Most health care providers advise sun-worshippers to protect their skin from the damaging rays of the sun. There are many persons who never listen to this advice. They end up developing skin cancers of the head and neck, eye and on their extremities. Most individuals grew up believing radiation is dangerous and should be avoided at every opportunity. Research data has shown that radiation can have positive results on the treatment of skin cancers. There are several types of radiation therapy used to treat various skin cancers.
According to West (1980), “basal cell is the most common type of skin cancer…and typically forms on the face and neck. ” Skin cancer cases were evaluated out of 325 cases 257 patients had been previously treated using radiation therapy. The recurrence rate for Basal cell carcinoma and squamous cell carcinoma was between 7. 8 percent and 14. 9 percent. West (1980) These control rates were very comparible to the other types of therapies. It is important to rember that esthetics and function are very important. These tests for both afformentioned reasons were very positive.
And should be considered a mode of therapy in the treatment of skin cancer. Perineural invasion occurs in 2% to 6% of cutaneous basal and squamous cell carcinomas of the head and neck and is associated with midface location, recurrent tumors, high histologic grade, and increasing tumor size. Patients may be asymptomatic with perineural invasion appreciated on pathologic examination of the surgical specimen (incidental) or may present with cranial nerve deficits (clinical). The cranial nerves most commonly involved are the 5th and 7th nerves.
Magnetic resonance imaging is obtained to detect and define the extent of perineural invasion; computed tomography is used to detect regional lymph node metastases. Patients with apparently resectable cancers undergo surgery usually followed by postoperative radiotherapy. Patients with incompletely resectable cancers are treated with definitive radiotherapy. The 5-year local control, cause-specific survival, and overall survival rates are approximately 87%, 65%, and 50%, respectively, for patients with incidental perineural invasion compared with 55%, 59%, and 55%, respectively, for those with clinical perineural invasion.
A corneal shield is placed between the eyelid and globe to protect the ocular structures, when skin cancer is near the eye. A test was performed to determine if the shield was enough protection for the eye. In order to simulate the real human face a phantom eye was made. A mock up was created to reconstruct the set up that had been used to treat a real patient with basil cell carcinoma of the lower lid. The face was made of solid pieces of water-equivialant epoxy. In the region of the eye the face was milled to the exact shape of a human face.
This will give the researcher more specific data to use when treating a real patient. Contemporarily, there is increasing evidence supporting the concomitant use of cetuximab, a monoclonal antibody against the epidermal growth factor receptor (EGFR), in addition to high-dose radiotherapy in primary treatment concepts of head and neck cancer [1]. In comparison to conventional chemotherapy, molecularly targeted agents reveal lower haematological toxicity. However, some specific side-effects such as allergic rashes and skin reactions may limit the therapeutic use and compromise the individual patient’s compliance.
With respect to skin reactions secondarily to the administration of EGFR inhibitors (EGFRI), pruritic follicular eruptions with either pustular or maculopapular appearance are most common with an estimated occurrence in >70% of patients. Although acne-specific features such as comedones or microbial superinfection are lacking, the morphology is usually referred to as acneiform. Correspondingly, the clinical symptomatic is acne-like with a characteristic distribution in seborrhoeic areas (face, V-shaped neckline, upper torso).
Histopathological analyses show enlargement of follicles with suppurative folliculitis and follicular plugging by keratin as consequence of the altered keratinocyte differentiation and increased apoptosis by the EGFR blockade. Apparently, there is a great diversity of morphologic manifestations, and the majority of patients will experience only mild skin symptoms. However, severe reactions have been described in up to 10% of patients (grade 3/4 according to the common toxicity criteria).
There is only a little information available concerning possible risk factors as well as interferences with other dermatotoxic factors as, for example, concomitant radiotherapy Human evidence that ionizing radiation is carcinogenic first came from reports of nonmelanoma skin cancers (NMSCs) on the hands of workers using early radiation devices. An increased risk of NMSC has been observed among uranium miners, radiologists, and individuals treated with x rays in childhood for tinea capitis (ringworm of the scalp) or for thymic enlargement; NMSC is one of the cancers most strongly associated with the atomic bombing of Hiroshinma and Nagasaki.
Although exposure to ionizing radiation is a known cause of NMSC, it is not yet clear whether therapeutic radiation causes both major histologic types of NMSC, basal cell carcinoma (BCC) and squamous cell carcinomas (SCC). Additionally, the potentially modifying effects, such as latency, age when treated, and type of treatment, are not well understood. One of the most common forms of skin cancer is basal cell carcinoma. Newsweek magazine mentioned basal cell cancer as the most common form of cancer (“Your tan could kill you,” 2006) Rarely will this type of cancer cell metastasize or kill.
