El cáncer de piel

Información proporcionada por: Mayo Clinic, Jacksonville, Florida

Permanecer expuesto al sol sin protección es un riesgo que muchos no toman en serio, pues ignoran o prefieren no considerar su asociación con el cáncer de piel. Sin embargo, éste es la forma de cáncer más común en el mundo y una de las principales causas de muerte por dicha enfermedad. A nivel mundial, alrededor de 3.5 millones de casos son diagnosticados al año, de los cuales mueren unos 12,000 pacientes. Según estadísticas de la Sociedad Americana del Cáncer, 1 de cada 5 norteamericanos desarrollará esta enfermedad en su vida.

Para la época del año con mayor exposición solar, la Dra. Anokhi Jambusaria, dermatóloga con un especial interés en el cáncer de piel, de la Clínica Mayo de Jacksonville, Florida, explica algunos puntos importantes:

¿Qué es el cáncer de piel?

El cáncer de piel es cualquier crecimiento maligno en la misma. Genéricamente, hay dos tipos principales de este cáncer: melanoma y no-melanoma. Dentro del cáncer de piel no-melanoma, los dos tipos más comunes son el carcinoma de células basales y el carcinoma de células escamosas. El carcinoma de células basales es el más diagnosticado en cualquier órgano a nivel mundial, siendo más común que el cáncer mamario, el pulmonar e incluso el de colon. En tanto, el carcinoma de células escamosas es el segundo cáncer más frecuentemente diagnosticado en el mundo.

¿Qué es el melanoma?

El melanoma es la forma más mortífera de cáncer en la piel, ya que tiene más probabilidades de propagación a distintos órganos. La capacidad que tiene el melanoma de hacer metástasis lo convierte en el más letal. El melanoma se distingue de otros cánceres de piel por ser, a menudo, aunque no siempre, una proliferación de células pigmentadas.

¿Cuáles son los síntomas de este tipo de cáncer?

Regularmente, lo primero que las personas notan es un crecimiento nuevo o que algo está cambiando en su piel. Típicamente, el melanoma tiende a ser asintomático, lo que significa que no da ningún indicio. En algunas ocasiones, el crecimiento puede sangrar y otras doler un poco cuando se le presiona.

¿Cuáles son los tratamientos para los distintos tipos de cáncer de piel?

Los tratamientos para el cáncer de piel son individualizados al paciente, según el tipo de cáncer y cómo se ve al microscopio. Para cánceres pequeños y recientes, a menudo se realiza un tratamiento tópico o de raspado simple. Para cánceres ligeramente más agresivos, el médico puede recomendar que se elimine la lesión de forma quirúrgica.

¿Qué posibilidades de cura tiene un paciente frente a la aparición de un melanoma?

En la fase 1, el porcentaje de cura de un melanoma es de alrededor de 95%, por lo que detectarlo a tiempo resulta clave. Un melanoma más denso, pero que aún está confinado en la piel y no se ha extendido a los ganglios linfáticos o al resto del cuerpo (fase 2), también tiene una posibilidad de cura bastante alta, cerca de 70% a 80%. Un melanoma en fase 3, el decir, el que se ha “escapado” de la piel a los ganglios linfáticos –y distinguimos aquí las fases A, B y C, dependiendo de cuántos ganglios estén invadidos– la tasa de curación decae fuertemente a niveles de apenas 20% si hay muchos ganglios implicados, contra niveles más altos de 60 a 70% si sólo es uno. Un melanoma en fase 4 es aquel que salió de los ganglios y se ha extendido a órganos distantes del cuerpo. En este caso, la supervivencia es muy baja. Puede ser de unos meses hasta un año, aunque las nuevas terapias están permitiendo mejorar estas cifras.

¿Cómo influye la exposición al sol en contraer esta enfermedad?

La exposición al sol es un factor de riesgo muy importante en el desarrollo del cáncer de piel. La exposición que una persona tuvo en su infancia y en particular, una historia de quemaduras solares con ampollas, son factores sustanciales. Sin embargo, la mayoría de los médicos estarían de acuerdo en que es importante minimizar la exposición al sol en la adultez, lo que puede también ayudar a disminuir el riesgo de contraer este cáncer.

¿Hay personas con mayor riesgo que otras para cáncer de piel?

También puede haber una predisposición genética a contraer el cáncer de piel. Hay ciertos grupos de pacientes que tienen más probabilidades de sufrir estos cánceres. Por ejemplo, las personas de piel muy clara que tienden a quemarse muy fácilmente antes de broncearse, tienen mayor riesgo. Regularmente, estos sujetos tienden a ser pelirrojos y de ojos azules. No obstante, también puede ocurrir en personas morenas, como hispanos, asiáticos del este y afroamericanos, aunque en mucho menor cantidad. En realidad, cualquier persona puede desarrollar cáncer de piel.

¿Qué otros factores pueden influir en el cáncer de la piel?

El lugar donde se vive juega un papel muy importante en el riesgo de desarrollar cáncer en la piel. Los rayos ultravioleta, que son los que lo causan, son más fuertes en las zonas cercanas al ecuador y se debilitan cuanto más lejos del ecuador se esté. La altitud también es un factor significativo. Las personas que viven muchos años en una gran altitud tienden a estar más expuestas a la luz UV que aquellas que viven a menores altitudes o a nivel del mar.

¿Cómo debemos protegernos de la radiación solar y prevenir el cáncer de la piel?

Los aspectos más destacados para la práctica del “Sol Seguro” (Safe Sun en inglés) son:
– Aplicar protector solar con un mínimo de factor de protección solar (SPF) de 30. Dicho protector debe ser de amplio espectro, esto es, que proteja tanto contra la radiación UVA como contra la UVB.
– Aplicar el protector solar aproximadamente 30 minutos antes de exponerse al sol y volver a aplicarlo cada dos horas e inmediatamente después de nadar o sudar en exceso. El protector solar “a prueba de agua o sudor” es un mito.
– Aplicar una cantidad equivalente a la de un vaso pequeño en todo el cuerpo, incluso debajo de la ropa. Una persona de contextura normal debiera aplicarse unos 50 mililitros en todo el cuerpo, de pies a cabeza.
– Invertir en un sombrero, de borde ancho, que cubra no sólo la cabeza sino también las orejas y la parte posterior del cuello y usarlo junto con gafas de sol. Para actividades al aire libre existe actualmente en el mercado la llamada “ropa protectora del sol” (Sun-Protective Clothing), cuyas telas están tratadas con protector solar. Con ello se reduce la cantidad de crema protectora solar que es necesario aplicar sobre la piel.
– Tener presente que los rayos solares alcanzan su mayor intensidad entre las 10 a.m. y las 4:00 p.m. Por ello, es preferible realizar las actividades al aire libre antes o después de este período.

¿Cuándo se debe acudir a un médico para prevenir el cáncer de piel?

Es recomendable que toda persona que esté en la pubertad y entrando a su adultez sea examinada por un dermatólogo para una evaluación de riesgo, particularmente si tiene un antecedente familiar de cáncer de piel o un historial de excesiva exposición al sol. Basado en los hallazgos del examen, el médico le recomendará la frecuencia posterior con la cual debe examinarse.

Para más información acerca de los tratamientos de cáncer de piel disponibles en la Clínica Mayo en Jacksonville, Florida, puede llamar al Departamento de Servicios Internacionales al teléfono 904-953-7000.


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