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What is the outlook for people with actinic keratosis?
Most actinic keratoses (AKs) go away with treatment. About 90% of people with actinic keratosis don’t develop skin cancer. However, most diagnoses of squamous cell carcinoma started as AKs. If you think you have an AK, it’s important to see your healthcare provider right away.
Diabetic patients have a 15–25% lifetime risk of developing diabetic foot ulcers, of which 40–80% become so severely infected it involves the bone, leading to osteomyelitis [4]. Global epidemiological studies suggest a higher prevalence in North America [5].
The takeaway: the risk of infection IF YOU HAVE DIABETES from a non-healing wound, is higher than the risk that you will get cancer from your actinic keratosis.
AND
The cancer you get from the actinic keratosis, IF you get it at all - has a lower risk of interfering with your life, than the recurrence rate and risk of interfering with your life if you have a non-healing wound infection.
The takeaway: the risk of infection IF YOU HAVE DIABETES from a non-healing wound, is higher than the risk that you will get cancer from your actinic keratosis.
Major qualifier.
And if one does not have diabetes, as quoted by another poster on this thread: “Actinic keratosis is an abnormal growth of cells caused by long-term damage from the sun. They are not cancerous, but a small fraction of them will develop into skin cancer. Because we don’t know which ones will become cancer and which will not, dermatologists recommend treatment of these lesions,” says Dr. Christensen Sean R. Christensen, MD, PhD, a Yale Medicine dermatologic surgeon and an assistant professor of dermatology at Yale School of Medicine.
Thanks to all for your input. Yes, I've spent hours reading the same stats, articles, medical journals scientific papers including the relatively small 10-20% probability factor. I'm hovering right around the 70 yr. old mark.
I have no idea how many years it had developed till i finally noticed. during the last few months it quickly started changing shape and size finally turning to a protruding horn shaped stem. My understanding is being diabetic increases the risks for complications for any medical condition. Hence, my extreme concern. How should I present my second opinion to the initial treating clinician? (still, he was a PA not even a full on dermatologist)It may come back the same result, i cant fore tell. please pardon my French, With out Pissing him or my HMO off so to speak, and refusing further treatment. This is my first time down road and don't know how to proceed. Cant believe any one could put some one through this degree of agony after successfully fighting through and making a full depressive recovery.
Hi all. My husband and I had a whole set, both skin precancer and cancer. I have actinic keratosis and my husband has both basal cell and squamous cell cancer. By the way, one of my husband's two tumors appeared in a place where he had actinic keratosis before, but the second tumor appeared spontaneously and was not preceded by anything. We talked to a lot of doctors. Afterward, I concluded that the likelihood of actinic keratoses turning into cancer is high if one lives in the southern states. Lately, articles about skin cancer have been increasingly talking about a 20% chance of precancerous lesions turning into skin cancer. I think that's not a small percentage.
I read that diabetes doesn't seem to cause cancer, but it can speed up the growth of existing tumors.
Find a responsible and knowledgeable doctor, or better yet, consult several doctors. If there is a precancer, it should be treated and not delayed.
Hi all. My husband and I had a whole set, both skin precancer and cancer. I have actinic keratosis and my husband has both basal cell and squamous cell cancer. By the way, one of my husband's two tumors appeared in a place where he had actinic keratosis before, but the second tumor appeared spontaneously and was not preceded by anything. We talked to a lot of doctors. Afterward, I concluded that the likelihood of actinic keratoses turning into cancer is high if one lives in the southern states. Lately, articles about skin cancer have been increasingly talking about a 20% chance of precancerous lesions turning into skin cancer. I think that's not a small percentage.
I read that diabetes doesn't seem to cause cancer, but it can speed up the growth of existing tumors.
Find a responsible and knowledgeable doctor, or better yet, consult several doctors. If there is a precancer, it should be treated and not delayed.
The figures vary widely, from 1 to 20%, which in my opinion shows that doctors sign their own incompetence. Frequent medical incompetence and inattention lead to the fact that so often time is missed for proper diagnosis and actinic keratoses or some bump on the skin turns into skin cancer. Two of my relatives had skin changes that were not noticed in time and later turned into cancer. Doctors noticed the tumors only when they were pointed out the changing spot on the skin with their finger on the second or third checkup. And only after that a biopsy was ordered, which they had to wait over a month for.
