Harshness of the Ambient World: Skin Cancer

Millions of people step outside their doors daily and face the harshness of the ambient world. In a place full of artificial chemicals, pollutants, radiation, and carcinogens we voluntarily consume it is not surprising that cancer is one of the leading causes of death in the world. Accounting for 22% of fatalities in the United States alone, the “c” word is enough to send shivers down the spine of any person as its uttered by health professionals for a plethora of reasons. Defined as the abnormality of cellular division occurring in the body without any control, cancer invades nearby tissues and highjacks the systems which supply nutrients to tissues and grows as a free radical until it inhibits the homoeostatic conditions of its host organism. What makes cancer the beast to battle is the fact that it can show up in any part, system, or tissue of the body. The most overlooked type of cancer is actually on the largest organ of the body, the skin. As hundreds of thousands of people bask in the welcoming warmth of the sun, cells in the epidermis struggle against the UVA and UVB rays of the sun trying to not be killed by the solar radiation.

There are 5 basic types of skin cancer the first being Basal Cell Carcinoma, which is the most common and usually only spreads locally. Precancerous Actinic Keratosis, the next type of skin cancer, occurs when there are changes in keratinocytes which are not normal. Keratinocytes are a type of skin cell that produces keratin. Precancerous Actinic Keratosis can turn into Squamous Cell Carcinoma, which shows up as firm red, sometimes scaly and crusted, flat spots. This can spread throughout the skin if not treated properly. To continue, Dysplastic Nevus is another type of skin cancer which grows from a mole. The melanocytes in a mole grow abnormally and can turn into Melanoma. The last type of cancer is the most dangerous and life-threatening, Malignant Melanoma. This cancer-like mentioned before can come to grow from moles or just normal skin. The reason this cancer is the most dangerous is because if it is not found early or treated, can spread all throughout skin, lymph nodes, and your entire body. Much of the literature that it is published in the dermatological community deals with the important case diagnosis, treatment, and prevention of skin exposure of skin to harmful solar radiation. Many of the skincare products released into the world are aimed at preventing solar exposure and also creating a barrier between the bare flesh and the product. Items such as makeup, skincare lotions, and sunscreen all inundate the skincare market to assure that people protect themselves from the harmful effects of over solar exposure. Different methodologies are implemented by dermatologists to diagnose and be able to detect the early onset stages of the disease. The ABCDE method is one of the most common methods that are implemented in diagnosing skin cancer and its forms. Melanoma detection using this technique begins by looking at the asymmetry, border, color, diameter, and evolution of a skin abrasion that forms on the epidermal layer of tissue. Skin lesions that are abnormal in color, bigger than 6 mm, and grow at a rapid rate are indicators of carcinogenic tissue present on the body. Many of these moles can be overlooked since they can originate in places which are not easily seen such as the lower side of the back or in the lower extremities. Palpation of these abrasions to see if they’re painful and simple histological biopsies are all the gold standards used in the clinical setting to adequately diagnose this condition.

The Skin Cancer Foundation defines the SPF scale (sun protection factor) as a number that tells, “how long the sun’s UV radiation would take to redden your skin when using the product exactly as directed versus the amount of time without any sunscreen”. The concern for dermatological health began in the early 20th century as the medical movement and scientific community began to link the causes of skin abrasions and conditions to cancers in people who worked in labor-intensive jobs in the sun such as lumber and agriculture. In 1938 a Swiss chemist named Franz Greiter suffered from a sunburn where he set out and created the first effective sunscreen. It was not another 40 years until the Food and Drug Administration (FDA) proposed the regulations for the safety and effectiveness of this sun protection product which today is a commonality in many cosmetics and skincare products implemented from an infantile to elderly age. Different scales have been developed by medical professionals to quantify the severity of patients. The Clark level is based on which layer of skin the tumor has invaded from the top layer of the skin (Level I) to the invasion of the tissue under the skin, or subcutaneous tissue (Level V). The Clark scale is just one of the methodologies to quantify the cancer of a melanoma patient. Not only as a preventative method, people who suffer from skin conditions in which melanin, the molecule in the body which emits pigment and gives color to tissue, is lacking; melanoma becomes not only a concern but a matter of life or death.

The Journal of Dermatological Medicine does yearly studies on the different causes, cases, and abnormalities that show up in the statistical information for patients who suffer from different skin conditions. The incidence and mortality rates of skin cancer are rising in the United States and in many other countries. Concerns about stratospheric ozone depletion adding to the problem have made many organizations look at public and professional health programs as a possible solution. As the newer methodologies of skin cancer treatment such as, lasers, optical technologies, and immunotherapies techniques are becoming emerging treatment methods as the traditional radiological and chemotherapy routes are proving more detrimental to the help of patients with fragile immune systems such as people with autoimmune diseases or compromised systems due to age. The international immunology journal from Oxford recently reported in 2019 that skin cancer tumors are especially susceptible to immunotherapy and, “reported response rates for anti-PD-1 (anti-programmed-death 1) therapy for cutaneous malignant melanomas (MM), Merkel cell carcinomas, basal cell carcinomas, cutaneous squamous cell carcinomas, and Kaposi sarcomas are all above 40%”. These different treatments all work to help people around the world to work towards having healthy epidermal tissues and living a life which is cancer-free.

Today, in 2019, the skin cancer organization reports that 60% of patients diagnosed with malignant skin cancer are rediagnosed within the next decade. Methodologies from clinicians are evolving from the gold standard of the ABCDE method to the immunological methods that work with the systems within the human body. Ranging from the SPF scale to protect the skin with products to natural alternative modalities such as aloe Vera and chamomile, skincare has been a concern from the first moments humans dipped into the golden sun and worked under the scorching UVA, UVB rays of the sun. As the future of research dips deeper into this dermatological nuisance, melanoma can hopefully become cancer that is just referred in medical text and not a commonality of life.

References

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2. American Cancer Society. (2016, May 10). What Are Basal and Squamous Cell Skin Cancers? Retrieved March 31, 2019, from https://www.cancer.org/cancer/basal-and-squamous-cell-skin-cancer/about/what-is-basal-and-squamous-cell.html
3. CDC. (n.d.). What Are the Symptoms of Skin Cancer? | CDC. Retrieved March 31, 2019, from https://www.cdc.gov/cancer/skin/basic_info/symptoms.htm
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7. O'Brien, S. (2017, May). Stages of Melanoma. Retrieved March 31, 2019, from https://skincancer.net/types-signs/melanoma-diagnosis-stages/
8. Paulson, G, K., Lahman, Chapuis, Brownell, & Isaac. (2019, February 08). Immunotherapy for skin cancer. Retrieved March 31, 2019, from https://academic.oup.com/intimm/advance-article/doi/10.1093/intimm/dxz012/5310046
9. Wang, S. Q., MD. (2018, May 21). Skin Cancer Foundation. Retrieved March 31, 2109, from https://www.skincancer.org/skin-cancer-information/ask-the-experts/does-a-higher-spf-sunscreen-always-protect-your-skin-better
10. What to look for: ABCDEs of melanoma. (n.d.). Retrieved March 31, 2019, from https://www.aad.org/public/spot-skin-cancer/learn-about-skin-cancer/detect/what-to-look-for