Because it can cause significant damage by invading surrounding tissues it is considered malignant. Those individuals with a family history of cancer and who are fair skinned are at greater risk. Ultra violet rays from the sun are a major factor in two thirds of cancer cases. That is why doctors recommend sunscreens. Cancer can also occur on areas of the body that are not exposed to the sun. According to Holcomb (2006), “basal cell is the most common type of skin cancer…and typically forms on the face and neck.
There are two major types of cancer no melanoma and melanoma. The nonmelanoma type of cancer is basal cell. In the United States the most commonly seen cancer is basal cell. According to the Skin Cancer Encyclopedia (n. d. ), the outermost layer of skin is the epidermis this is where basal cell carcinoma begins. It is painless and slow to grow. Regular exposure of skin to sunlight or other types of ultra violet radiation, like tanning beds, cause this type of cancer to grow. It is more common to develop on people over 40 years of age.
SKIN CANCER 3 Basal cell carcinoma may look only slightly different than normal skin. That cancer may appear as a skin bump or growth that is: pearly or waxy, white or light pink, flesh colored or brown often in cases the skin may just be slightly raised or even flat. According to the Medline Online Dictionary (n. d. ) An individual is at greater risk for basal cell skin cancer if they have: Blonde ore red hair, green or blue eyes, fair skin complexion or an overexposure to any type of radiation. Basal cell skin cancer rarely spreads.
However, if left untreated, it will grow into surrounding areas and could spread into the tissue and bone of areas in close proximity. Treatment for either basal or squamous cell carcinomas depends on size, location and the speed at which the tumor is growing. Here are a few of the procedures used to irradicate the cancer growth. Laser therapy is when an intense beam of light causes the cells to vaporize with very little trauma caused to the healthy tissue. These lasers are used to trea cancers located in delicate tissue areas.
Moh’s surgery is considered the most effective way to remove the squamous cell carcinomas. A doctor will remove the tumor layer by layer, examining each layer as he proceeds. Many feel this is a surgery that should be performed by doctors specifically trained in this specific procedure. Finally, for cancers that are only on the surface of the skin, creams or lotions containing anti-cancer agents are applied directly to the skin. The website for the Mayo clinic (2009) has many interesting facts about this potentially dangerous disease. < SKIN CANCER4.
Reference Page
West, J. (1980, November, 7) Radiation therapy for skin cancer ,PBC, 133(5), 379-382 Retrieved from, http://www. ncbi. nlm. nih. gov/pmc/articles/PMC1272348/ McApp, A. (2007, February 30) Skin cancer of the head and neck with perineural invasion. Oncology, 30(1), 93-6. Retrieved March 9, 2010, from http://www. ncbi. nlm. nih. gov/pubmed/19688856? ordinalpos=1&itool=PPMCLayout. PPMCAppController. PPMCArticlePage. PPMCPubmedRA&linkpos Radiation, (2006, September, 7). Radiation biology physiology journal, 1992-23 (4) 769-79.
Retreived March 9, 2010, from http: www.ncbi. nlm. nih. gov/pubmed/1618670 Berger, B. (2008, January 28) Radiation Oncology,3(5) 12-15 retrieved March 7, 2010, from http://ro-journal. com/content/3/1/5 Karagas,K. (1996, December 18) Risk of basal call and sqaumous skin cell skin cancer after ionizing radiation. 88(24) 1848-1853 retrieved March 8, 2010 from http://jnci. oxfordjournals. org/cgi/content/short/88/24/1848 1. Basal cell carcinoma. (n. d. ). in Wikipedia encyclopedia online. Retrieved January 18, 2010, from http://en. wikipedia. org/wiki/Basal_cell_carcinoma 2. Basal cell skin cancer.
(n. d. ). Skin cancer encyclopedia. Retrieved January 18, 2010, from http: //www. skincancer. org 3. Holcomb, S. (2006) Nonmelanoma skin cancer, patient education. Nursing, 36 (para. 6) http://www. nursing2006. com 4. Nonmelanoma skin cancer. (n. d. ). Medline dictionary online. Retrieved January 18, 2010, from http://www. nlm. nih. gov/medlineplus/ency/article/000824. htm 5. Squamous cell carcinoma. (2009). Treatment and drugs. (para. 1-4) Retrieved January, 18, 2010, from http://www. mayoclinic. com/health/squamous-cell-carcinoma/DS00924.