Prevention is the most effective instrument for reducing the incidence and mortality of skin cancer. Early diagnosis is a priority aspect based on signs of skin cancer, as it allows you to diagnose skin cancers at an early stage, reducing the weight of therapies and assuring the best prognosis.
Enlisting medical experts from a cancer reference centre allows adequate and prompt screening of the population. For patients who have already received a diagnosis of skin cancer, a centre of excellence enables correct description of the disease and planning of therapy.
Early diagnosis forms the most effective instrument for reducing death associated with melanoma skin cancer. Recognising the signs of skin cancer at the initial phase means having an excellent prognosis. To make an early diagnosis of skin cancer it is essential to undergo periodic specialist consultations at centres with specific and expert professionals.
Forms of prevention for melanoma and skin cancers
Primary prevention involves appropriate behaviour for reducing the risk of onset of a skin cancer. For melanoma and skin cancer it is important to limit exposure to sunlight, find areas of shade if remaining in sunlit places for long periods and avoiding exposure to the sun during the middle part of the day.
Sun protection cream can be helpful for avoiding erythema (sunburn, for instance) and should be applied every 2 hours, in adults and in children.
Secondary prevention has the goal of reducing mortality through melanoma and other skin cancers by anticipating diagnosis and early treatment of the high-risk forms.
For melanoma and the main skin cancers, secondary prevention is based on the following:
- periodic self-examination of the skin looking at possible signs of skin cancer every 3 months
- periodic dermatology visits at specialist centres
Signs of skin cancer - what does skin cancer look like?
When self-examining the skin it is essential to look carefully. A relative, friend or partner can help to inspect the less visible regions of the body, such as the back and the rear surface of the thighs, paying attention to skin cancer symptoms.
For self-examination of the skin and in particular for distinguishing the skin cancer symptoms as potential malignant lesions, it can be helpful to remember the ABCDEF rule:
A for Asymmetry: the shape of a benign neo is generally circular or at least regular, while a melanoma is irregular
B for Borders: in melanoma, irregular and indistinct
C for Colour: variable in melanoma (or with different shades within the neo itself)
D for Dimensions: increasing in melanoma, both in width and thickness
E for Evolution: in melanoma, the characteristics of the neo (symmetry, borders, colour, dimensions) change over time
F for Firmness
Symptoms of skin cancer: one or more clinically atypical or suspected lesions
Regardless of the risk attributable to the subject based on the information collected, if one or more suspected skin lesions are found the patient will be offered the option of undergoing more thorough diagnosis using a digital videodermatoscope and confocal laser microscopy.
Digital videodermatoscopy allows magnified, high-resolution images of the skin lesions to be obtained to be able to examine the characteristics that cannot be appreciated with the naked eye or by manual dermatoscopy alone.
Confocal laser microscopy is a non-invasive technology which can obtain live images of the skin lesions at variable depth and with a very high resolution (virtual biopsy).
The combination of videodermatoscopy and confocal laser microscopy will, in many cases, enable avoiding surgical removal of the skin cancer. Where one or more lesions present the suspected characteristics of skin cancer, surgical exeresis will be carried out for histopathological investigation.
Patients who have risk factors for the development of melanoma (high-risk patient), especially if they have numerous moles or naevi, will be offered digital mapping.
Digital mapping is carried out in two phases. The first takes high resolution photographs of various areas of the body (face, trunk, limbs, extremities). The second phase involves acquiring a series of high-resolution images and neos and any other skin lesions by digital videodermatoscopy. This will provide a digital archive of the representative lesions of a subject in order potentially to follow the evolution of these lesions in skin cancers. In addition, by comparing the images of the various areas of the body it will be possible to identify any new recently onset lesions.
In each case the consultation for the skin lesions, as possible skin cancers, will be followed by a brief explanation of the best strategies for reducing the risk of melanoma and non-melanoma skin cancer. Specifically, each subject will be explained how to avoid excessive exposure to ultraviolet rays and the appropriate sun protection will be indicated. Furthermore, it will be explained to each subject how to perform a self-examination of skin lesions, looking at signs of skin cancer and following simple and understandable rules.
We believe that the moment of diagnosis must always be accompanied by a moment of education for both children and adults on how to provide correct prevention of the skin cancer risk.