▶ Nomi Ryeong, Professor of Dermatology, Gangnam Severance Hospital
Skin cancer is a prevalent type of cancer that is rapidly increasing alongside the aging population. This rise is attributed to the accumulation of UV rays over a lifetime, as life expectancy rises, and the depletion of the atmospheric ozone layer. The number of skin cancer patients grew by 34% in five years, increasing from 23,605 in 2018 to 31,661 in 2022.
-What types of skin cancer exist?
Skin cancer is mainly categorized into malignant melanoma and non-malignant melanoma. Non-malignant melanoma includes basal cell carcinoma and squamous cell carcinoma, which together account for 70% of all skin cancers. Malignant melanoma occurs when melanocytes become cancerous and is considered a fatal condition among skin cancers, with a five-year survival rate of approximately 60%.
-What causes its outbreak?
The primary cause is exposure to ultraviolet rays. Ultraviolet B rays directly damage skin DNA and induce cellular mutations, which can lead to skin cancer. Additionally, as people age, the number of melanocytes—cells that protect the skin from ultraviolet rays—and Langerhans cells, which are responsible for immune functions, decrease, further heightening the risk of developing the disease. Considering that skin cancer can also occur on the soles of the feet and toenails, which are not typically exposed to ultraviolet rays, it is believed that other factors, such as strong irritation or constant pressure, may also contribute to its development.
-What symptoms may indicate skin cancer?
Skin cancer can cause pain if there is inflammation, but it generally does not cause pain or itching. Skin cancer lesions tend to grow larger or change shape over time. As cancer cells multiply, ulcers may develop in the lesions that do not heal.
-How do spots and skin cancer tissues compare?
Moles or benign tumors are usually symmetrical with smooth borders. They have a uniform and clear appearance in one or two colors, and there is typically no change in size, shape, or color. Most are small, measuring less than 6mm.
In contrast, malignant tumors tend to be asymmetrical and have irregular borders. They are often larger than 6mm and exhibit various colors. The size, shape, and color of these tumors can change over time.
-What are the treatment options?
The primary treatment for malignant tumors is surgical removal. This can be done through wide resection or Mohs micrographic surgery. Wide resection involves the removal of a significant amount of normal tissue surrounding the tumor. Given the uncertainty of how far the cancer has spread, between 0.5 to 5 cm of normal tissue is removed.
Mohs micrographic surgery aims to completely excise the cancer while preserving as much surrounding normal skin as possible. First, the visible lesion is removed, and the section is frozen to check for cancer cells at the cut surface; any remaining cancer cells are then further excised.
Kwon Dae-ik, medical specialist Reporter>
Understanding Skin Cancer: Insights from Nomi Ryeong, Professor of Dermatology at Gangnam Severance Hospital
▶ Nomi Ryeong, Professor of Dermatology, Gangnam Severance Hospital
Skin cancer is a pressing health concern, especially as the elderly population continues to rise. The increase in life expectancy, combined with the cumulative effects of UV radiation and a thinning ozone layer, has led to a significant uptick in skin cancer cases. From 2018 to 2022, skin cancer diagnoses surged by 34%, escalating from 23,605 to 31,661 patients.
What Types of Skin Cancer Exist?
Skin cancer is primarily categorized into two main types:
- Malignant Melanoma: This occurs when melanocytes, the cells responsible for skin pigmentation, turn cancerous. Malignant melanoma is one of the most serious types of skin cancer, with a 5-year survival rate of approximately 60%.
- Non-Malignant Melanoma: This includes basal cell carcinoma and squamous cell carcinoma, which together account for about 70% of all skin cancer cases.
Causes of Skin Cancer: What You Need to Know
The primary culprit for skin cancer is exposure to ultraviolet (UV) rays.
- Ultraviolet Damage: UVB rays can directly damage skin DNA, causing mutations that may lead to cancer.
- Aging Effects: As people age, the number of melanocytes decreases, weakening the skin’s protective mechanisms against UV rays and reducing immune cell function.
- Additional Contributors: Skin cancer can also develop in areas of the body like the soles of the feet and toenails, where UV exposure is minimal, suggesting other factors such as trauma or persistent pressure may play a role.
Recognizing Symptoms of Skin Cancer
While skin cancer may not always cause pain or itchiness, there are specific symptoms to watch for:
- Growth or change in size of existing moles or lesions.
- Asymmetry or irregular borders in the shape of moles.
- Color variations and larger sizes, generally over 6mm.
- Development of ulcers that do not heal.
Moles vs. Skin Cancer Lesions: How to Differentiate
Understanding the differences between benign and malignant growths is crucial:
| Feature | Benign Moles | Malignant Tumors |
|---|---|---|
| Shape | Symmetrical | Asymmetrical |
| Border | Smooth | Irregular |
| Color | Uniform (1-2 colors) | Diverse color variations |
| Size | Less than 6mm | Often larger than 6mm |
| Change Over Time | No significant changes | Change in size, shape, or color |
Treatment Options for Skin Cancer
The primary treatment approach for malignant tumors includes surgery, with the following methods:
- Wide Resection: This technique involves removing the tumor along with a significant margin of healthy tissue, anywhere from 0.5 to 5 cm, depending on cancer spread.
- Mohs Micrographic Surgery: This method aims to preserve as much healthy skin as possible. The cancerous growth is removed layer by layer, with each layer being analyzed for cancer cells until no cancerous cells remain.
Benefits of Early Detection
Early detection of skin cancer can lead to:
- Increased likelihood of successful treatment.
- A higher survival rate.
- Less extensive surgical procedures.
- Reduced treatment costs and emotional stress.
Practical Tips for Skin Cancer Prevention
Here are some effective strategies to reduce the risk of skin cancer:
- Use Sunscreen: Apply broad-spectrum SPF 30 or higher daily, even on cloudy days.
- Avoid Tanning Beds: These increase the risk of all types of skin cancer.
- Wear Protective Clothing: Long sleeves, wide-brimmed hats, and UV-blocking sunglasses can help shield your skin.
- Regular Skin Checks: Conduct self-exams monthly and schedule annual skin evaluations with a dermatologist.
- Stay Informed: Educate yourself about skin cancer and its symptoms.
Case Studies: Learning from Experience
Here’s a short collection of real-life experiences highlighting the importance of early detection:
- Case 1: A 55-year-old male discovered a rapidly growing mole on his back. After an early visit to a dermatologist, a biopsy confirmed stage 1 melanoma, which was successfully treated through Mohs surgery.
- Case 2: A 70-year-old woman noticed an irregular spot on her shoulder. By responding quickly and getting treatment, she underwent wide resection and has remained cancer-free for three years.
Conclusion: Your Skin, Your Responsibility
Awareness, prevention, and early intervention can significantly affect skin cancer outcomes. Stay vigilant, protect your skin, and seek regular dermatological care.
Kwon Dae-ik, Medical Specialist
Reporter
