Photodynamic therapy: New hope for patients that suffer from non-melanoma skin cancer

Caracas Daily Journal: Patients -- specialists have good news for you! At present, Venezuelan specialists count on one of the newest tools to combat the non-melanoma skin cancer. It is about the photodynamic-MAL therapy which -- thanks to its selective action mechanism -- acts efficiently on the visible and non visible tumor cells without affecting the healthy tissue, and thus supplies an effective cure against the non-melanoma skin cancer with excellent aesthetic results.

The name of this group of cancer tumors is due to the fact that it includes all types of skin cancer except the malignant melanoma. It comprises sub-types such as the acnitic keratosis and the basal cell carcinoma, among others.

Types of non-melanoma skin cancer

Acnitic keratosis (AK). This is pre-cancer cutaneous tumor more frequently in white-skin ageing people and in young people with a clear-skin color who have been exposed to the sun. It is calculated that 60 percent of the population older than 40 years will develop at least an AK lesion. This condition might persist, move back spontaneously or progress to melanoma. Normally, these lesions appear in areas such as the back of the hands, forearms, scalp and face. They are small lesions (1cm of diameter), dried, rough with a brown-yellowish color with well defined flakes that do not come off.

The basal cell carcinoma or basocellular carcinoma (CaBC). The majority of cases of this condition occurs in people of white race, older than 55 years of age and mainly men. It represents 75 percent of non-melanoma skin cancer. Rarely, this condition produces metastasis and it grows very slowly. However, the risk should not be dismissed and an early treatment is important.

There are three types of basocellular carcinoma:

1. Nodular CaBC. The most common of them; it is similar to a plain, circular, bright and yellow or grey color papule (variable size).
2. Superficial CaBC. They are red with a lightly elevated surface, sometimes ulcerated and squamous.
3. Amorphous form CaBC. Not so frequent. It is usually seen as a plain plaque or with a small, bright, hard, and whitish with jagged edges depression. It is very difficult to eradicate.

The incidence of AK is ten times superior to the CaBC one and it increases according to age. Watch out with the symptoms! If you have any of the following symptoms, visit your doctor immediately:

Rough and dried texture of the lesion of the skin.

A spot, patch or tumor on the skin (grey, pink, red -erythematous- or the same color of the skin); limited in a discreet zone located in the face, scalp, back of the hands, thorax or other areas exposed to the sun.
Initially, the surface is plain and squamous, and step by step it becomes lifted.
The lesion becomes hard, rough and warty or sandy.

Efficacy and excellent cosmetic results

Patients that suffer from skin cancer are more selective each day in relation to the options of the treatment that they are ready to accept and they prefer options that preserve a healthy tissue and the appearance. The therapy of any kind of skin cancer should consider a long term treatment and the result of the options of treatment, since it could be decisive for the patient's quality of life. Among the available treatments for non-melanoma skin cancer, the therapy photodynamic-MAL(5-Metil AminoLevulinato) by Galderma Laboratories is the newest and most successful treatment at present. The application of 5-Metil AminoLevulinato on the skin results in a selective accumulation of photoactive porphyrins in the neoplastic or carcinogenic tissue.

The red light exposure (specialized) in presence of O2, generates a reactive species of oxygen that damages the cell membranes – especially in the mitochondria – which leads to a selective cell death. The surrounding healthy tissue that has not accumulated photoactive porphyrins, will stay intact. The technique is highly selective, in other words, it only attacks tumor cells and avoids the healthy tissue. Its non-invasive nature and a recovery rate superior to 90% are key advantages of this therapy.

Patients with non-melanoma skin cancer should consider the following recommendations at care time:

Visit the dermatologist frequently. The patient should be examined in time and follow the doctor's instructions and treatment.

Cloth protection. Including a shirt, a hat and sunglasses with a 99% to 100% absorption of UV rays.

Use sun protection creams with SPF 50 or more (Ex: Cetaphil® defense 50+) in the exposed zones, especially when the sunlight is intense.

Prevention is first

Avoiding the sun is the best defense against skin cancer. According to the American Academy of Dermatology, the over-exposure to the sun without protection is the biggest cause of skin cancer, especially when it provokes sunburns and blisters. People with clearer skin or that can be sunburned more easily have a particularly higher risk of developing skin cancer.