White skin cancer
Who is mainly affected? Light-skinned people over the age of 45 with chronic cumulative exposure to light are particularly affected. Each sunburn is a small piece of the mosaic on the way to the onset of skin cancer. But even "tanned skin types" can get skin cancer from years to decades of exposure to sunlight. Added to this is the change in our earth's atmosphere (hole in the ozone layer), which allows the damaging ultraviolet light rays to reach the earth more and more unfiltered.
What are the types of white skin cancer?
There are 3 forms of white skin cancer:
- Basal cell carcinoma (basal cell carcinoma), the second most common type
- Actinic keratosis = in situ carcinoma, by far the most common type
- Invasive prickle cell carcinoma (spinalioma), the rarest type
Incipient white skin cancer
Actinic keratosis (carcinoma spinocelluare in situ). You usually feel it before you see it: a small rough, slightly reddened area that can disappear completely in between - especially if it is treated with a grease cream - but comes back in the same place. This is an early-stage skin cancer, i.e. it is located in an upper layer of the skin and has not yet broken through the basement membrane. Thus, no metastases can form at this stage.
However, actinic keratoses can penetrate deeper into the skin if left untreated and develop into prickle cell carcinomas (spinaliomas). The first signs of photodamage to the skin can become apparent even before actinic keratoses develop and are serious warning signals: "coloration" of the skin with brown pigment spots or even small whitish areas, "thinning" of the skin with the formation of wrinkles, translucent veins, development of bruises even after the slightest impact.
Predominantly affected are the face, back of the hands and forearms, i.e. the areas most exposed to sunlight.
Therapy
All skin changes with suspected malignancy should be surgically removed or the diagnosis confirmed by a fine tissue (histological) examination.
Melanoma, white skin cancer ((prickle cell carcinoma, spinalioma) and most basal cell carcinomas must be surgically removed completely and sometimes with a safety margin (melanoma). Actinic keratoses can be treated non-invasively by nitrogen therapy, various local therapeutics or a combination therapy of CO2 laser and subsequent light treatment (so-called photodynamic therapy, PDT). The latter is a gentle, elegant and at the same time very effective healing method with the best medical and cosmetic results.
Photodynamic therapy (PDT):
PDT has been increasingly used in recent years to treat superficial white skin cancer (actinic keratoses, flat basal cell carcinomas, in situ Bowen's disease-type carcinomas). Advantages of the treatment, which can usually be performed without local anesthesia, are low invasiveness and scar-free healing with excellent therapeutic success.
Article Südkurier about a lecture of Dr. Braun to the European dermatologists in Brussels
The dermatologist Dr. Martin Braun from Überlingen is an expert in the field of skin cancer treatment. Thus, he was invited as a speaker to the European capital Brussels to present his experiences and innovative findings from practice to the "European Society for Photodynamic Therapy (short: EURO-PDT)" in a guest lecture. During his long career, he has performed over 70,000 skin cancer treatments and nearly 10,000 photodynamic therapies.
Photodynamic therapy (PDT) involves a gentle light treatment to cure white skin cancer. Dr. Braun has succeeded in both shortening the treatment time of this method tenfold to 1-2 minutes and avoiding the associated pain for patients. He refers to this form of treatment, which has been specially developed by Dr. Braun, as "PDT-Light".
During the lecture, Dr. Braun's descriptions of his personal experiences during several treatments that he performed on himself with the "PDT-Light" therapy received special attention.
How does PDT work? The cells of our body are constantly renewed. In the process, a certain substance, the so-called DNA, provides the blueprint of the genetic material. If small "errors" in cell division now occur - triggered, for example, by many years of exposure to UV rays from sunlight - a malignant degeneration can develop in the cell. Cells with DNA damage preferentially take up a certain substance, aminolevulinic acid (ALA). This is a naturally occurring substance in the human body that is needed in the formation of red blood pigment. From the "sick" cells, ALA is converted into protoporphyrin (PP), which is very sensitive to light. When exposed to light, this substance provokes the decomposition of oxygen molecules into oxygen radicals, which are toxic for the cell - it dies. Healthy skin cells are largely spared. PDT has taken advantage of this repair mechanism of nature. If it is possible to completely convert the ALA in the cancerous skin cells (by applying additional ALA to the skin) into the highly light-sensitive protoporphyrin, the diseased cells can be destroyed by the subsequent irradiation with red light. They are then replaced by regrowing healthy skin cells.
During treatment, there is often a sunburn-like burning sensation, and occasionally pain, which is relieved by cooling. If desired, an anesthetic cream can be applied or the treatment can be performed under local anesthesia. After PDT, temporary redness, brown discoloration, swelling and the formation of crusts may occur on the treated skin areas.
Unfortunately, the costs of PDT are not covered by statutory health insurance, but are usually fully reimbursed by private health insurance.
