Case Study Analysis Report: Skin Cancer Diagnosis and Treatment

This case study analysis report delves into the complexities of skin cancer, beginning with the identification of lesions and differentiating between malignant and non-malignant forms. The report outlines the characteristics of skin cancer, including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. It explores the causes, signs, and symptoms of melanoma, emphasizing the importance of early detection and the role of UV radiation. The analysis provides a detailed overview of the treatment options for melanoma, including surgery, radiation therapy, chemotherapy, and targeted therapy, tailored to the cancer's stage. Furthermore, the report contrasts melanoma with non-melanoma skin cancers, highlighting their distinct symptoms and treatment approaches. The case study underscores the significance of understanding skin cancer types and the various treatment modalities available to improve patient outcomes. The document is contributed by a student to be published on the website Desklib. Desklib is a platform which provides all the necessary AI based study tools for students.

CASE STUDY ANALYSIS
REPORT

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................1
MAIN BODY...................................................................................................................................1
Identification of Lesion................................................................................................................1
Skin Cancer..................................................................................................................................1
Difference in treatment options for both a malignant and non-malignant skin cancer................7
Recommendations........................................................................................................................7
CONCLUSION................................................................................................................................7
REFERENCES................................................................................................................................8

INTRODUCTION
Cancer is one of the dangerous disease known till now. It can simply be defined as
abnormal growth of cell tissues. There is no particular definition of cancer and there is no
defined age group who mostly suffers from cancer (Robles & et.al. 2017). Cancer is mostly of
two types first is malignant and second is non malignant cancer. Non malignant cancer does not
result in patient's death whereas malignant can develop more frequently and can result in
patient's death. Cancer is a term used for various kinds of diseases and out of which Skin cancer
is one of the most common type of cancer that can occur at any stage. It is extremely important
to detect Skin cancer at early stages because if one fails to detect it at initial stage then it can
result in patient's death as well. In this assignment case study analysis will focus on lesion and
difference in treatment options for both a malignant and non-malignant skin cancer.
MAIN BODY
Identification of Lesion
Lesion can be defined as abnormal change or damage in tissues of an organism. It is
mostly caused by a disease but mostly caused by tumour or cancer. If lesion is cancerous then it
is known as malignant or benign. If Lesion is caused by kainic acid or amino acid then it is called
as excitotoxic lesion. This lesion kills all kinds of neurons through over stimulation. There are
many types, but most commonly used lesion are: Macules are normally flat and represent change
in colour. These are normally patches like tattoo, flat moles, port wine Stains and many more.
Papules are elevated lesions which can be felt like insect bite, acne skin cancer. Other than this
other lesions are not dangerous. But the main lesions that are dangerous are malignant, papules
are one of those lesions that are cancerous.
Skin Cancer
Skin cancer is a type of cancer in which cancer starts to grow within normal cells,
transform and multiply within other cells as well without normal controls (Mantso & et.al. 2018).
As these cells multiply they form a tumour. These tumours are of two types malignant and non
malignant. They are dangerous only if they are malignant because they are cancerous i.e.
whenever they occur they damage neighbour tissues as well and become uncontrollable until and
unless are treated correctly. There three main types of skin cancer: basal cell carcinoma (BCC),
Squamous cell carcinoma (SCC) and melanoma. The first two types of skin cancer i.e. BCC and
SCC comes under non-melanoma skin cancer. Most of the skin cancers are non-melanoma i.e.
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they are likely to spread to other body parts as well. Whereas malignant skin cancer cannot
spread to other body parts but if such type of skin cancer is not treated at easy stage then it can
spoil someone's appearance. One of the highly aggressive type of skin cancer is malignant
melanomas as they can spread to other parts of body and if it is not treated properly then it can
become fatal. Skin cancer starts with pre cancerous lesions that are not cancer at initial stage but
can convert into cancer if they are not treated on time (Badavanis & et.al. 2017). The two types
of skin cancer that mostly occur within individuals are melanoma and non-melanoma skin
cancer.
Melanoma Skin Cancer
It is one of the most serious type of skin cancer that mostly develops within cells that
produces melanin. It is one of those pigment that gives skin its colour. Not is not compulsory that
melanoma will occur at outer skin only, in fact it can occur within internal organs as well, under
or within eye and on various other body parts. So it can be said that it can develop anywhere and
at any body part whether in normal skin, existing mole. In men it mostly occurs on face or their
trunk whereas in women it mostly occurs on their lower legs. It can also occur on body parts that
are never exposed to the Sun. It can occur to any person with any colour skin tone.
