Malignant neoplasms of the skin - symptoms and treatment

Causes of malignant tumor formation

Modern oncologists believe that the causes of the formation of a malignant tumor are multiple and it is impossible to identify any single factor leading to the formation of a pathological formation. Research published in the journal Nature indicates that the development of a malignant tumor is most often influenced by the external environment rather than heredity. More than 30 cell mutations leading to tumor development have been carefully assessed and analyzed. As a result, the results showed that no more than 30% of these mutations occurred due to internal factors, and about 70-90% were directly dependent on the influence of harmful factors in the external environment. Among these are: drinking alcohol, smoking, the negative impact of ultraviolet and ionizing radiation on the body, and some viruses.

So, the modern oncological polyetiological theory identifies the following causes of the development of malignant tumors:

• Exposure to chemical carcinogens on the body. Moreover, this effect appears both locally and on the body as a whole. For example, chimney sweeps develop scrotal tumors, smokers develop lung tumors, people working with asbestos develop pleural tumors, etc.
• Exposure to physical carcinogens on the body. Physical carcinogens include two types of radiation: ionizing radiation (X-rays, gamma rays, atomic particles), as well as exposure to ultraviolet rays, which provoke the development of skin carcinoma.
• Genetic causes causing the development of malignant tumors. We should not completely discount the fact that a small proportion of tumors appear in people as a result of a genetic predisposition. Thus, breast tumors in girls whose mothers suffered a similar disease are three times more common than in the population as a whole. The same applies to colon tumors and endocrine gland tumors. At this point in time, a genetic connection with 50 types of tumors has been proven and tracked.
• Dependence of the development of malignant tumors on the geographic area of ​​residence of a person. So far this phenomenon has not been scientifically explained, but it has been established that geographical factors have a certain influence on the development of oncology in the population living in the same territory. Scientists believe that factors such as nutrition, climate, environmental conditions, etc. have an influence.
• The influence of oncogenic viruses. Infectious factors that can provoke the development of a malignant tumor should not be excluded. It has been proven that hepatitis B can provoke liver tumors, and type 2 herpes virus leads to cervical tumors.

However, scientists point out that one of the listed factors is not enough for a person to develop a malignant tumor. A combination of several reasons is necessary, as well as disturbances in the functioning of the human immune system.

In addition to the polyetiological theory, which points to the causes of the development of malignant tumors, there are other theories of their origin, including:

• The immunological concept suggests that even the slightest malfunction of the immune system can lead to the formation of a tumor. Adherents of this theory believe that if the immune system has not destroyed at least one mutated cell, then a tumor can develop from it.
• The viral theory has existed since 1946 and indicates that viruses that enter them lead to the transformation of healthy cells into tumor cells. However, at this point in time, only a few viruses have been proven to be pathogenic.
• The concept of germ buds indicates that tumors develop from dormant cells that remain in the embryo. Under the influence of a number of factors, they begin to grow and develop. However, it has been proven that this theory is applicable exclusively to dysembryonic tumors.
• The concept of irritation, which was popular in the 19th century, states that tumors form in those parts of the body that are most exposed to trauma.
• Another theory is that a tumor is the result of regenerative processes that occur in order to eliminate the negative effects of carcinogens. This concept is called regeneration-mutation.

However, none of the listed theories can fully explain the causes of all malignant tumors. Therefore, the polyetiological concept remains the most popular.

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Like cancer, a malignant neoplasm can grow into adjacent tissues and organs, metastasize, destroying the body; some types of cancer develop rapidly, others may not show themselves for many years.

The neoplasm itself can arise in any organ or tissue and represents cells that have differentiated and acquired new properties and lost the old ones. A kind of capsule is formed around the cancer cells, which, as the tumor cells grow, moves apart, occupying an increasingly larger volume. The appearance of neoplasms can occur under the influence of various factors or processes within the body.

It should be noted that a malignant tumor is not always cancer, and that this does not always happen - the degeneration of a neoplasm into cancer, but in the overwhelming majority, malignancy of cells still occurs. For example, in a precancerous condition, when some changes have occurred in an organ or tissue, triggers are needed for the appearance of cancer itself. Therefore, it is important to identify these conditions to avoid their further development into cancer and the dire consequences of this disease.

