Introduction
The skin can be divided into (1) epidermis (2) dermis (3) subcutaneous tissue (4) skin appendages. And any cancer that comes from any of the cells that make them is called skin cancer. For this reason, it can be said that there are many types of skin cancer.
However, even if all of these many types of skin cancer patients are added together, the number of skin cancer patients is small, and among the cancers that Japanese people get, the number of skin cancer patients is not in the top ten. Hmm.
In addition, there are differences in the susceptibility to skin cancer depending on the race, and in Caucasians, malignant melanoma, spinous cell carcinoma, and basal cell carcinoma are the areas that are often exposed to sunlight (ultraviolet rays). It is easy to develop what is called large skin cancer, and it is not a rare cancer.
What to Look for During Your Hearing Aid Test? - Health GuideFor this reason, even though skin cancer is a rare cancer, it has two aspects: skin cancer, which is a rare cancer for human, and rare cancer, which is rare in the world regardless of race.
The main types of skin cancer are listed below.
- Epithelial
basal cell carcinoma
Squamous cell carcinoma
Extramammary Paget's disease
Merkel cell carcinoma
Sweat
adenocarcinoma Sebaceous adenocarcinoma
Hair follicle carcinoma - Malignant melanoma
- Mesenchymal
dermatofibrosarcoma protuberans
angiosarcoma
other sarcomas (epithelioid sarcoma, leiomyosarcoma, liposarcoma, such as undifferentiated polymorphic cell sarcoma)
Skin cancer derived from epithelial cells
Of these, basal cell carcinoma is the most common type of skin cancer in Japan and is not included in rare cancers.
Spinous cell carcinoma
It is a skin cancer with many known incentives and origins. In the old days, most of them occurred after a wide range of burns and chronic dermatitis after irradiation, but in recent years, more have occurred on the scalp and facial skin affected by ultraviolet rays. I have. If erosions or ulcers that are difficult to heal, red nodules that easily bleed, or hard keratinized nodules appear in these areas, suspect spinous cell carcinoma.
Since it can be formed on the surface of the skin, it is easy to notice, and 90% can be expected to be cured by surgery alone if a specialist is consulted early and a diagnosis is made. However, the effectiveness of methods other than surgery is not well understood, and the development of new anticancer drugs has been delayed, so there are only a limited number of hospitals that can treat cases where surgery is not possible or when cancer has recurred or metastasized and spread. Has been done.
12 Things to Do in Your Meal - Habits of Successful PeopleExtramammary Paget's disease
It is thought that the cells of the apocrine sweat gland, which produces odorous sweat, change and occur. Although it is not named "cancer," it is a type of cancer that typically forms around the vulva and anus and spreads widely in the shallow part of the epidermis for many years. It has the ability to metastasize when it invades dermatitis, but the establishment of surgical methods for lymph node metastasis is delayed, and anticancer cancer occurs when lymph node metastasis occurs frequently or visceral metastasis occurs.
Due to the little development of drug treatments, the number of hospitals with experience in treating this progression is limited to spinous cell cancer and above. Extramammary Paget's disease is a common illness among older patients in their 70s and 80s. When it affects young people in their 60s or younger, it may invade the dermis earlier than the elderly and may easily cause lymph node metastasis, so caution is required.
Merkel cell cancerA cell named Merkel cell becomes cancerous. It often occurs on the head and face of the elderly, and it has been pointed out that this cancer is also associated with ultraviolet rays. Recently, the possibility of carcinogenesis due to viruses is also considered. During surgery, it is advisable to remove the primary lesion with a margin of at least 2 cm from the size of the tumor.
Because it is easy to metastasize to lymph nodes, it is recommended to find the lymph node, called the sentinel lymph node, where cancer metastasis first occurs, and perform histopathological examination when performing surgery for the primary lesion, even if the lymph node is not swollen. I have. Radiation therapy also works well.
The development of drug therapy has been delayed because Merkel cell cancer is rare cancer, but it has a shape very similar to small cell lung cancer, and drug therapy is also performed with reference to the treatment of this cancer. ..