We talked to a lot of doctors. Afterward, I concluded that the likelihood of actinic keratoses turning into cancer is high if one lives in the southern states.
Most skin cancers grow slowly (BCC and SCC) and if diagnosed late in life, the likelihood of them killing you is small, something else will probably beat them to it!
But if anyone is concerned, they should always get a second opinion. There are 3 kind of docs
1. Conservative docs who are hesitant to treat without robust evidence
2. docs who just copy the SOC, regardless if the SOC has a robust evidence base backing it or not
3. docs who will treat anything with any treatment that has a whiff of probability that it will work.
Just know that sometimes the treatments introduce more problems than the conservative approach.
And sometimes a novel treatment is validated and becomes the SOC. No guarantees in life.
And find a doc who matches your philosophy on treatment.
The figures vary widely, from 1 to 20%, which in my opinion shows that doctors sign their own incompetence. Frequent medical incompetence and inattention lead to the fact that so often time is missed for proper diagnosis and actinic keratoses or some bump on the skin turns into skin cancer. Two of my relatives had skin changes that were not noticed in time and later turned into cancer. Doctors noticed the tumors only when they were pointed out the changing spot on the skin with their finger on the second or third checkup. And only after that a biopsy was ordered, which they had to wait over a month for.
I partly agree, sometimes doctors are at fault. But diagnosis is a complicated matter and that's what the doctors themselves say. A doctor told us that at least half of any changes in the skin after the age of 40 should be considered as a potential pre-cancer. And what and when it will turn into skin cancer is difficult to predict. Doctors not only visually have difficulty in diagnosis, they write that the biopsy may not show immediately accurate results. In this article it is briefly shown that there are difficulties with diagnosis. it's easy to get confused and make mistakes
Do with that info what you will. I take it as we don’t really have a good grasp of what causes the most dangerous form of skin cancer yet.
Actually, I don't think it's all that strange considering some of the factors that study identified: statistical percentages of more vulnerable fairer skinned people in higher latitudes, more people spending more time outdoors during the year at those latitudes (if it isn't boiling hot people spend more of their lives outdoors and it is easier to forget to cover up/wear sunscreen if the temperature is mild. Exposure is cumulative). If its freezing cold your skin is mostly covered so you aren't exposing it to the sun unless you're into winter sports. One other consideration at least for very far north is daylength and sun angle during summer. In the higher latitudes, the sun stays measurably higher above the horizon for up to 18 hours a day. It spends a higher percentage of its time at a angle at which it can burn. The angle at which UV radiation (as well as the wavelength of the UV spectrum penetrating the atmosphere) can cause skin damage may be higher for more hours during each of those long days too.
Last edited by Parnassia; 08-15-2023 at 02:55 PM..
Actually, I don't think it's all that strange considering some of the factors that study identified: statistical percentages of more vulnerable fairer skinned people in higher latitudes, more people spending more time outdoors during the year at those latitudes (if it isn't boiling hot people spend more of their lives outdoors and it is easier to forget to cover up/wear sunscreen if the temperature is mild. Exposure is cumulative). If its freezing cold your skin is mostly covered so you aren't exposing it to the sun unless you're into winter sports. One other consideration at least for very far north is daylength and sun angle during summer. In the higher latitudes, the sun stays measurably higher above the horizon for up to 18 hours a day. It spends a higher percentage of its time at a angle at which it can burn. The angle at which UV radiation (as well as the wavelength of the UV spectrum penetrating the atmosphere) can cause skin damage may be higher for more hours during each of those long days too.
Ah no. Go to the tropics, you will burn there faster than you will in one of those northern states listed, even if it’s the summer there . Sun is most intense between the tropics and equator. Above 22.5N the sun will never reach peak intensity.
I suspect people spend more time outdoors in the southern states but that’s hard to quantify. I guess we can leave this guess as an open one to explore. Certainly people in Hawaii and California are more active outdoors in the summer (anytime for that matter) than people in the Midwest/northeast. Not sure about other areas of the South
As for more fair skinned up north. I’m not sure. Lots of Americans with Scotch-Irish ancestry in the south. It would be nice to see computer modeling of this instead of guessing.
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