About:
The main and exact cause of melanoma is still not clear but there are few assumptions
due to which it can occur such as exposure to ultraviolet rays from sun, tanning lamps or bed
increases chances of melanoma skin cancer. If a person limits their exposure to UV radiation
then it can reduce chances of this skin cancer type. As per a survey (Leachman & Merlino 2017),
it has been observed that chances of this cancer type is increasing within people under 40 years
of age and especially within women. It is quite important to notice symptoms of any kind of
changes within skin cell before they convert into cancerous cells. Early detection of melanoma
can helps in successful treatment.
Sign and symptoms:
It can occur to any body part but mostly it occurs on parts that are exposed to sun like
face, legs, back, arms etc. and on body parts that are not exposed to sun such as hands, nails, feet
etc. First sign that can be observed for identification melanoma skin cancer are: first is change in
existing mole like change in colour, size and second is development of unusual or new pigment
that continues to grow on skin. There is no surety that this melanoma begins on a mole in fact it
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can appear on other normal skin as well. There are few other signs that help in identifying
growth of melanoma such as: growth of large brownish spot with speckles, mole that changes
colour or size or bleeds, small lesion with irregular shape and border and has red, pink, white and
blue or black colour, painful lesion that burns or itches.
Cause:
It mainly occurs when something goes ways in melanocytes i.e. melanin producing cells
(cells that gives colour to an individual's skin). Normally skin sells develop in a normal and
orderly way (Xiong & et.al. 2018). Healthy tissues develop and push older tissues towards skin
surface where they die and fall off but if any one of the tissue develop damaged DNA then it can
result in growth and development of new cells that might grow uncontrollably which might
further form a group of cancerous cells. But it is not clear how damaged DNA within skin cells is
created and how it leads to melanoma skin cancer but according to doctors and studies carried
out main cause of melanoma is UV rays, tanning beds or lights.
Treatment:
Treatment of melanoma skin cancer completely depend upon the stage at which skin
cancer is at and the body part at which it has occurred.
 Treatment at stage 0: At this stage melanoma skin cancer has not grown beyond the top
layer and normally are treated with the help of surgery where melanoma and minute skin
around it are removed. The removed part is then checked again in lab and if the cells are
at the edge then this excision is repeated (Litvinov & et.al. 2016). Another alternative of
surgery is radio therapy but it completely depends upon the doctors which treatment they
want to choose.
 Treatment at stage I: At this stage surgery (cancerous skin is removed and margin of
normal skin is removed) process is repeated. Repeatation of surgery is also called
excision. Marginal normal skin is removed based on the thickness and location of
melanoma. Another treatment is sentinel lymph node biopsy as well but this is done when
there are chances that melanoma can spread to other lymph nodes as well. There is no
surety that even after this treatment cancerous cells are removed but many times
vaccines, medicines are also given as a part of treatment which ensures that this
melanoma will never come back.
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 Treatment at stage II: At this stage wide excision is done, it is one of the standard
treatment that is given to patients (Apalla & et.al. 2017). At this stage melanoma might
have spread to lymph nodes as well so for this other than excision lymph node biopsy is
recommended by the doctors. If in this biopsy cancer cells are detected then the lymph
node is removed as well.
 Treatment at stage III: at this stage cancer already reaches lymph nodes when they are
first diagnosed. At this stage wide excision is done where tumour at early stage is
detected. At this stage lymph node dissection and tumour surgery are done. After this
targeted therapy or radiation therapy is given to the patients which helps in ensuring that
cancer never comes back. If melanoma is present at hand, legs then other than surgery
chemotherapy, immunotherapy, targeted therapy or their combination is given to the
patients.
 Treatment at stage IV: This is the last stage of cancer where melanoma has already
spread to lymph node and other body parts. This stage is often hard to cure and chances
of survival reduces (Leinonen & et.al. 2017). For this surgery and radiation therapy can
be given to the patients. There are various other treatments that are given to the patients
like chemotherapy and many more. It depends upon the part where melanoma has
occurred and body parts that have been affected by this. Small portion of people survive
and respond well to the treatment after diagnosis.
Non melanoma Skin Cancer
This cancer mainly starts within a cell of the skin. These cancer cells uncontrollably get
multiplied, form a group and destroy nearby tissues. It can spread to other body parts as well but
it is rear with non melanoma skin cancer. Skin is one of the largest organ of a human body that
covers and protects whole body against various harmful factors. It is important to identify
symptoms of Non melanoma Skin Cancer at initial stage only as at this times growing cells are in
pre cancerous condition but afterwards it converts into cancerous cells. It can be in form of
moles, skin tags, warts etc.
About:
Non melanoma Skin Cancer is a term that is used to refer all kinds of skin cancer that are
not melanoma. It is quite a broad category that comes under skin cancer but, however of the most
common types of Non-melanoma Skin Cancer are BCC (basal cell carcinoma) and SCC
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(Squamous cell carcinoma) other than this third common type of non melanoma skin cancer is
Merkel cell cancer (MCC). There are different types of Non-melanoma Skin Cancer and each
type has different reattainment based on its type (Herberhold & et.al. 2017). It is not a dangerous
type of skin cancer but its treatment and cure might take time for patient to recover fully.
