How can you tell if you have skin cancer?

The World Health Organisation says currently, between 2 and 3 million non-melanoma skin cancers and 132,000 melanoma skin cancers, occur globally each year.

Monday July 14 2014

Dr Edward Ogwang, a dermatologist at The Skin

Dr Edward Ogwang, a dermatologist at The Skin Specialist Clinic in Wandegeya, a Kampala suburb explains how a person with Kaposi’s sarcoma can develop skin cancer. He says lack of awareness is still a key challenge to managing the disease. PHOTOs by Rachel Mabala 

By Beatrice Nakibuuka

For 10 years now, John Bagole (not real name) has lived with skin cancer. He is 32 years old. It all started with a small painful swelling on an area near his ear. “At the time, I went to a nearby clinic and got medication and became fine. But after one year, the swelling reappeared,” says Bagole.

“My left side head and toes were swollen and before I could get proper treatment, the skin on my entire body had been affected. I developed moulds on my skin and people could not easily identify who I was at that point. I did not know what had happened to me,” he adds.

Bagole says he got advice from different people on what to do about his condition, with some offering local herbs. “The herbal medicines were so many yet not a single one worked to cure my condition. I was in too much pain, and my body felt heavy,” says Bagole.

It is at this point that he decided to go to Jinja hospital, where a dermatologist cut off skin from part of his swollen body that was then tested for skin cancer.

“I got the results after one week, and the doctor told me I had skin cancer. I was not surprised because I have known that cancer can affect anyone, at any time. The doctor, however, explained to me that it was because of the blood clots that remained in my body following an accident I had suffered a year earlier,” explains Bagole.
Dr Henry Manson Ngobi, a dermatologist at Jinja hospital, who had diagnosed Bagole’s condition, then referred him to the Uganda Cancer Institute at Mulago hospital.

“The pain on my skin was unbearable yet the treatment I received for the first five months did not make any difference on my health,” says Bagole.
He was then started on another form of treatment that involved extracting excess water from his body.

“The doctor told me that I had to continue with this type of treatment twice a month, which I adhered to but then it became costly for me. I could not afford to get money for transport from Jinja to Mulago hospital a month. Instead, I have been using herbal medicine but when I get money, I will return to get proper treatment from Mulago,” he says.

Doctors say one of the biggest challenges is people not knowing what skin cancer exactly is. Many do not know the warning signs and symptoms, and when they are affected, they take long to seek medical help.

What is skin cancer?
“A skin cancer can be described as uncontrolled growth of abnormal cells in the skin, and are broadly categorised into two types as melanoma and non- melanoma caners, depending on the cell of origin within the skin from which they develop,” explains Dr Kafeero.
Melanoma cancers arise from the destruction of the melanin which is responsible for skin pigment (colour). These are more serious and normally spread fast.

Non-melanoma cancers on the other hand, arise from the damage of the outer layer of the skin, and they include basal cell carcinoma (BCC) and squamous cell carcinoma (SCC.

“Basal cell carcinoma is the most common type of skin cancer among albinos because their skins lack melanin pigment. They are common on sun-exposed areas of skin such as the nose, ears and lower lips,” says Dr Ogwang.

He adds: “basal cell carcinoma BCCs are composed of cells derived from the basal cell layer of the epidermis. They are slow-growing, however, they can result in serious deformation of the skin. It can also be hard to treat.

People exposed to chronic sun damage, scars as a result of burns, arsenic exposure, chronic inflammation as seen in longstanding skin ulcers, and spots of previous x-ray therapy are predisposed to the development of squamous cell carcinoma.
Other types of skin cancers may arise from damage of the sweat glands and blood vessels known as kaposi’s, sarcoma, which is a common type of skin cancer in Uganda. This type of cancer, however, can affect any other part of the body besides the skin.

Signs that you have skin cancer.
Dr Ngobi says, “The cancer may appear as a pearly lump or a scaly or dry area that is pale or bright pink and shiny, which may bleed or be inflamed and the dead tissue may become an ulcer. The wound may heal but may break down again.”
The typically red, scaly patches which appear on areas of chronically sun-exposed skin may be a warning sign for the cancer.

“Moles and dark black birthmarks, which later become itchy or painful could also be a sign that you have skin cancer,” explains Dr Kafeero.
“When skin cancer is in the early stage, it is not dangerous and can easily be treated. In the last stage however, the cancer is hard since it has already spread to different parts of the body. Affected body parts could include the lymph nodes, bones and spine,” notes Dr Ogwang.

“Because the symptoms are usually painless, you need a skin specialist to diagnose it. That is why it is recommended that people undergo regular skin check-ups. This will help the dermatologist to establish if you are developing a skin condition or not,” says Dr Kafeero.

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