At minute 40:40 of clip (a), Pra Ajarn Paisarn Visalo talked about the volunteer who had an assignment talking with a cancer patient. This patient is suffering from face cancer that affected his lifestyle. He became a very private person for a while.
Basically many people, even the volunteers, are afraid of this kind of job. Because cancer tumors usually damage the affected tissues or organs. When it happens on face, it may leave the horrible detriment. Besides the injurious face, it badly affected the mood of the patient.
Anyway, this patient looked happy and enjoyed the day more than she expected. Keeping himself private is also the great chance to watch the documentary TV program. The more he saw the hard life of others, the more he realized the value of life. Even life is not the same as ever, he is still alive. It seems that the volunteer also got a wonderful experience at home visiting.
There are many other case-studies inside the clip (a) which is available online in Thai language. If you are interested in Palliative Care, please click that link.
Basically, normal cells can replicate correctly by DNA checkpoint. There are several checkpoints responsible for clearing up the erroneous cells. If the wrong cells evade this critical step and increase the number as a mutant colony later, it may be cancer.
When the abnormal cells are remarkably multiplying, they consume a lot of cellular food and oxygen. So, they are the terrible competitor of surrounding normal cells. Finally, the increasing rate of cellular burning or metabolism affects the weight of cancer patients.
At the beginning, I tried to gather Thai face cancer through Google Search. But it is really hard to match what I want to know. Two of Thai cases are just weird reported news with a little medical detail.
Facial cancer is the very little portion among recorded Thai cancer cases. It differs from other well-known cancers which the Public Health ministry has collected and published the official statistical record since 2019.
The first top 5 of cancers in Thais are (1) liver cancer, (2) esophagus-bronchus-lung cancer, (3) breast cancer, (4) cervical cancer and (5) leukemia. Moreover, cancer is the cause of death 3 times more than heart and vascular disease among Thai people. (c)
This patient had suffered from hard palate cancer in her mouth for many years and died three year ago. Even though she had got many kinds of cancer treatment such as surgery and radiation, the fatal malignant still invaded throughout nearby tissues such as the optical nerve (it is the reason for her subsequent blindness) and her brain (that is why she has lost her balance ability).
This little boy had a diagnosis of malignant cancer in facial bone. After he got the marvelous surgery, his overall symptom was better in 2 months. For the best result, the physician teams planned to treat him by sequential chemotherapy for one year and then watchful waiting.
The meaning of “oma” is the progressively abnormal growth of tissue. The skin cancer and the internal layers of the organ are classified as carcinoma. The carcinoma may be found in many organs such as renal cell carcinoma in kidney and ductal carcinoma in situ in breast.
The upper layer of epidermis which is exposed to sunlight and tanning bed UV radiation contains innumerable squamous cells. If the uncontrolled mutation happens in this layer, it is generally named “squamous cell carcinoma” or “SCC”.
Under the layer consisting of epidermal squamous cells, there are uncountable cubic-like cells settled down to the base. So, it is named basal layer. When the mutation happens, it is named “basal cell carcinoma” or “BCC”.
Under the basal layer is the habitat of melanocytes, pigment-producing cells. Then, melanoma is the name of its cancer type.*
*Melanin is a brown-black pigment that can be produced both in human and animal skin. Moreover, it can be found on the peel of some fruits such as banana, apple, persimmon (it is the yield of biological reaction of polyphenol oxidase). (h)
Among all subtypes, the BCC is the most incidence happening in Caucasian. The second is SCC. In the US, there are reliable records showing new cases of BCC and SCC patients for about 5.5 millions people per year. Occasionally, you may see the word “Non-Melanoma Skin Cancer” or “NMSC” that means the combination of BCC and SCC.
Compared to the new case of melanoma which is approximately 0.09 millions people/ year. It seems that the NMSC should be more considered than melanoma, anyway the statistical death of melanoma diagnosed patients (10%) is a considerable amount. So, melanoma is the most horrible type of skin cancer. (i)
โชคดีที่ตัวเลขผู้ป่วยมะเร็งผิวหนังในไทยมีน้อยมาก โดยสถาบันมะเร็งแห่งชาติเคยเก็บสถิติไว้ว่าผู้ป่วยมะเร็ง 100 คน เป็นมะเร็งผิวหนัง ชายหรือหญิงเพศละ 1 คนเท่านั้น และไม่ติดอันดับ 1 ในสิบ top ten มะเร็งสาเหตุที่พบในคนไทยด้วยค่ะ (j)
In Thailand, the data collected by the National Cancer Institute showed the little portions (just 1 percent of each gender) who are diagnosed being cancer is skin cancer. Skin cancer does not rank on the top 10 of cancer types in Thais. (j)
The terrible trigger of skin cancer is ultraviolet light from sunlight and tanning beds, the equipment that darkens skin indoor comfortably.
