Dr. Luisa González de Bogaert, head of surgery at the Dominican Dermatological Institute and Dr. Huberto Bogaert Skin Surgery. ( EXTERNAL SOURCE )
We have recently celebrated World Skin Cancer Day, a disease that each year has more and more cases of skin cancer.
Timely diagnosis and rapid therapy in the initial stages of presentation are of vital importance for the prognosis of patients with skin cancer and their survival.
Skin cancer has become one of the fastest-growing in recent years, is it true that there are more and more?
It is true, that skin cancer is currently the most common cancer, most of which are Basal Cell Carcinoma and Squamous Cell Carcinoma. It is estimated that about 5.4 million Basal Cell Carcinoma and Squamous Cell Carcinoma are diagnosed each year in the United States. This situation occurs in about 3.3 million people since a patient can have several lesions at the same time. In the Dominican Republic, specifically in the Dominican Dermatological Institute and Skin Surgery (IDCP), we have noticed through our statistics an increase in annual cases of approximately 80 to 100 new cases.
Could we say that the skin has memory and we are reaping the consequences of a bad attitude towards the sun from years past?
The skin definitely has a memory, this is due to cellular DNA. It is known that after 20,000 to 21,000 hours of exposure, in light-skinned or mestizo patients, degenerative changes begin at the cellular level with their corresponding mutations. The individual who in his childhood was exposed to solar radiation for a time of impact, such as sunstroke, is the person who has the highest incidence of a Malignant Melanoma-type Carcinoma in his adulthood. Solar radiation is cumulative, which is why we place so much emphasis so that from an early age the individual is aware of the prevention and education that he should have in this regard.
Do you think that the population is becoming more aware when it comes to protecting themselves from the sun today?
I believe that educational campaigns worldwide have occupied a very important space in prevention, where health systems currently have primary care at all levels as their objective. Medicine and health care prevention. The population, in general, is aware of this type of management, except in exceptional cases that due to educational factors have not been included in the health systems.
In addition to avoiding the sun at certain times and applying sunscreen daily, what else can we do to prevent skin cancer?
There are many preventive measures that do not imply an obstacle or economic expense, such as not exposing yourself during the maximum hours of incidence of the sun, especially at noon, wearing appropriate clothing, covering yourself with a hat or cap, and drinking plenty of water and using sunscreen. We remind you that at the Dominican Dermatological Institute and Skin Surgery we have a pharmaceutical production laboratory with low-cost products, accessible to all.
What are the most common types of cancer?
The most common types of cancer are Basal Cell Carcinoma and Squamous Cell Carcinoma. Basal Cell Carcinoma presents as a papule, similar to an insect bite or acne lesion; Squamous Cell Carcinoma presents a red plaque, a raised area, with scales, that bleeds and does not finish healing. Both are 98 and 99% curable; They occur more frequently in areas exposed to the sun, especially on the face, neck, ears, arms, and hands. Early diagnosis and surgical care are of utmost importance to avoid complications such as ulcerations, bleeding, and destruction of the area where they occur.
What is the incidence of this cancer in the DR?
Incidence in the Dominican Dermatological Institute, according to our statistics, in the year 2021 we had 451 cases diagnosed in the Central Unit of Santo Domingo, of which 257 corresponded to the female sex and 194 to the male sex; of these, 311 cases were Basocellular Ca, 102 cases Epidermoid Ca, 8 cases Baso-squamous type. The number of these cancers has increased over the years, probably due to a combination of better skin cancer detection, increased exposure to sunlight, people living longer, and also being exposed to more environmental pollution.
According to data from the American Cancer Society, it is rare for skin cancers of the Basocellular Ca and Ca Epidermoid type to cause death; This is not the case with Malignant Melanoma, which is very aggressive and has a rapid course with a very dangerous progression and rapid metastasis to organs such as the lungs, brain and bone tissues, causing death.
How should we act when we notice an injury or strange pigmentation on our skin?
If a person notices or sees a sudden-onset lesion on their skin that does not go away, bleeds changes color, texture, and gradually grows, they should be alert for these signs. Also before a pigmented lesion that looks like a dark, black, or brown mole, or a mole present from birth that experiences some of the changes already mentioned. For others, if you also feel some kind of discomfort such as itching, itching, or redness. Timely diagnosis and the establishment of rapid therapy in the initial stages of presentation are of vital importance for the patient’s prognosis and survival.
What advances in medicine allow us to be more optimistic today?
Advances in the field of medicine go hand in hand with the patient’s prognosis; the early detection of the lesion is basic, an accurate diagnosis in the initial stages. The use of dermatoscopy and focal microscope allows us to see more precisely the characteristics of these cases; These two instruments pinpoint your diagnosis with better precision in time. Moh’s Microsurgery also allows us to perform surgical procedures with greater precision and this trans-surgical evaluation of the excised tissue tells us if the surgery is complete with healthy tissue, free of tumors. Early detection is essential for a better resolution of the carcinoma and a better survival rate for the patient.
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