Sign and symptoms:
Different types of Non-melanoma Skin Cancer have different symptoms and signs. Two
most common type cancer (BCC and SCC) signs and symptoms are different from others. Basal
Cell Carcinoma might have following signs and symptoms such as: An open sources that bleeds,
crusts, oozes and remain open for several weeks. A raised, reddish patch or irritated area that
might crust or itch but rarely hurts. A shiny red, pink, white or translucent bump. Pink growth
with an elevated border and central crusted indentation. A scar like yellow, white, waxy area
often with poorly defined area. Squamous cell carcinoma signs and symptoms are: Growth like a
wart. Persistent, scaly red patch with irregular borders which might easily bleed. An open sore
that persist for weeks. A raised growth with rough surface and central depression. Sign and
symptoms of Markel cell cancer are: shiny, painless, firm lumps on skin. These lumps can be
pink, red and blue.
Cause:
The main cause of Non melanoma Skin Cancer is not confirm yet but mainly it is caused
because of ultraviolet radiations as it damages DNA skin cells. There are three types of UV
lights present and each have different effect on skin (Sathyanarayana & et.al. 2018). Three types
of ultraviolet rays are: ultraviolet A (UVA), ultraviolet B (UVB), ultraviolet C (UVC). However
UVC rays are filtered by earth's atmosphere but UVA and UVB damages skin over time and
becomes one of the main reason for skin cancer to develop. Out of all the three UVB is the main
root cause of Non melanoma Skin Cancer. Artificial sources of UV rays such as tanning beds or
lamps also increases chances of skin cancer as well. Other than this there is another cause due to
this skin cancer can occur which is family history. However, in most of the cases Non melanoma
Skin Cancer does not run in families but there are some families that have higher percentage of
skin cancer problem as compared to others due to which Non melanoma can occur. Due to
family history chances of getting skin cancer increases by almost 50 to 70 percent. It does not
matter that whether the family has a history of melanoma or non-melanoma, chances of getting
skin cancer are always high.
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Treatment:
If an individual is suffering from Non melanoma Skin Cancer then a treatment plan is
created in which all the required information related to the disease is captured and based on this
treatment is provided to the patients. This plan consist of type of non-melanoma skin cancer,
whether it is at low risk or high risk, which body part is the cancer present, what is the overall
size of that cancer and various others (Coldiron, 2017)(Perera & et.al. 2015). Based on this
treatment of Non melanoma Skin Cancer is provided to the patients. It includes various kinds of
treatments such as:
 Surgery: One of the main treatment of Non melanoma Skin Cancer is surgery. It depends
upon the type, risk, location and size of the cancer. Based on this data type of surgery
required by the patient is decided by the doctors. It involves: surgical excision where
cancer is removed and normal skin near it is also removed. In Mohs surgery cancer is
removed in layers till the time there is no cancer left. In Curettage and electrodesiccation
surgery sharp tools are used to scrape out the cancer then on the same area electrical
current are used to destroy remaining cancer cells. In Cryosurgery extreme cold is used to
destroy cancer cells. It is mainly used at low risk cancer. In Reconstructive surgery first
of all tumour is removed then the skin is treated and in Lymph node dissection lymph
nodes destroyed are removed from the body part.
 Radiation therapy: In this external beam radiation machine is used to direct radiation
beams to the skin area and nearby tissues in order to remove or destroy high risk cancer.
This treatment is given to the patients when surgery cannot be done (Apalla & et.al.
2017). Sometimes it is also used when small amount of cancer cells are still left on the
body even after surgery.
 Photodyamic therapy: In this therapy drugs are used which helps in making skin cells
sensitive to light in order to destroy them. It is used when cancer is somewhere visible on
an individual's body and surgery cannot be done.
 Drug therapy: It completely depends upon the type and location of the cancer. It is of
three different types which are: In Topical therapy creams or gels are directly applied to
the affected region of the body. In targeted therapy specific molecules are used on or
inside the cancer cell so that its growth can be stopped and in systemic chemotherapy
anticancer drugs are used to destroy cancer cells.
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 Follow up care: It is important for a cancer patient especially first two to three times after
the treatment gets over as it helps in fast recovery from the treatment.
