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What is that ugly thing on my back? If you notice conspicuous changes on your skin, you should go to a dermatologist immediately. This applies to every type of cancer: the earlier it is treated, the bigger is the chance to fully recover again.

What is skin cancer?

Skin cancer occurs when skin cells degenerate, which leads to cell proliferation. There are two different kinds of skin cancer, malignant skin cancer and light skin cancer. For light skin cancer, there are two subcategories: basal cell carcinoma and squamous cell carcinoma.

Causes and Frequency

The frequency of skin cancer has been increasing for several decades which can be explained by a change in leisure behavior. That way, it has been proven that the UV rays in a solarium are just as carcinogenic as the natural rays of the sun. According to a statistics by the WHO, two to three million people worldwide are diagnosed with light skin cancer per year and more than 132,000 people come down with the significantly more aggressive malignant skin cancer.

Besides sunrays, another factor that can cause skin cancer is genetic predisposition. Sometimes it is even possible that hereditary factors are the sole explanation for the development of skin cancer, as also non-smokers can be concerned by lung cancer.

As skin cancer often develops from already existing moles, the following applies: the more moles exist, the higher is the risk of melanoma.

Symptoms: Skin cancer is not painful

Generally, skin cancer often occurs in body regions that are most exposed to sunlight: the nose, forehead and cheeks. Among men, melanomas (= cancerous, black tumors) are also often found on the back, among women they often occur on the legs. Sometimes, skin cancer develops from already existing moles. However, most of the time, the black spots appear on parts of the skin that have not changed before. The tricky part is that skin cancer is not painful. It is possible that the tumor is itchy or bleeds a little, but often the people affected don’t feel anything.

Suspicious change of a fleck

The more of the above mentioned criteria apply, the urgent is a visit at the doctor’s. However, even if all the aspects apply, a skin change does not necessarily have to be malignant.

Diagnosis and Therapy: Surgery is the standard treatment

When a patient with suspected skin cancer visits a doctor in Germany, the doctor will examine the skin change with a magnifying glass, the so-called dermatoscope. If the doctor also thinks that there is a melanoma, he removes the relevant area and has the sample examined in the laboratory. It is only after the examination under the microscope that the final diagnosis can be made. If the suspected cancer is confirmed, further examinations are carried out in order to see whether metastases have formed in the body.

Surgery

The therapeutic measure of choice is surgery, as long as the melanoma can be removed completely. If the malignant tumor is thicker than one millimeter, the so-called sentinel lymph node is examined as well. Its name can be traced back to the fact that it is the first lymph node the cancer cells have to pass on their way to other organs. This lymph node has the role of a first “sentry”. If there are no cancer cells found in the lymph node, no other measures besides surgery have to be taken.

Immunotherapy

If there are malignant cells found in the sentinel lymph node, the cancer probably spread further. That is why the lymph nodes situated near the melanoma are surgically removed as well. If the probability of metastases in other regions of the body is high, a supporting immunotherapy with interferon alpha can be helpful. Interferon alpha influences the immune system, which is why the therapy is called immunotherapy. Because side effects can occur, the advantages and disadvantages of treatment have to be discussed with the treating doctor.

Chemotherapy

Some patients with metastases cannot undergo surgery. In this case, chemotherapy is applied. Depending on the size of the tumor and the type of the metastases, chemotherapy with one or several drugs can be carried out. The medicine destroys the tumor cells in the body, however, it also attacks healthy cells.

Costs of Surgery

The treatment of skin cancer is different for every patient, that is why there is no general cost estimate. It is possible that only a small melanoma is removed and no further measures have to be taken. Then, the expenses remain comparably low. It the tumor has formed metastases, therapy becomes more complex and more expensive.

In general, foreign patients pay the same prices as German patients. This is because billing is based on statutory cost catalogues.

When individual services like treatment by the head physician or a single room are added, prices increase. For foreign patients in particular, costs for travel, translation and accommodation occur.

There are 38 different prices for the treatment of malignant skin cancer in German hospitals. The flat rate J22Z is applied in most cases. In this case, the patient stays in hospital for 5 days and pays about 2,600 euros. These costs and the time in the hospital are averages.

However, only the costs that occur during the time in the hospital are included here. Follow-up and preliminary examinations are charged additionally and can sometimes be even more expensive than the surgery itself.

Aftercare

The time intervals for aftercare by a dermatologist depend on the extent of the tumor and the type of therapy. According to the German Guideline on Melanoma, aftercare is recommended over a period of ten years. In the first five years after surgery, check-up is especially important.