Symptoms of a malignant tumor

If we consider the symptoms of a malignant tumor, its specific manifestations will depend on where it is located and what tissues are involved in the pathological process. A characteristic feature of all malignant oncological formations is a progressive increase in symptoms. Oncologists have identified common symptoms for all tumors of a malignant nature:

• Small sign syndrome. This syndrome was first described by Savitsky A.I., who in 1947 characterized a malignant tumor of the stomach. These symptoms were then supplemented and generalized. So, the early manifestations of oncology are intoxication of the body and its exhaustion. Although it is possible that these signs of a malignant tumor may occur in a later period of the disease.

  The patient begins to get comfortable more quickly, and unmotivated weakness and fatigue develop. At the same time, appetite suffers. Lack of desire to consume food leads to weight loss. A stomach tumor is characterized by an aversion to meat. Anemia progresses, the level of ESR in the blood increases.

  Another symptom that should alert patients is an increase in body temperature, which cannot be explained.

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• Plus tissue syndrome. This syndrome is characterized by the appearance of new tissue in an area where it should not be. That is, a tumor appears in the body, which is not typical for it. Often it can be felt during a standard examination. In some cases, even deep tumors can be palpated, especially if they are located in the abdominal cavity or in the retroperitoneal space. Other diagnostic techniques also help in their detection.
• Atypical discharge syndrome. Malignant tumors always lead to the appearance of secretions that are not typical for a healthy body. This may be bleeding when the tumor damages blood vessels. Their localization depends on where exactly it is located. Gastric and uterine bleeding, expectoration of blood, the appearance of blood in urine or stool, etc. are possible.

  In addition, the body reacts to the presence of a tumor by inflaming its surrounding tissues. This will be expressed in the appearance of mucous or purulent discharge. Naturally, the location of inflammation depends on where the tumor is located.

• Organ dysfunction syndrome

  The dysfunction of organs directly depends on the location of the tumor:

  Intestinal damage provokes its obstruction.

• Damage to the stomach leads to a variety of dyspeptic disorders: belching, vomiting, heartburn, etc.
• Damage to the esophagus makes it difficult for food to pass through it, leading to impaired swallowing.
• Brain damage provokes nausea, headaches, and mental disorders.
• Damage to the mammary gland leads to nipple retraction, pain, and enlarged lymph nodes.
• Damage to the uterus leads to disruption of the menstrual cycle, impossibility of conception, etc.
• Damage to the ovaries provokes hormonal imbalance in the body.
• Kidney damage provokes problems with urination, hypercalcemia, anemia, edema, etc.

Occurrence of metastases

Cells that are separated from the malignant tumor that forms them travel in various ways to neighboring organs and tissues. Having settled there, they begin the process of their own division, producing new cells and forming daughter tumors. Most often, metastases are similar in structure to the primary tumor, but in rare cases they can be more aggressive.

Metastases can spread along the following routes: lymphogenous (prevalent), hematogenous, implantation, liquor, spread through intertissue gaps. In some cases, a mixed path of metastasis is observed. It has been established that different tumors are characterized by different routes and frequency of metastasis. For example, a laryngeal tumor rarely metastasizes, but a lung tumor most often has already spread throughout the body when it is first detected.

Symptoms

Tumors have quite a few symptoms. But all of them can be divided into just 2 categories:

1. Symptoms of compression are caused by the pressure of the resulting tumor on other organs or nerves. As a rule, it manifests itself in the form of pain - initially dull and aching, turning into acute.
2. Symptoms of intoxication - in the process of damage, intoxication of the body occurs with the following signs: loss of appetite, and against this background, weight loss, changes in the skin (rashes, peeling, itching), drowsiness and fatigue, apathy and depression.

Types of malignant tumor

The following types of malignant tumors are distinguished: carcinoma or cancer, which originates from epithelial cells and sarcoma, which develops from connective tissue and its subtypes. Therefore, to designate malignant tumors, the suffix “– carcinoma” or “– sarcoma” is used, for example, osteosarcoma, angiosarcoma, etc.

So, types of malignant tumor:

• Carcinoma (based on epithelial cells).
• Melanoma (based on melanocytes).
• Sarcoma (based on connective tissue).
• Leukemia (based on transformed bone marrow cells).
• Lymphoma (based on lymphatic tissue).
• Teratoma (based on embryonic cells).
• Glioma (based on glial cells).
• Choriocarcigoma (based on placental tissue).

TNM system

Let us add that in oncology, several classification systems are used to accurately classify the diagnosis. One of the most frequently used is TNM. It usually looks like these letters with numbers indicating the course of the disease. You can read about the classification here. And in this article we will only briefly recall the designation of these letters:

• T – tumor size (0-4).
• N – damage to lymph nodes (0-1).
• M - metastases in other organs (0-3).

