Early diagnosis and regular check-ups, key tools to beat skin cancer

Within the framework of World Skin Cancer Prevention Day, commemorated every June 13 in order to inform and raise awareness about this disease, the COVID-19 pandemic and mandatory isolation have reduced preventive studies and post-diagnostic follow-ups in patients with this disease, who – processed on time – has a survival rate that reaches 99% in some cases.

“Skin cancers other than melanoma and melanoma have a very high survival rate when diagnosed at an early stage“, specified Infobae the doctor Yanina Pfluger, responsible for skin tumors and sarcomas at the Alexander Fleming Institute.

“The pandemic has dramatically altered the diagnosis and treatment of primary tumors. We saw more advanced tumors than usual, especially in older people who were in isolation the longest. In patients who had previously been treated and were on follow-up, connectivity allowed some type of contact and eventual intervention», Explained the doctor in his turn. Etchichuri dart, deputy head of the skin oncology unit of the IAF.

Symptoms that activate alarms

The doctor Caroline Spinelli, a dermatologist at the Fleming Skin Oncology Unit, said that “the way to detect skin cancer early is to see a dermatologist for a general exam. It is the dermatologist who detects it by inspecting and performing manual dermoscopy, which allows us to observe structures of the skin imperceptible to the human eye, increasing the sensitivity and specificity of the clinical diagnosis of melanoma and other skin tumors ”.

Periodic self-examination (checking our skin) is a great tool that helps with early detection. “Early diagnosis, with adequate treatment, results in a cure in most cases», Indicated the doctor Marcela moreno, head of the dermatology department of the IAF.

During childhood, dermatological checks should be carried out by the pediatrician, who will consider whether it is necessary to consult a pediatric dermatologist, taking into account the type of skin, the lesions present and the history. From the age of 16 you can start to carry out checks with the dermatologist, who will examine the skin in general, and will advise you on good skin cancer prevention habits..

In the case of melanoma, the signs to take into account are the so-called ABCDE: Asymmetry (one half of the mole is different from the other), Irregular edges, Color (change or multiple), Diameter greater than 5 mm, Evolution of the elevation of the mole. Or the sudden appearance of a mole. If the patient performs regular mole examinations, the dermatologist can detect it long before these criteria are present.

What are the steps to follow once the diagnosis is confirmed? The surgeon Etchichuri dart details that “the most common non-melanoma skin tumors are basal cell carcinoma and squamous cell carcinoma. Depending on the degree of invasion, treatments range from methods of local destruction to more complex surgical techniques such as Mohs surgery, which achieves cure rates of 99% ”. The IAF performs some 3,000 surgeries per year with this technique, most of them under local anesthesia and on an outpatient basis.

For melanoma, once the diagnosis is confirmed, treatment depends on the depth of the tumor. In the most superficial cases, only enlargement of the skin margins is usually sufficient.

In deeper melanomas, sentinel node biopsy is indicated. This is a technically reliable procedure that allows early detection of microscopic metastases localized in regional lymph nodes.

There are inherited genetic syndromes that promote the development of melanoma, but the biggest genetic or hereditary characteristic is the phototype, that is, the color of the skin. Sun exposure is the main cause of the development of tumors other than melanoma.

Some people are at greater risk for melanoma than others. For example, patients with a family history who have had melanoma or if they have had certain abnormal moles in the past. Among families predisposed to melanoma due to genetic mutations, the incidence is 21 times higher, presumably due to an interaction between increased sun exposure and the predisposing genetic mutation.

Targeted therapies, which are indicated in basal cell carcinoma and melanoma, also have response rates between 40% and 70%, although in the case of melanoma their indication is individualized taking into account the biological characteristics of the tumor. Despite the novelties and recent therapeutic developments, preventive practices are essential because the opportunities increase in cases of early detection.

In what situations should the oncologist indicate treatment?

The oncologist must be involved from the start of the diagnosis of skin tumors. “In this way, the best treatment strategy can be properly evaluated with the tools available so far (surgery, radiotherapy, chemotherapy or immunotherapy), as well as to coordinate with the patient a series of future checks for the best benefit”, said the doctor. Tomás Soulé, clinical oncologist in the field of sarcomas and melanomas at IAF.

Skin cancer by sex and age

According to IAF professionals, there are incidences of age and gender in skin cancer cases, although they respond to specific factors. “In general, women tend to be more sensitive to skin care and this leads to consultations at earlier stages of the disease compared to men,” says Etchichuri.

“It is important to mention that the biology of some skin tumors is different in young patients compared to older adults. Classically, in the event of melanoma, in children under 10 years of age, a more favorable prognosis has been described. However, this data is controversial. It should be taken into account that in the juvenile population there are particular biological types of melanoma, such as “spitzoid”. In older young people, the frequency of regional lymph node involvement increases when the disease is diagnosed, ”adds the doctor. Frédéric Wiasberg, Fleming’s clinical oncologist.

“At the population level, it is suggested to increase the possibilities of sun protection in outdoor environments, to provide people with the information they need to make concrete and healthy decisions regarding exposure to ultraviolet rays. Promote national skin cancer prevention policies and strengthen research, surveillance, monitoring and evaluation related to skin cancer prevention ”, concludes the oncologist Andres Rodriguez of the IAF.

The latest technological advances for a better quality of life

At the Skin Oncology Unit (UOC) of the IAF, we work with digital dermoscopy (Fotofinder), known to patients as “mole mapping”.

The technique consists of two steps: first, photographing the whole body and then dermoscopy using an optical system to amplify and illuminate individual moles. This is documented and carrying out the study over time (usually annually) can detect early changes or the appearance of new lesions. It is recommended for patients with a personal and / or family history of melanoma, or in the presence of numerous moles. According to Dr. Carolina Spinelli, dermatologist at UOC, “the most relevant scientific advances are the new drugs for advanced disease, however, control with the dermatologist continues to be the most important means for early detection. skin cancer. “.

Practical maintenance guide

To protect the skin from the harmful effects of the sun, it is important that photo-education is done from an early age. Photoprotection is the key. To achieve this, these premises are mandatory:

-Keep newborns out of direct sunlight

-Wear a wide-brimmed hat

-Glasses with UV filter

-Light clothes, with a sleeve or with sun filters

-Use a photoprotector with a factor greater than 30 of recognized quality, which blocks UVA and UVB radiation, broad spectrum. The application must be done 30 minutes before the exposure and renew it every 2 hours. Its use in children is from 6 months

-Avoid sun exposure from 10 a.m. to 4 p.m. in spring-summer

-Avoid sunburn

-Avoid the use of tanning beds and screens

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