Skin Cancer: Experts: Patients Need to Know Where to Go with a Worrying Change
- We do not know the exact number of skin cancer cases because basal cell carcinomas are not subject to reporting, just like squamous cell carcinoma in situ - says Dr. Monika Słowińska
- They are particularly dangerous for certain groups of patients: after organ transplants, after bone marrow transplants, with polycythemia vera - he lists
- Early diagnosis in the form of dermatoscopy is needed, but it takes time to be available in the public health care system.
- The Polish Oncological Society has developed a tab with addresses and telephone numbers of offices that perform dermatoscopy and accept patients covered by the National Health Fund - says Dr. Marcin Ziętek
"How many new skin cancer cases do we have each year? We don't really know—we suspect tens of thousands. The lack of information on this topic stems from the fact that basal cell carcinomas are not subject to reporting, just like squamous cell carcinoma in situ. And although we don't know the exact number, we do know that it's growing rapidly, especially in the case of squamous cell carcinomas," said Dr. Monika Słowińska from the Dermatology Clinic of the Military Institute of Medicine-National Research Institute in Warsaw during a Polish Oncology Society (PTO) webinar.
"While we hear a lot about melanoma in the public sphere, we hear much less about other skin cancers. That's why it's worth reminding people about them, especially in the context of several very difficult patient groups ," she added.
The specialist emphasized that skin cancers pose a significant risk to organ transplant recipients . As a result of chronic immunosuppressive treatment, they develop numerous squamous cell carcinomas.
"The second population that deserves attention are patients who have undergone bone marrow transplantation . They often develop basal cell carcinomas in areas where they received radiation therapy before the transplant. We often see young people with extensive cancerous lesions on the scalp or torso, which is due to the fact that these patients received an additional dose of radiation to the central nervous system," she explained.
She said the third group consists of patients with polycythemia vera and myelodysplastic syndromes who have been treated with hydroxycarbamide for years. They develop a large number of advanced squamous cell carcinomas, especially in areas exposed to UV radiation.
"These patients require absolute sun protection year-round, even in winter. This includes the use of appropriate sunscreens, appropriate clothing, and avoiding sun exposure during work and leisure. These patients currently pose a significant challenge because their treatment is difficult, and due to various health conditions, they have contraindications to systemic therapy," Dr. Słowińska pointed out.
Dr. hab. Marcin Ziętek, head of the Department of Oncological Surgery (II) at the Lower Silesian Centre for Oncology, Pulmonology and Hematology in Wrocław, pointed out that the reporting process is expected to improve significantly, as histopathology laboratories will automatically report skin cancers.
- We will soon know their actual number - he noted.
Specialists also shared their comments on early detection of skin cancer.
As Dr. Słowińska pointed out, the tool that most aids in diagnosing them is dermoscopy . Currently, access to this procedure has improved significantly, as dermatologists perform it very commonly. Furthermore, oncologists and oncological surgeons are also increasingly performing dermoscopy.
"Many new skin diagnostic facilities have also been established, mostly privately . The test can, of course, be performed within the public healthcare system, but this involves waiting times, as the queues for dermatologists are very long . Oncologists are more readily available, but their workload is so high that they are unable to perform such screening," she said.
"It seems that the best solution in this situation is a family doctor , who should be educated enough to assess whether a lesion that concerns the patient can be considered a potential cancer. A family doctor, who has access to the patient's entire history, can also select patients from the highest-risk groups . This includes people with atypical lesions or significant skin photodamage. Such action would make sense," argued Dr. Słowińska.
According to Dr. Marcin Ziętek, it is also important to disseminate knowledge among patients about the facilities to which they can go if they experience disturbing skin changes .
"The PTO's scientific section has developed a tab with the addresses and phone numbers of offices that perform dermatoscopy and accept National Health Fund (NFZ) patients, where patients can register near their place of residence. The tab can be found on the pto.med.pl website; the information just needs to be disseminated," the specialist pointed out.
He also referred to the issue of skin cancer screening that has been emerging in the public space.
"This is a difficult topic because, although every patient should be examined, not everyone should be examined equally frequently. Therefore, it is necessary to select patients at increased risk of developing the disease . This group includes people with a history of skin cancer, those who have undergone cancer treatment, and those with weakened immune systems, which cause skin cancers to develop more frequently and quickly," said Dr. Marcin Ziętek.
- Such selection is crucial because screening covering the entire population is impossible to implement - added the specialist.
Copyrighted material - reprint rules are specified in the regulations .
rynekzdrowia
