Older adults are more vulnerable to skin cancer due to the aging process and cumulative sun exposure, according to Dr. Doan Minh Trong, from the Department of Breast and Head and Neck Surgery at Tam Anh General Hospital in Ho Chi Minh City. He added that most skin cancers caused by ultraviolet (UV) radiation appear on the head, face, and neck, while melanoma develops from moles. Other risk factors include radiation exposure, chronic skin inflammation, arsenic exposure, albinism, and genetic predisposition.

Skin cancer can occur at any age, but the risk increases with age, especially after 50. "Cells in the body are constantly dying and regenerating. As we age, the cell regeneration process is more prone to errors, leading to the formation of malignant cells," Dr. Trong explained.

The three most common types of skin cancer are basal cell carcinoma (70-80%), squamous cell carcinoma (about 20%), and melanoma (malignant moles, about 5%). Melanoma is the most dangerous, accounting for most skin cancer deaths. In 2022, Globocan reported 200 new cases of melanoma and 122 deaths from the disease in Vietnam.

Dr. Dang Thi Ngoc Bich, Head of the Department of Dermatology and Cosmetic Dermatology at Tam Anh General Hospital in Ho Chi Minh City, noted that older patients and their families often mistake skin cancer nodules for age spots or skin growths, leading to delayed diagnosis and treatment. By the time symptoms become severe, the cancer is often in an advanced stage.

For instance, 82-year-old Lieu from Can Tho initially dismissed a small nodule on her temple as a scab. When it grew to the size of a grape and began to itch and bleed easily, she sought medical attention at Tam Anh General Hospital. Dr. Trong diagnosed her with squamous cell carcinoma, a type of skin cancer. The 2 cm tumor was surgically removed along with surrounding tissue, and a skin graft from her cheek was used to close the 2.5 cm wound.

Dr. Trong encourages Lieu during a follow-up appointment. Photo: Tam Anh General Hospital

Dr. Trong encourages Lieu during a follow-up appointment. Photo: Tam Anh General Hospital

Similarly, 72-year-old Hung from Khanh Hoa initially mistook a dark spot under his eye for an age spot. A year later, it became raised, itchy, and started bleeding, with the ulcer spreading to about 2 cm. He was diagnosed with skin cancer and underwent surgery to remove the affected skin, with a skin graft from his cheek used to cover the area.

This was a complex surgery, according to Dr. Trong, due to the tumor's proximity to the optic nerve. The 2 cm wide, over 1 cm deep malignant tumor required precise removal to avoid damaging the nerve. The skin graft from the cheek was also carefully planned to prevent the lower eyelid from being pulled down, which would have hindered blinking and closing the eye.

The biopsy results indicated that the malignant tumor had not metastasized and had a low risk of recurrence. Neither patient required further radiation therapy due to the clear margins around the tumor, suggesting a high probability of recovery.

Slow-growing skin cancers like squamous cell carcinoma and basal cell carcinoma can be completely cured if detected and treated early. However, in advanced stages, when the cancer has spread to the lungs, heart, or brain, the success rate of treatment drops to 20-40%, according to Dr. Trong.

When skin cancer causes ulceration and spreads before patients seek medical attention, treatment becomes more challenging. Surgeons may remove the cancerous tissue and a 1-2 cm margin of surrounding tissue, then use a skin graft from a nearby area or elsewhere on the body to close the wound, which can impact cosmetic appearance. Depending on the biopsy results, patients may undergo radiation therapy to prevent recurrence.

Dr. Bich advises older adults to consult a dermatologist or head and neck surgeon if they have skin nodules that don't heal within 1-2 weeks, light brown, pink, or red discolored spots, or lesions that bleed easily. Scaly or crusted skin growths with a rough or bumpy surface can also be warning signs of skin cancer. Any unusual dark spots that increase in size, moles with irregular borders or unusual colors, itchy or swollen moles, or asymmetrical moles should also be examined by a doctor for proper diagnosis and treatment.

Bao Tram

*Patient names have been changed.