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您现在的位置: 医学全在线 > 医学英语 > 临床英语 > 临床英语 > 正文:Skin Cancer——皮肤癌
    

皮肤癌-Skin Cancer

What are the symptoms of BCC and SCC skin cancers?

BCC - Basal cell carcinoma
A BCC typically develops on a sun exposed area of the skin such as the head and neck. However, they can develop on any area of skin. The first sign is often a small red, pink or pearly lump which appears on previously normal skin. The lump is often dome shaped. However, BCCs can vary in shape and colour. They usually grow very slowly and and it can take many months for one to grow to a centimetre or more.

In time the lump on the skin may crust over, ulcerate or bleed from time to time. A skin ulcer caused by a BCC is sometimes called a 'rodent ulcer' which often looks like a small inflamed crater with a raised edge.

BCCs rarely spread (metastasise) to other parts of the body. However, untreated they will continue to grow locally and can cause damage to nearby structures. For example, a BCC may erode and damage the nose or an ear.

SCC - Squamous Cell Carcinoma
An SCC typically develops on the face - most commonly on or around the ears or lips. But, again, any area of skin can be affected. It typically starts as a small crusted or scaly area or skin with a red or pink base. It may grow into a lump which may look like a wart. An SCC may ulcerate or bleed from time to time. However, an early SCC can vary in shape, appearance and colour.

Bowen's disease is a condition which is thought to be a very flat early 'pre-cancerous' SCC. It looks like red-brown, scaly patch which may resemble psoriasis or eczema. If untreated, it may become a 'true' SCC.

As an SCC grows larger and deeper and damages nearby structures. For example, if left untreated, an SCC next to a nose or ear can grow into, erode, and then completely destroy the nose or ear. An SCC may also spread (metastasise) to other areas of the body. However, this is uncommon in the early stages and most are treated before any spread occurs.

The 'take home message' is: see your doctor if you develop an abnormal lump or patch of skin which does not go within a few weeks.

How is a BCC or SCC diagnosed?

Biopsy
A biopsy (small sample) of tissue can be taken from a suspicious lump on the skin. This is looked at under the microscope which can confirm the diagnosis. If the skin lump is small, the whole lump may be removed and then looked at under the microscope (an 'excisional biopsy'). This may diagnose and cure the problem at the same time.

Further tests
No further tests are usually needed for a BCC or an SCC which is diagnosed when it is small. If a doctor suspects that there has been some spread from an SCC to other parts of the body, then further tests such as x-rays, blood tests or scans my be advised.

What is the treatment for BCC or SCC skin cancers?

Treatment for small skin cancers
Most cases are diagnosed when the skin cancer is still quite small. Depending on the site, size and depth of the tumour, one of the following treatments may be used.医.学 全在.线,提供www.med126.com

  • A common treatment is a simple operation done under local anaesthetic to cut out the cancer. The edges of the normal skin are then stitched together.
  • Curettage and cautery. In this procedure the tumour is scrapped off (curettage) and the bleeding is stopped by small electrical burns given by an electric needle (cautery).
  • Cryosurgery (freezing treatment) with liquid nitrogen which destroys cancer cells.
  • Photodynamic therapy (a special kind of light therapy which kills cancer cells).
  • Chemotherapy creams are sometimes placed on skin cancers to kill cancer cells.
  • Mohs micrographic surgery is done in some situations. In this technique, the tumour is removed piece by piece. Each piece is looked at under the microscope straight away for cancer cells. Further pieces are removed until no cancer cells are seen. The aim is to remove all the cancer but to remove as little healthy tissue as possible.

More extensive surgery is needed in some cases
If the skin cancer is larger then a more extensive operation may be required. This may need a general anaesthetic. For example, if a large area of affected skin is cut away you may need plastic surgery to place a skin graft over the wound.

If an SCC cancer has spread to the nearby lymph glands then an operation to remove these glands may be advised.

Other treatments
Radiotherapy is sometimes used as an alternative to surgery. For example, if the area covered by the cancer is large, if the site is difficult to operate on, or if an operation cannot be done for any other reason. Radiotherapy is a treatment which uses high energy beams of radiation which are focussed on cancerous tissue to kill cancer cells.

If an SCC has spread to lymph nodes or other areas of the body, radiotherapy and/or chemotherapy may be used to treat the secondary cancers.

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