The most common facial cancers is Basal Cell Carcinoma (BCC) followed by the skin Squamous Cell Carcinoma (sSCC). Referrals for these cancers are increasing every year and hence needs a closer look at. I have to remind you now that prevention is better than cure, so it’s imperative when outside in the SUN to wear the appropriate protective clothing, hats, caps and apply the appropriate sun factor in accordance with sun screen manufacturers.
These primary cancers originate in the epidermis (outer skin layer) and most commonly occur on the SUN exposed sites, mostly head and neck. Specifically the noses, cheeks, ears, scalps, and foreheads. NB NB Remember to apply copious amounts of sun screen to these prone SUN exposure areas. Let’s also not discount the upper limbs that people tend to leave on window ledges while driving or sitting on public transport, they too are prone to SUN exposure injuries. Often the wind chill factor in comparison with the current environment masks the rays burning the SUN exposed areas while we are on the move. In Australia local government are so aware of SUN exposure injuries, communal loud speaker broadcasts occur on public beaches to remind locals and travellers alike to take the appropriate action against SUN exposure!
It’s important to know that facial cancers are locally infiltrating which means they begin spending on the skin surface, but have the potential to disseminate to the regional lymph node system if left unchecked and left to spread without medical treatment.
Who is at risk:
- Chronic inflammatory diseases e.g. prev. burns, scars, ulcers, skin disorders, Xeroderma
- Taking medical drug treatments e.g. voriconazole, doxycycline and some go the immune suppression drugs. Please check your personal meds which your taking with your doctor
- Immunosuppressed people
- People receiving ultraviolet radiation
sSCC usually occur on older people >60yrs with the highest reported incidence being in Australia. Age cannot be discounted as skin injuries are likely to be associated with the duration and intensity of sun exposure over time, so young people are at risk if they fail to protect themselves early on in life. It’s also important to note that sun beds also facilitate these types of sun injuries that can go on to develop into cancer lesions. sSCC lesions tend to begin as a non-healing plaque, pimple or ulcer in contrast to the rolled pearl looking BCC lesion. The sSCC lesions may also be painful, tender, bleed easily and spread rapidly. Please seek urgent help if you suspect this. Diagnosis is usually obtained through a skin biopsy.
Treatment is usually associated with complete removal of the skin lesion. This will however be discussed with a dermatologist plus or minus a plastic surgeon depending on the complexity and location of the facial tumour. It’s important to note the Mohs microsurgery together with fresh frozen tissue sections to evaluate the lesions boundaries is associate with high curative rates. Curative rates are high, but this all depends on cancer skin depth, degree of spread extension, type go cancer and whether it’s disseminated to the region lymph node system.
The onus is on all of us the take proper precaution again the SUN specifically to the areas of maximum sun exposure as it’s these areas which are prone to skin cell mutations into the cancer lesions the know of today.