A diagnosis in TNM can already tell an experienced doctor a lot, help him choose the right course of treatment and save the patient.

Stages of development of malignant tumors

Domestic oncologists work with a classification that includes four stages of development of malignant tumors.

They look like this:

• The first stage is characterized by a clear localization of the formation, which is located in a limited area and does not grow into the organ. At this stage, the tumor does not metastasize.
• The tumor of the second stage of development is large in size, but does not extend beyond the organ. There may be metastases, but they are detected only in nearby lymph nodes.
• At the third stage of tumor development, it is large in size, and decay processes begin. Growth into the wall of the organ is recorded. Multiple metastases have spread to nearby lymph nodes.
• At the fourth stage of tumor development, its growth into adjacent tissues is observed. This stage includes any formations that give distant metastases.

The patient is assigned a stage once, and it remains with him until the end of his life. The stage is not changed, even if there is no relapse of the disease. The stages of tumor development should not be confused with the clinical groups that are assigned to patients. There are also four of them, but they can change depending on the person’s condition. These groups were created for the convenience of recording people with cancer.

Morbidity

More than 10 million cases of cancer of various origins and types are diagnosed every year in the world.
According to statistics, mortality from cancer ranks 2nd after diseases of the cardiovascular system. Among the oncological diseases themselves, the primacy belongs to lung cancer, followed by breast cancer. The worst prognosis is for cancer of the lungs, stomach, and mammary glands - they are the most dangerous and in the last stages are incurable. A more favorable prognosis for in situ cancer. It is also disappointing that every year the number of people on Earth who suffer from cancer is increasing. In Russia, according to morbidity statistics, every year about half a million people are diagnosed with cancer, and almost 3 million patients (2% of the population) are registered in the country for malignant neoplasms.

There are cancers that are more common among representatives of a particular race, while others do not make racial distinctions. But more often cancer is diagnosed in older people.

Diagnosis of malignant tumors

Diagnosis of malignant tumors is based on examination of a patient who presents certain complaints. If there is a suspicion of an oncological process, the patient is referred for consultation to an oncologist. He uses the following methods in his work:

• Laboratory diagnostics. It includes a blood test, determination of enzymes and special tests.
• Immunological diagnostics. Immunological diagnostics include the identification of monoclal bodies that produce hybridomas. In addition, immunological diagnostics are carried out using tumor markers, the number of which increases sharply in the presence of a malignant tumor in the body. Certain organs have their own tumor markers, for example, the alpha-fetoprotein tumor marker is used for liver and testicular tumors, the carcinoembryonic antigen tumor marker is used to determine a breast tumor, etc.

  Doctors also have markers in their arsenal that allow them to determine what tissue the metastases consist of if the maternal tumor site remains undetected.

• Instrumental diagnostic techniques. Instrumental examination methods will depend on what kind of tumor is suspected in the patient.

  These may be diagnostic procedures such as:

  Colonoscopy, FGDES, bronchoscopy – endoscopic examination methods.
• Ultrasound.
• CT.
• Contrast or standard x-ray examination.
• Radionuclide diagnostics.
• MRI.
• Thermography.
• Verification of oncological diagnosis. To confirm a malignant tumor, a cytological examination is performed, which makes it possible to clarify the diagnosis in 92% of cases. It includes puncture sampling, biopsy, fingerprint smear collection and scarification.

  Histological examination allows us to determine the probability of a malignant tumor in 99.8% of cases. To conduct a histological examination, a biopsy is performed, that is, a tissue sample is taken from the patient for the purpose of its subsequent study. The tissue can be excised, collected by puncture, or total removal of the tumor and its subsequent study is possible.

  A biopsy is not performed for melanoblastoma, since any damage to this type of tumor can provoke its accelerated growth.

• Carrying out differential diagnosis. A malignant tumor differs from a benign tumor by its rapid growth rate, lumpy surface, and increased density. Most often, such tumors are immobile, do not have clear boundaries and are associated with the skin. In this case, the lymph nodes are enlarged, but remain painless.

