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Skin Cancer (Malignant Tumors) in the Elderly

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Skin cancer is one of the major concerns of seniors with abnormal skin growths. A lifetime of sun exposure, often without the use of sunblocks in earlier life, is one of the main reasons for the development of this condition in the seniors years of life. Skin cancer is the abnormal growth of skin cells which usually develops on the skin exposed to the sunlight due to effect of ultraviolet light.

Some growths can be benign but cancer is a malignant tumor.Skin cancer can be prevented to a large extent by protecting yourself from exposure to ultraviolet light. Regularly checking the skin for any abnormal changes may help in early detection thereby improving the outcome after treatment. These lesions should not be confused with liver spots, warts or skin tags (achocondrons).

Signs and Symptoms

Usually the skin exposed to sunlight is involved, though cancer can be seen in covered parts of the body such as the skin over the genitalia. The symptoms vary by the type of cancer but are usually an abnormal lump or “bump” on the skin, formation of ulcers (sometimes) and discoloration of the skin. More specific signs and symptoms may depend on the type.

Types of Skin Cancer

The more common types of malignancies include :

Basal cell carcinoma

  • Usually occurring in the sun exposed areas.
  • Appears as a pearly waxy bump.
  • A flat brown colored or scar-like lesion.

Squamous cell carcinoma

  • Usually occurring in areas which are exposed to the sun but may also develop it on unexposed areas of skin.
  • Appears as a reddish firm nodule or flat lesions with crusted scaly surface.

Melanoma

  • Can develop anywhere and progresses from an existing mole which may become cancerous.
  • Large brownish spot with darker discolorations.
  • May have rough uneven border and may appear discolored.

Other less common types include Kaposi sarcoma, Merkel cell carcinoma and sebaceous gland carcinoma.

Causes and Risks

Abnormal mutations in the DNA of the skin cells causes the rapid growth of these cells which invades and destroys surrounding healthy tissue. There may be a genetic predisposition to developing skin cancer, and various toxic agents can cause it. However, in this day an age it is the prolonged exposure to ultraviolet light (mainly in sunlight) that appears to be the primary cause. Tanning beds may also have a similar potential in damaging the DNA of skin cells.

People who are at risk of developing skin cancer include :

  • People with fair skin.
  • With history of skin burns and who are exposed more to sunlight or those living on high altitude.
  • People with abnormally shaped and sized moles.
  • Personal or family history of skin cancer.
  • Immunocompromised.
  • Exposure to toxic substances such as arsenic.

Skin Cancer Treatment

A skin biopsy may help in the diagnosis. Treatment varies with respect to size, type, depth and location of the lesions. Common approaches to treatment are:

  • Excisional biopsy which is surgically “cutting out” the tumor along with the surrounding normal tissue to some extent.
  • Cryotherapy or freezing.
  • Laser therapy.
  • Mohs surgery which is layer by layer removal with scraping.
  • Curettage and electrodesiccation by burning the lesion.
  • Radiation therapy.
  • Chemotherapy. Anti-cancer drugs are administered either topically or systemically.
  • Photodynamic therapy (PDT) by making the cancerous cells photosensitive with medication and applying light to destroy it.
  • Biological therapy is the process of stimulating immune cells to act against cancer cells.

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