When the skin turns malignant
On World Cancer Day, we take a look at few celebs who battled with the disease
First Lady Jill Biden underwent a procedure to remove cancerous lesions called Basal Cell Carcinoma. According to the American Academy of Dermatology, it is the most common type of cancer in the world. According to the White House, the lesions were discovered during a routine skin cancer screening.
“Skin cancer is one of the most common cancers in the Western world, and its prevalence is rising in
India as well. Skin cancers typically develop from various types of skin cells and are classified as Basal Cell Carcinoma, Squamous Cell Carcinoma, and Melanomas based on the cell type. These cancers are more common in those with prolonged UV light exposure, and in people with fair skin. Skin cancer incidence is typically lower in people with dark skin,” says Dr Vamshi Krishna M, Director of Medical oncology AIG Hospitals, adding, “Other risk factors include chemical exposure and radiation exposure.”
TREATMENT
“It is slow growing, and if treated early, it is curable, and causes minimal damage,” says Dr. Madhu Devarasetty, Sr. Consultant Surgical Oncologist & Minimal Invasive Surgeon, KIMS Hospitals, adding, “The delicate facial skin around the eyes is especially vulnerable to sun damage.” “Mohs Micrographic Surgery is a technique in which one layer of tissue at the site of visible leison is removed at a time and checked under a microscope for the presence of cancer. This process is repeated until all cancerous tissue has been removed. It is frequently used to remove skin cancer from the face, fingers, or genitals in order to minimise disfigurement and functional loss,” adds Dr Madhu.
TYPES OF SKIN CANCERS
An ulcer, a new mole, or a dark-coloured lesion are common manifestations of skin cancer.
“The various types of skin cancer are named after the cells that cause them, as well as their clinical behaviour. Basal Cell carcinoma (BCC), Squamous Cell Carcinoma (SCC) (collectively known as nonmelanocytic skin cancers (NMSC)), and malignant melanoma (MM) are the most common types,” says Dr Madhu. “NMSC is the most common type of human cancer. Each year, 2-3 million new cases are reported worldwide. In people with fair skin, BCCs account for 75% to 80% of non-melanoma skin cancers, while SCCs account for up to 25% Melanoma is caused by the malignant transformation of melanocytes. Melanoma is the most lethal form of skin cancer, followed by BCC and SCC,” adds Dr Madhu.
SQUAMOUS CELL CARCINOMA
The skin is made up of two layers, called the epidermis and dermis. The epidermis is the upper portion, which is very thin and has five layers. The most common type of skin cancer is squamous cell carcinoma. This cancer originates in the base layer. People with fair skin are more likely to develop SCC though it can develop in the dark-skinned too. SCC frequently appears as a red firm bump, scaly patch, or a sore that heals and then reopens. SCC forms on skin that is frequently exposed to sunlight, such as the rim of the ear, face, neck, arms, chest, and back. SCC can cause damage and disfigurement by growing deep into the skin. Early detection and treatment can prevent SCC from spreading to other parts of the body, says Dr. Kishore B. Reddy, HOD orthopaedics and orthopaedic Oncology, Amor Hospital.
CANCEROUS MOLES
American reality television star Khloe Kardashian was forced to undergo surgery after discovering a cancerous mole. She discussed the incident in a post on her app and website in 2016. “I’m writing this post in the hope that my story will persuade some of you to see your doctor if you notice something wrong with your skin,” she explained. Eight inches of skin had to be removed at the time. “It was definitely painful because there was so much skin... but most of the time, the removals weren’t that bad,” she explained.
MERKEL CELL CARCINOMA
Actor Terry Bradshaw, the Hall of Fame quarterback, revealed during a Fox NFL Sunday broadcast in the fall of 2022 that he had battled skin cancer. Bradshaw discovered a tumour on his neck that turned out to be Merkel Cell Carcinoma, a rare type of skin cancer. He told the audience that he was “cancer free and feeling great” after treatment.
MELANOMA
When ‘Dancing with the Stars’ actor Witney Carson was diagnosed with melanoma, she was only 22 years old. Carson, whose father died of melanoma, has been outspoken about the importance of regular skin exams and early detection. “Melanoma is the most dangerous type of skin cancer that frequently appears in moles. Moles are common skin lesions that affect many people as they age. If there is a sudden change in the size, colour, or consistency of a mole, this could indicate that the mole has transformed into a cancer. Melanomas necessitate surgery. Depending on the size and location of the melanoma, the surgery will need to be micrographic, with a good margin taken around the melanoma. Because the likelihood of recurrence is high. Melanomas have a strong proclivity to spread to nearby organs, including the lymph nodes,” says Dr Vamshi.
“We also provide a one-year course of immunotherapy, which has been shown to reduce the risk of the disease returning if the melanoma is advanced and has spread to other organs. Other medications, such as chemotherapy, are used. However, the efficacy of chemotherapy is decreasing, and immunotherapy is now the standard care. If the cancer is localised, it is usually treated with surgery, followed by immunotherapy,” adds Dr Vamshi.
AMERICAN REALITY TELEVISION STAR KHLOE KARDASHIAN WAS FORCED TO UNDERGO SURGERY AFTER DISCOVERING A CANCEROUS MOLE. SHE DISCUSSED THE INCIDENT IN A POST ON HER APP AND WEBSITE IN 2016. “I’M WRITING THIS POST IN THE HOPE THAT MY STORY WILL PERSUADE SOME OF YOU TO SEE YOUR DOCTOR IF YOU NOTICE SOMETHING WRONG WITH YOUR SKIN,” SHE EXPLAINED.
BASAL CELL CARCINOMA
Perhaps best known for his role as Wolverine in the XMen films, Australian actor Hugh Jackman openly discussed his skin cancer battle with fans. In recent years, Jackman has had several cancerous portions of skin removed, and he frequently uses social media to remind his fans of the importance of sun protection and regular skin exams.
“Basal Cell Cancers are commonly found on the face of the elderly, especially around the nose and under the eyelid. This type of cancer can only be treated surgically. If it is recurrent or in multiple locations, radiotherapy can be used after surgery in some cases. Chemotherapy is usually not required for such malignancies. Carcinomas are typically found in sun-exposed areas or in areas where the skin has been damaged,” says Dr Vamshi.
“MOHS MICROGRAPHIC SURGERY IS A TECHNIQUE IN WHICH ONE LAYER OF TISSUE AT THE SITE OF VISIBLE LEISON IS REMOVED AT A TIME AND CHECKED UNDER A MICROSCOPE FOR THE PRESENCE OF CANCER. THIS PROCESS IS REPEATED UNTIL ALL CANCEROUS TISSUE HAS BEEN REMOVED. IT IS FREQUENTLY USED TO REMOVE SKIN CANCER FROM THE FACE, FINGERS, OR GENITALS IN ORDER TO MINIMISE DISFIGUREMENT AND FUNCTIONAL LOSS”
— DR. MADHU DEVARASETTY, Sr. Consultant Surgical Oncologist & Minimal Invasive Surgeon, KIMS Hospitals