SKIN CANCER

What is Skin Cancer?

Skin cancer is the uncontrolled growth of abnormal skin cells. It occurs when unrepaired DNA damage to skin cells (most often caused by ultraviolet radiation from sunshine or tanning beds) triggers mutations, or genetic defects, that lead the skin cells to multiply rapidly and form malignant tumors.

There are 3 main types of skin cancers:

• 1. Basal cell skin cancers (basal cell carcinomas)
• 2. Squamous cell skin cancers (squamous cell carcinomas)
• 3. Melanomas

Basal and squamous cell cancers

Basal and squamous cell skin cancers are by far the most common cancers of the skin. Both are found mainly on parts of the body exposed to the sun, such as the head and neck. These cancers are strongly related to a person’s sun exposure.

Basal and squamous cell skin cancers are by far the most common cancers of the skin. Both are found mainly on parts of the body exposed to the sun, such as the head and neck. These cancers are strongly related to a person’s sun exposure.

Basal and squamous cell cancers are much less likely than melanomas to spread to other parts of the body and become life threatening. Still, it’s important to find and treat them early. If left alone, they can grow larger and invade nearby tissues and organs, causing scarring, deformity, or even loss of function in some parts of the body. Some of these cancers (especially squamous cell cancers) can spread if not treated, and can sometimes even be fatal. 

Signs and symptoms of basal cell 

carcinomas include:

• *Appearance of a shiny pink, red, pearly, or translucent bump

• *Pink skin growths or lesions with raised borders that are crusted in the center

• *Raised reddish patch of skin that may crust or itch, but is usually not painful

• *A white, yellow, or waxy area with a poorly defined border that may resemble a scar
• Signs and symptoms of squamous cell carcinomas include:
• • *Persistent, scaly red patches with irregular borders that may bleed easily
  • *Open sore that does not go away for weeks
  • *A raised growth with a rough surface that is indented in the middle
  • *A wart-like growth

Melanomas

Melanomas are cancers that develop from melanocytes, the cells that make the brown pigment that gives skin its color. Melanocytes can also form benign (non-cancerous) growths called moles. (Your doctor might call the mole a nevus.)

Melanomas can occur anywhere on the body, but are more likely to start in certain areas. The trunk (chest and back) is the most common place in men. In women, the legs are the most common site. The neck and face are other common places for melanoma to start.

Melanomas are not as common as basal cell and squamous cell skin cancers, but they can be far more serious. Like basal cell and squamous cell cancers, melanoma can almost always be cured in its early stages. But if left alone, melanoma is much more likely to spread to other parts of the body, where it can be very hard to treat.

The first melanoma signs and symptoms often are:

• A change in an existing mole
• The development of a new pigmented or unusual-looking growth on your skin

Melanoma doesn't always begin as a mole. It can also occur on otherwise normal-appearing skin.

Other skin cancers

There are many other types of skin cancers as well, but they are much less common:

• Merkel cell carcinoma
• Kaposi sarcoma
• Cutaneous (skin) lymphoma
• Skin adnexal tumors (tumors that start in hair follicles or sweat and oil glands)
• Various types of sarcomas 

Together, these types account for less than 1% of all skin cancers.

It’s important for doctors to tell the types of skin cancer apart, because they are treated differently. It’s also important for you to know what skin cancers look like. This can help you find them at the earliest possible stage, when they are easier to treat and most likely to be cured.

Skin cancer risk factors

GENERAL

Age: Skin cancer risks increase as you age, which is likely due to accumulated exposure to UV radiation. But skin cancers may also be found in younger individuals who spend a lot of time in the sun. Frequent sunburns, especially when they occurred during childhood, increases the risk of developing melanoma. 

Immune suppression: Conditions that weaken the immune system, such as viruses, diseases or immune suppression therapy associated with organ transplantation, may increase skin cancer risks.

Gender: Men are approximately two times more likely to develop basal cell carcinomas and three times more likely to develop squamous cell carcinomas than women.

BODY

Skin tone: Caucasians have a greater risk of developing skin cancer than non-whites. The risk is also higher in individuals with blond or red hair, blue or green eyes, or skin that burns or freckles easily.

Moles: Most moles are harmless and may never develop into cancer, but having a large number of moles may increase the risk for developing melanoma. The presence of dysplastic nevi (moles that may resemble melanoma) may also increase risk, by 10 percent. Although most dysplastic nevi will not develop into melanomas, a small percentage may, and individuals with these types of moles should see a dermatologist regularly for thorough skin exams.

GENETICS

Family and/or personal history: Individuals with one or more parents or siblings with skin cancer may be at increased risk. Individuals who have previously been diagnosed with skin cancer are also at increased risk for developing the disease again.

Inherited conditions: Conditions such as xeroderma pigmentosum, an inherited disease that affects the skin’s ability to repair UV damage, are at increased risk for developing skin cancers, and may develop them at an earlier age.

LIFESTYLE

Smoking: Smokers are more likely to develop squamous cell skin cancers, particularly on the lips.

Chemical exposure: Certain chemicals, including arsenic, industrial tar, coal, paraffin and certain types of oil, may increase the risk for certain types of non-melanoma skin cancers.

UV exposure: People who work outdoors during the day or who choose to spend much of their leisure time outdoors and are exposed to UV light are at an increased risk. People who choose to use tanning beds increase their risk of skin cancer.

Treatment for Skin Cancer

Almost all skin cancers can be treated successfully if diagnosed and treated early. However if not treated, some types of skin cancer can be fatal.

No skin cancer should be neglected. The earlier any skin cancer is diagnosed, the less invasive and more successful any treatment is likely to be.

Get to know your own skin! The better you know any moles, freckles birthmarks and other blemishes you already have, the more likely it is you will recognise anything new or different about your skin.

See your general practitioner (GP) immediately if you see anything that has changed or was not on your skin the last time you looked.

Diagnosing skin cancerYour GP will examine the suspicious spot, freckle or mole. If skin cancer is suspected, a biopsy will usually be done. A biopsy is a quick and simple procedure where part or all of the spot is removed and sent to a laboratory for testing. Your GP will tell you the result of the biopsy. If you have skin cancer your GP can discuss and advise you on the best treatment options for you or refer you to a specialist such as a dermatologist for a second opinion and/or treatment.

 Treating skin cancer

Treatment for skin cancer will depend on a number of factors:

• The type of skin cancer
• The size and location of the skin cancer
• Whether the skin cancer has spread (metastasized) to other parts of the body.

 Treatment options can include:

• Surgical removal (excision) of the tumour and surrounding tissue.
• Curettage (scraping and burning).
• Cryotherapy with liquid nitrogen (commonly referred to as “˜freezing’).
• Radiotherapy (use of high energy rays such as X-rays to destroy cancer cells within a     specific area).
• MOHS is highly specialised surgery in which the cancer (generally NMSC only) is removed little by little and checked under the microscope immediately.
• Photodynamic therapy – uses a light source and special cream to destroy cancer cells.
• Imiquimod – a cream that destroys skin cancer by stimulating the body’s immune system to fight the cancer.
• Chemotherapy is treatment with drugs, either pills or injections. It may be used to treat melanoma that has spread to other parts of the body.

After treatment you may need regular check-ups with your GP or specialist for early detection of any new skin cancers. If you notice any spots you are worried about between follow-up appointments it is important to speak with your GP or specialist as soon as possible.