Interestingly, the retrospective clinical studies concluded that the risk of skin cancer depends on the frequency of using tanning beds and the previous experience of skin burning. Using tanning beds more than 10 times per 12 months or using them periodically for 20 years increases the risk of skin cancer, especially in UV-burned people.
For this reason, applying sunscreen and using tanning beds properly is very important. Seriously, when you notice the irregular changes or problems in your body, you have to consult the physician. Because it may be the SCC, BCC or melanoma. (l) (m)
What skin cancer looks like at the beginning? There are various characters such as the formation of widen glossy bumps, the pinky-brown or black freckles that spread widening. The rashes or bumps which do not disappear themselves within 4-6 weeks are also considerable.
The change in existing moles or the development of chronic lesions which has appeared for a month may originate from skin cancer. (n)
ในเคสผู้ป่วยวัย 74 ปี คุณ Keith Londsdale ได้ผ่านการผ่าตัดรักษามะเร็งมาแล้วไม่น้อยกว่า 45 ครั้ง จำเป็นต้องเลาะเอากระดูกอ่อนที่จมูก กระดูกขากรรไกรบน กระดูกโหนกแก้มที่มะเร็งกินลามลงไป แต่โชคดีที่ได้วิวัฒนาการพิมพ์สามมิติ 3D printer ดีไซน์หน้าส่วนที่หายไปจากการใช้ใบหน้าของบุตรชายเป็นต้นแบบ เพื่อทำเป็นหน้ากากที่ดูเหมือนจริงมาก ๆ ปิดช่องโหว่ที่หายไป
นี่เป็นตัวอย่างหนึ่งที่ชัดเจนอธิบายได้ด้วยภาพว่า มะเร็งผิวหนังเป็นลักษณะแบบ Outside In เริ่มเป็นในจุดที่เราสังเกตได้ ก่อนจะลามกว้างและลึกลงไปข้างใต้กัดกินกล้ามเนื้อและกระดูกได้ Credit: Nottingham’s Queen’s Medical Center (o)
In this case, Mr. Keith Londsdale, a 74-year-old elder, underwent facial surgery more than 45 times for eradicating the basal cell carcinoma (BCC) tumors. The cancer penetrated the deeper tissue and bone such as nasal bone, upper jaw bone and cheek bone. Obviously, the photos show the horrible results after the progression of BCC.
Fortunately, the advance of medical 3-D printing technique can renovate his destroyed face by producing the virtual facial mask. Its shape is based on his son's face. You can see Mr. Keith Londsdale’s 3D-face mask here. Credit: Nottingham’s Queen’s Medical Center (o)
It seems that the BCC which originates from skin may lead to the horrible damage deeper as “Outside-In”.
The word “sarc” as sarcoma means deadly cancer. It is much more dangerous than carcinoma many times. The sarcoma implies the cancer which happens in connective tissue such as bone, cartilage, fat tissue, muscle and even blood vessels. Two Thais cases I talked about in the early paragraph are grouping in sarcoma patients. (d), (e)
Mr. Tim McGrath, the 38-year-old man from Michigan, has suffered from synovial sarcoma which looks like a huge ball on one side of his face. He underwent the complicated surgical treatment removing this harmful tumor. Even though his lineament has changed, he still has a positive attitude in life.
This is in contrast to carcinoma, sarcoma is the “Inside-Out” danger originated deeply inside, then badly expressed outside later. Moreover, the scientists found that cellular mutation which originated this type of cancer is related to two genes named syt and sxx that are linked together on chromosome X. It indicates that the diminutive abnormality on DNA may lead to horrible results. (q), (r)
5-year-old Nguyet has been diagnosed with sarcoma on facial blood vessels or vascular sarcoma. When she was borned, she had a strawberry-like birthmark or infantile haemangioma on her face which happens to about 5 percent of premature infants. Luckily, she has access to the successful surgery with kindly help from many generous people. Credit : PATTI MAXEY / CATERS NEWS) (s)
The meaning of “leukae” and “emia” is the white blood cells and the blood respectively. Leukemia is the type of cancer that originated in stem cells settled in bone marrow inside the backbone. This cancer affects the maturation of red blood cells, white blood cells and platelets. Thus, there are numerous symptoms such as fatigue, bleeding spots, recurrent fever caused by pathogen infection, which all of them may happen immediately or chronically.
Skin rash without itching is one of leukemia symptoms which cannot be seen obviously on the face. This rash is mostly spread all over the body, arms, legs and neck because of abnormal bleeding spots under the skin. (t), (u), (v)
The next case is Ms. Kathryn Cartwright. She died at 28 years old from liver infection after having been diagnosed with aggressive leukemia since 16-year-old. When she had fallen from the wheelchair accidentally, she had injuries in her face.