Surgical operations

One of the best methods of combating any tumors is surgery. Of course, radiation and chemotherapy for cancer can produce positive results, but they are usually used as auxiliary treatments. But a simple operation can not only remove a tumor, but also completely rid a person of this disease. Here are the types of operations in oncology:

1. Radical – complete removal of the tumor in order to save a person’s life. An ordinary operation - there is a tumor, it needs to be removed. The removed tumor is what cures the cancer patient. It is used for operable tumors without metastases.
2. Palliative – aimed primarily at alleviating the patient’s condition. It is used in cases where radical surgery is impossible, with metastases and damage to the lymphatic system. This operation may affect the tumor partially (for example, to reduce the blockage of passages), or not have anything to do with it at all.

Treatment of malignant tumors

Treatment of malignant tumors is exclusively surgical. Hormonal therapy is possible, but the indication for this is the presence of hormone-dependent tumors.

In addition, treatment of malignant tumors can be carried out using chemotherapy, radiation therapy and immunotherapy. All these methods can be used either separately or in combination with each other. Chemotherapy and immunotherapy are not able to save the patient from metastases, as they are systemic methods of treatment.

So, the options for operations in the presence of a malignant tumor are as follows:

• Radical therapy. The tumor is excised along with the organ that it affected. In addition, nearby lymph nodes and cells are removed. Surgeries are not performed if a stage 4 tumor is detected.
• Palliative care. If the operation cannot be performed, then the patient’s life is prolonged and its quality is improved with the help of palliative treatment. The tumor is removed, but the lymph nodes are left behind. They are treated with other methods, for example, radiation therapy. This helps to cope with the disease for a while.
• Symptomatic surgery. This therapy is aimed at eliminating the main symptom that poses a direct threat to the patient’s life, for example, intestinal obstruction. The tumor is not removed from the body.

When it comes to radiation therapy, the radiation source can be X-rays, gamma rays, alpha rays, and beta rays. Lymphosarcoma, cancer of the skin, larynx, bronchi, esophagus, and cervix respond well to radiation therapy. The dose and radiation regimen for each patient are selected individually. Intracavitary, interstitial and external irradiation is possible. You should know that radiation therapy cannot pass without leaving a trace on the human body. It is almost always associated with a number of complications. Doctors must advise each patient about this.

Chemotherapy comes down to the drug effect on the tumor. This can be achieved through the use of various drugs.

It is prescribed for the following indications:

• In combination with other treatment methods;
• Before the operation in order to increase the effectiveness of the upcoming intervention;
• As a palliative technique.

To perform chemotherapy, drugs such as cytostats (Vinblastine, Embiquin, Cyclophosphamide, etc.), antitumor antibacterial drugs (Doxorubicin, Mitomycin, Mitoxantrone, etc.), antimetabolites (Mercaptopurine, Pentostatin, etc.), hormonal drugs (they are selected) are used taking into account the location of the tumor), platinum drugs (Platidiam, Cisplatin, etc.), other drugs.

Immunotherapy also includes several varieties, including: nonspecific immunotherapy (the effect will not always be achieved), local application of vaccines, administration of cells with cytostatic and cytotoxic effects, administration of proteins (hematopoietic growth factors), specific immunotherapy (administration of anticancer vaccines and serums ).

Disease prognosis

The prognosis of the disease depends on many factors, primarily on the stage of the disease, the location of the tumor, the shape of the tumor, the general health of the patient who has cancer, and the age of the patient.

Five-year survival rate for patients with cancer is individual, depends on all of the above factors and ranges from 10 to 90%. Undifferentiated cancer has the most unfavorable prognosis, as it is more prone to metastasis and causes a higher percentage of deaths.

Prevention

There are no specific rules for the prevention of neoplasms of the appendages, but it is possible to reduce the likelihood of their development. Every woman needs to know the characteristics of her body and follow general recommendations:

• maintain weight at a physiological norm;
• include in the diet vegetables and fruits containing a sufficient amount of plant fiber;
• do not abuse alcoholic beverages, stop smoking;
• do not forget about physical exercise and daily walks in the air.

This is interesting: Luule Viilma, an Estonian gynecologist and esotericist, writes that health will come when a person finds the psychological cause of his illnesses.

In particular, tumor diseases of organs are associated with anger towards others or oneself. Changing your mindset starts your recovery program.

Be sure to visit a gynecologist at least 1-2 times a year. At the slightest suspicion of a disease of the gonads, you need to undergo a full medical examination, including blood tests for tumor markers, ultrasound, computed tomography or magnetic resonance imaging.

Timely detection of pathology and its treatment increase patient survival, rehabilitation time, and maintain quality of life.