Difference in treatment options for both a malignant and non-malignant skin cancer
There is much difference between treatment option for both the type of skin cancer
(Simões, Sousa & Pais, 2015). The main difference between their treat is that in malignant skin
cancer treatment is given based on the stage at which skin cancer is present on the body whereas
in non-malignant skin cancer, treatment completely depends upon the type, level of risk, body
part on which it is present and the suitability of various options of cancer that are available. It has
been observed from the above case study that malignant cancer is required to be diagnosed as
soon as possible because the sooner they are detected, sooner they can be treated in an efficient
manner and chances of survival are much higher and if it is not detected at earlier stage then
treatment becomes harder and harder and chances of survival decreases as treatment effectively
decreases. Treatment of non-malignant skin cancer completely depends upon the type of cancer,
location and risk associated with the skin cancer (Khalil & et.al. 2016). This skin cancer can be
treated in much more effective manner as compared to malignant skin cancer.
Recommendations
As is has already been discussed that skin cancer is a dangerous disease but at initial level
all the damaged cells are pre cancerous. So, if some precautions are taken chances of getting
cancer can reduce. Here, are few recommendations that can help in preventing both the type of
skin cancer: Awareness can be generated which will help people to understand type of cancers
and their causes so that timely treatment can be provided to them. Exposure to harmful UV
radiations should be reduced as it is one of the main root cause of skin cancer and if still it is
required to go out then sun protection creams or lotions should be used. Tanning bed or lights
should be avoided to be used.
CONCLUSION
From the above case study it has been analysed that there are two main types of skin
cancer malignant and non malignant skin cancer. Malignant skin cancer can spread to other body
parts and can cause patients death if they are not diagnosed timely whereas non malignant skin
cancer are does not cause patient's death. It has been analysed that treatment of malignant cancer
is much more effective and efficient at earlier stages and treatment of non malignant skin cancer
is efficient if proper treatment is provided to the patients.
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REFERENCES
Books and Journals
Apalla, Z., & et.al. (2017). Epidemiological trends in skin cancer. Dermatology practical &
conceptual. 7(2). 1.
Apalla, Z., & et.al. (2017). Skin cancer: epidemiology, disease burden, pathophysiology,
diagnosis, and therapeutic approaches. Dermatology and therapy. 7(1). 5-19.
Badavanis, G., & et.al. (2017). Safety of Systemic Biologic Agents in the Treatment of Non-
malignant Skin Disorders. Current Drug Safety. 12(2). 76-94.
Coldiron, B. M. (2017). Commentary on A Retrospective Case-Matched Cost Comparison of
Surgical Treatment of Melanoma and Nonmelanoma Skin Cancer in the Outpatient
Versus Operating Room Setting. Dermatologic Surgery. 43(7). 902-903.
Herberhold, S., & et.al. (2017). Human polyomavirus and human papillomavirus prevalence and
viral load in non-malignant tonsillar tissue and tonsillar carcinoma. Medical
microbiology and immunology. 206(2). 93-103.
Khalil, D. N., & et.al. (2016). The future of cancer treatment: immunomodulation, CARs and
combination immunotherapy. Nature reviews Clinical oncology. 13(5). 273.
Leachman, S. A., & Merlino, G. (2017). Medicine: The final frontier in cancer
diagnosis. Nature. 542(7639). 36.
Leinonen, M. K., & et.al. (2017). Quality measures of the population-based Finnish Cancer
Registry indicate sound data quality for solid malignant tumours. European Journal of
Cancer. 77. 31-39.
Litvinov, I. V., & et.al. (2016). Investigating potential exogenous tumor initiating and promoting
factors for cutaneous T-cell lymphomas (CTCL), a rare skin
malignancy. Oncoimmunology. 5(7). e1175799.
Mantso, T., & et.al. (2018). Hyperthermia induces therapeutic effectiveness and potentiates
adjuvant therapy with non-targeted and targeted drugs in an in vitro model of human
malignant melanoma. Scientific reports. 8(1). 10724.
Perera, E., & et.al. (2015). Incidence and prevalence of non‐melanoma skin cancer in Australia:
A systematic review. Australasian Journal of Dermatology. 56(4). 258-267.
Robles, J. F., & et.al. (2017). Anti-proliferative Properties of Methanolic Extracts of Annona
muricata in Colon, Lung and Skin Cancer Cell Lines. The FASEB
Journal. 31(1_supplement). 807-5.
Sathyanarayana, U. G., & et.al. (2018). Retraction notice to" Sun exposure related methylation in
malignant and non-malignant skin lesions"[Cancer Letters 245/1-2 (2007) 112-
120]. Cancer letters. 432. 272.
Simões, M. C. F., Sousa, J. J. S., & Pais, A. A. C. C. (2015). Skin cancer and new treatment
perspectives: A review. Cancer letters. 357(1). 8-42.
Xiong, Y. Q., & et.al. (2018). Optical coherence tomography for the diagnosis of malignant skin
tumors: a meta-analysis. Journal of biomedical optics. 23(2). 020902.
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