cases: Wood eye, be vigilant! Keep an eye on your skin regularly, best supported by mirrors and partners. If existing liver spots - each European has on average about 20 of them - change or new appear, then have a dermatologist look at it. Especially when the change seems somehow suspicious. For a rough estimate of a possible malignancy the ABCDE rule is used

  • asymmetry
  • limit
  • Color / Color
  • diameter
  • Sublime / Development

... and use the screening test at the dermatologist!

The experienced dermatologist is often simply looking to give the all-clear or - in a much rarer case - to take further measures. The conscientious practitioner uses the magnifying glass (dermatoscope) for the screening, the advanced software-based possibilities for visual capture and storage for later comparison. The statutory health insurance pays a check-up every two years from the age of 35, but only in the first variant (simple top view).

The German Dermatological Society recommends a check once a year for incidental liver spots using reflected-light microscopy (option 2). Your dermatologist will inform you about the computer-assisted variant 3, provided that he has the appropriate qualifications and equipment. Although you have to pay yourself for options 2 and 3, this investment in your own health is much more recommendable than many other things offered in the medical sector.

Black skin cancer already accumulates in the middle, white skin cancer only in the higher age

Skin cancer can develop very slowly, but also within a short time and in principle affect people of all ages. Black skin cancer often occurs already in middle age (50 to 60 years), and thus on average much earlier than the white. Fortunately, both types of skin cancer are almost never seen in children.

Healing (only) by early removal

If detected early, malignant melanoma is almost always curable - by removing it completely and with sufficient safety margin in healthy tissue. However, if metastases have already formed in the nearby lymph nodes or even elsewhere in the body, the chances of recovery decline rapidly. In very advanced stages, the survival time may only be a few months.

If the melanoma can not be completely removed or has already spread, then, as with other forms of skin cancer, various other procedures known from cancer medicine are used. These include above all chemotherapy (locally applied or systemically, ie via the bloodstream), radiation and drugs that support the immune system.

Healthy mix of caution and precaution

A healthy mix of care and precaution is always considered the best possible protection against skin cancer. And the right way to deal with the sun. In contrast to the not recommended solarium we need the sunlight, u.a. for the formation of vitamin D in the skin, for our emotional well-being and probably also for further benefits that have so far barely been researched. The meaningfulness of the massive use of sunscreen must therefore be questioned and it will be. On the one hand, the protective effects are doubtful, on the other hand, the net benefit in balance with the impaired vitamin D production.

Undoubtedly useful are the avoidance of the blazing midday sun and the use of a suitable headgear, light clothing and shading utensils. Those who know their skin type and care for their body perception will be able to intuitively control the right amount of sunbathing. Parents have a special responsibility for their children.

Author: Dr. Hubertus Glaser