Learn more about Skin Cancers & Lumps and other symptoms,
and how it can be treated here at NC TAN Surgery.
The skin consists of three layers. The most superficial layer is the epidermis, followed by the dermis, and the deepest layer is the subcutaneous fatty tissue. Lumps in the skin can arise from any of these 3 layers.
Signs & symptoms
Epidermal cysts are usually slow-growing and painless. However, they can become infected, resulting in the lump becoming painful, red, swollen, and even discharging pus.
Lipomas are benign skin lumps arising from adipose (fat) tissue and is usually found in the subcutaneous layer of the skin. They are not cancerous and generally, they are painless, soft, and slow-growing. It is possible but rare for a lipoma to turn into a liposarcoma, which is cancerous in nature.
Surgery for lipomas may be indicated when:
Your doctor wants to be certain it is a non-cancerous lump.
The lipoma is large or is growing in size.
The lipoma is causing symptoms, for example pressing on a nerve or blocking the bowel.
You want to have your lipoma removed for aesthetic reasons.
Common Skin Cancers
The three major skin cancers are Squamous Cell Carcinoma (SCC), Basal Cell Carcinoma (BCC) and Melanoma.
Most skin cancers occur in the sun-exposed area of your body, like the face, neck, and hands. However, they can still be found in areas that are not exposed to the sun.
Taken from Miiskin
1. Squamous Cell Carcinoma (SCC) & Basal Cell Carcinoma (BCC)
Signs & symptoms
Cutaneous squamous cell carcinoma and basal cell carcinoma are commonly found on the skin of the scalp, face and neck areas. SCC is frequently found on the back of the hands as well. SCC and BCC are usually not life-threatening, though they can be aggressive.
Treatment involves an initial skin biopsy, which involves removing a small sample of the skin lump for testing in a laboratory. This will reveal whether you have skin cancer and, if so, what type of skin cancer.
SCCs and BCCs are commonly treated with surgery or radiotherapy.
1. Excision Surgery.
In this procedure, the cancerous tissue and a surrounding margin of healthy skin is surgically removed (wide excision). The additional healthy skin around the tumour is excised to ensure that all cancer cells are removed. In some instances, if the resulting skin defect is over the face or scalp, or the defect is large, reconstructive surgery is needed to minimise scarring and ensure a good cosmetic outcome.
2. Mohs Surgery.
During Mohs surgery, the cancer is removed layer by layer, examining each layer under the microscope until no abnormal cells are seen. This allows the surgeon to be certain the entire growth is removed and avoids taking an excessive amount of surrounding healthy tissue.
Radiotherapy uses ionising radiation to kill cancer cells. It is an option for people who are not medically fit to undergo surgery or the surgery itself may result in a poor cosmetic outcome. Less commonly, it is given after surgery as an adjunct to further prevent the risk of recurrence.
Signs & symptoms
Melanoma is a cancer of pigmented cells in the skin. Although it is not the most common skin cancer, it can be the most serious.
Melanoma can develop anywhere on your body, but women are more likely to develop melanomas in the arms and legs. In men, the face, back and chest are the common sites. Melanoma can arise in otherwise normal skin or in an existing mole that turns cancerous.
To determine if the skin mole is or has developed into melanoma, the ABCDE guideline is frequently used.
A: Asymmetry. If the pigmented lump is asymmetrical in shape, the risk of cancer is higher.
B: Borders. The risk of melanoma is higher if the borders are highly irregular.
C: Colour. Benign moles are uniform in colour as compared to melanoma, which has a variegated appearance.
D: Diameter. Harmless mole is usually less than 6 millimetres while melanoma is often more than 6 millimetres.
E: Evolving. Pigmented lumps that evolve over time in size, colour, shape, height or develop ulceration or bleeding, is suspicious for melanoma.
The treatment for melanoma generally includes:
1. Biopsy for diagnosis of melanoma.
2. Imaging scans to determine the extent of cancer.
3. Surgery, with or without systemic therapy and radiotherapy.
Surgery is the mainstay of treatment for melanoma. It involves removing the melanoma with a good margin of healthy skin to improve the likelihood that all the cancer cells are removed.
In the same setting, reconstructive surgery (see reconstructive surgery) may need to be done in certain cases to resurface the skin if the skin defect is big or if the defect is in the scalp, face, and neck area. Further, surgery such as sentinel lymph node biopsy or lymph node dissection may be needed to address regional lymph nodes that are possibly involved by the melanoma as well.