It was a terrible black and blue bruised round shape which has been appearing longer than usual. The thrombopenia or the subnormal platelet counts is its reason. She wrote “F - - k c a n c e r” on her injured face and posted online humorously. Later, it is the well-known viral on social media where many people encouraged her. Credit : BMP Medias (w)
The “Lymph '' is the fluid which contains the immune cells for fighting against pathogens. The “Lymph nodes” are the habitats of B and T lymphocytes linked together as web chains throughout the body. The function of lymph nodes is to get rid of the bacteria, viruses, and other immunogens.
The meaning of “myelo” is the spinal cord inside the backbone which is the origin of B-lymphocytes, a type of white blood cells that normally produce antibodies against specific immunogens. If “myeloma” has been diagnosed, it would have violent effects on the body's self-protection.
Three pairs of tonsil glands near the throat are lymph nodes which are larger than usual if they have an infection. If the lymph node is infected as tonsillitis, it can be cured by antibiotics.
ทั้งนี้ ยังมีต่อมน้ำเหลืองที่อยู่บนผิวหน้าที่เป็นมะเร็งได้ ดังตัวอย่างเคสของคุณ Kim Debling เป็นมะเร็งต่อมน้ำเหลืองชนิด Cutaneous T-Cell Lymphoma (CTCL) ซึ่งเป็นชนิดย่อยของประเภท Non-Hodgkin lymphoma อีกทีหนึ่ง Credit : PA Real Life (x)
The next case is Mrs. Kim Debling, she has suffered from cutaneous T-cell lymphoma (CTCL) which is one type of Non-Hodgkin lymphoma. Later, she has been treated by chemoradiation. Credit : PA Real Life (x)
We usually know that the important risk of cancer on the lips and mouth is smoking. Anyway, the oral intercourse or oral sex is another critical cause which has been proved by many researches.
The oral sex may transfer the pathological virus, Human Papilloma Virus (HPV) to the another in both gender. The HPV infection is also the cause of cervical cancer in women.
However, there are many HPV vaccines consisting of different subtypes of HPV virus boosting the immunity against them. This vaccine is most effective if people are injected before they become sexually active. (z), (aa), (bb)
The central nervous system (CNS) can divide into the brain and spinal cord. Both of them have two different areas, the grey and white matter.
We cannot exactly identify which of them, even the excellent brain surgeons. Thus, sometimes the brain operation in a delicate area undergoes when the patient is conscious for checking real-time responses. It is called awake craniotomy.
I also wrote about the awake craniotomy in the violin player in this following link.
There are two areas inside the brain and spinal cord which can describe the details here.
The first area is called grey matter. It is a brownish pink area which gathers the body part of neurons or nerve cells. The blood capillaries also penetrate into this area for nourishing oxygen and essential nutrients.
The name of the second area is white matter. Its colour comes from the fatty sheath (called myelin sheath) covering the trunk of neurons. It looks like the white sponge wrapping the stalk of water mimosa growing in the river.
The usefulness of this interval wrapping is to fasten the electrochemical signals across the neurons. Interestingly, the nerve signal direction usually sends from the axons (entrance way) to dendrites (exit way). Besides the fat-covered trunks, there are many subtypes of supporting cells (called glial cells) in this area.
The symptom of CNS cancer does not appear on the face frame as other types. The patients with CNS cancer mostly present the disability of physical sensation such as blurred vision, visual loss, slurred speech, changing of smell and taste. The seizure (a sudden uncontrolled contraction), memory loss, serious headache which caused vomiting are also considerable.
If you are interested in the volunteer activities of the Buddhika Network for Buddhism and Society, search more details on this website “budnet.org”. There are nine foundations that work cooperatively with this foundation.
Latrice Hogue, et al. 2019. Basal Cell Carcinoma, Squamous Cell Carcinoma, and Cutaneous Melanoma in Skin of Color Patients. Dermatologic Clinics. [Online]. available : https://doi.org/10.1016/j.det.2019.05.009
Sean Singer, et al. 2020. Journal of the American Academy of Dermatology. Skin cancer and skin cancer risk behaviors among sexual and gender minority populations: A systematic review. [Online]. available : https://doi.org/10.1016/j.jaad.2020.02.013
Lacey Vence, et al. 2016. Journal of the American Academy of Dermatology. Multiple tanning bed–induced acral squamous cell carcinomas mimicking arsenical keratoses. [Online]. available : https://doi.org/10.1016/j.jaad.2016.02.791
Madigan, L. M., & Lim, H. W. 2016. Clinics in Dermatology. Tanning beds: Impact on health, and recent regulations. [Online]. available : https://doi:10.1016/j.clindermatol.2016.05.016
Lady Paola, et al. 2020. International Journal of Pediatric Otorhinolaryngology. Oral and maxillofacial cancer in pediatric patients: 30 years experience from a Brazilian reference center. [Online]. available : https://doi.org/10.1016/j.ijporl.2020.109879