Sweat gland cancer, sebaceous gland cancer, hair follicle cancer
It is an even rarer cancer among rare cancers derived from epithelial cells. The surgical method is determined according to the malignancy according to the extent of resection of spinous cell carcinoma and basal cell carcinoma. Radiation therapy is given to patients who cannot operate on the primary lesion or who have limited metastases.
Due to the very small number of patients, surgical excision is the most reliable way to get rid of cancer, and cancer chemotherapy has no information about more effective drugs than the above three types of skin cancer. It becomes difficult to choose a treatment method.
Malignant melanoma is a cancerous form of pigment cells (melanocytes) in the epidermis, and is classified as "derived from neuroectoderm cells" among skin cancers. And it has characteristics that are a little different from other rare cancers. Malignant melanoma occurs dozens of times more often in whites living in areas with strong UV rays, such as Australia and Hawaii, than in Japanese. And similarly, the type (disease type) of malignant melanoma is different. In this respect, malignant melanoma is a rare cancer for Japanese people.
In addition, malignant melanoma occurs anywhere in the body, not just on the skin, as long as pigment cells (melanocytes) are present. Malignant melanoma that forms on the mucous membranes of the oral cavity, nasal cavity, esophagus, vulva, rectum/anus, and the eyes (uvea) is rare regardless of race.
Malignant melanoma of the skin
Although it is rare in Japanese, it is common in Caucasians due to racial differences, so the surgical method is the same as that established overseas, and more than other countries with the fineness peculiar to Japanese. It can be treated by the method of.
Radiation therapy is known to be ineffective. However, stereotactic radiotherapy for brain metastases (such as gamma knife and cyberknife) has been effective, and the prognosis has been extended by more than half a year compared to conventional radiation therapy. It is as effective as any other cancer in reducing pain against bone metastases.
Although there has been no progress in drug therapy for nearly 40 years, new drugs have been developed one after another overseas since 2011. However, because it was thought that the number of target patients in Japan was smaller than that of Caucasians, the development and launch of these new drugs have been postponed.Drug lag is a condition in which there are drugs that can be used overseas but cannot be used by Japanese patients.
We Japanese experts are making various efforts to eliminate this drug lag, and by participating in new drug development conducted jointly internationally several times, patients who are waiting for new drugs to be available in Japan as well. Proved that there are many. 2014 will be a year of breakthrough change, the first step in eliminating drug lag.
Malignant melanoma of mucous membranes and eyes
The number of malignant melanomas that occur in each organ is small, it is necessary to provide medical care and share information across many clinical departments, and we are familiar with all surgical methods, radiation therapy, and drug therapy. There are only a limited number of specialists. For this reason, these are not skin tumors, but they are diseases that we skin oncologists need to work with.
Mesenchymal systemElevated cutaneous fibrosarcoma
It is a sarcoma that often develops in the fibrous cells that make up the dermis of the skin. Since the ability to metastasize is weak by nature, it is important to excise and cure with a margin of 23 cm to 3 cm in the first surgery of the primary lesion, but excise at a depth sufficient than the size of the excision. It is more important to put it away. It should be noted that repeated recurrences tend to disperse invisible cancer cells or change the properties of the original cells to increase their malignancy.
Angiosarcoma
According to skin specialist in islamabad,"The frequency of occurrence is less than 1/10 of that of malignant melanoma, which is a typical skin cancer, but it is a more difficult tumor to cure than malignant melanoma, which is famous for its high malignancy". In addition to being often triggered by trauma to the scalp and face of elderly people, areas where edema of the arms and legs continues after surgery such as breast cancer and uterine cancer, and areas of irradiation performed for cancer treatment.
Conclusion
There are things you can do on your skin. It starts with reddish-purple internal bleeding or something that looks like a bruise, but it is difficult to cure by surgery alone because the exact range is difficult to understand and effective surgical methods have not been determined.
However, it has been found that both radiation therapy and anticancer drugs work well, and it is expected that the treatment results will be improved by combining these various types of treatment for a certain period of time.
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