Skin cancer is a malignant tumour (growth) of the skin. There are various types, and together these form the second most common form of cancer in the UK, with over 33,000 new cases each year.

What is skin cancer?

The more common forms of skin cancer are:

• Basal cell carcinoma: Also known as rodent ulcer, this is a unique type of cancer in that it does not spread to other parts of the body. Although not fatal, it can cause extensive damage and disfigurement if not treated early.

• Squamous cell carcinoma: This is a cancer of the squamous cells (the outermost layer of flat skin cells). It is less common than basal cell carcinoma, but is more dangerous. If left untreated, it can spread to other parts of the body and be fatal.
• Malignant melanoma: This is the most serious form of skin cancer, although it is curable if treated early. Melanoma has one of the fastest rates of increase of all cancers among white people, especially in the young and middle-aged. Every year in the UK about 500 men and 600 women die from this form of cancer.
• Squamous cell carcinoma and Basal cell carcinoma. Both these types can appear as simple sores or scabs that will not heal.
• Other, rare types of skin cancer include mycosis fungoides (producing inflammation similar to eczema), and Kaposi’s sarcoma which often occurs in patients with AIDS or in the elderly. Pre-malignant skin lesions (which may become a squamous cell carcinoma if untreated) include solar keratoses, that appear as rough, red areas on sun-exposed sites, and Bowen ‘s disease, which tends to occur on the legs.

The risk of developing skin cancer increases with age. Both basal cell and squamous cell carcinomas occur mainly in those over 40 years old, men and women being affected almost equally. More women than men are affected by malignant melanoma which occurs mainly in those from 40 -60 years old, but can strike at any age. However, children are rarely affected.

SYMPTOMS

• Basal cell carcinoma appears as a small, slow-growing pearly, waxy or red lump. If left untreated, it may crust, ulcerate or bleed. It usually appears in the centre of the face, commonly on the skin around the inner corner of the eye and around the nose.

• Squamous cell carcinoma appears as a lumpy, scaling red area which may bleed easily and ulcerate. It usually develops on the head and neck or on the back of the hands.

• Malignant melanoma may develop in a previously healthy mole which changes in shape, becoming irregular, or changes in thickness or colour. It may also crust or bleed. This can occur anywhere on the body, including the legs and the back. Sometimes, it appears suddenly in a place where there was no lesion before.

What can I do to avoid skin cancer?

Protect yourself in the sun. Use a sunblock preparation, but be aware that although it may prevent burning, it does not totally protect the skin from the  damaging effects of UV light. Bald scalps are especially vulnerable. Remember that a wide-brimmed hat and clothing are the most effective form of sunscreen.

Avoid getting sun burnt by taking the sun in small doses, especially when your skin is unused to strong sunshine. The most dangerous time is the ‘midday sun’ between 11am and 4pm. Protect children from the sun. There is evidence that sunburn in childhood could increase the risk of malignant melanoma developing later in life. Those burnt during puberty are particularly vulnerable. Using sunbeds may increase the risk of cancer.

What causes skin cancer?

There is considerable evidence that skin cancers result from damage to the skin caused by over exposure to the sun’s ultraviolet (UV) light rays with direct DNA damage or via the repair mechanism.  Australia exhibits one of the highest rates of skin cancer incidence in the world.  Deficiencies in certain vitamins and mineral and genetic predisposition, Congenital Melanocytic Nevi Syndrome and environmental toxins like Arsenic can also lead to skin cancer .

How is skin cancer diagnosed and treated?

Skin cancer is usually suggested by a physical examination of the affected area. Additionally, in most cases, either the whole lesion or a sample of tissue will be biopsied (removed for laboratory examination) to confirm the presence of malignant changes in the tissue.

Treatment will depend on the type of skin cancer.

Basal cell carcinoma: This is treated by radiotherapy, cryosurgery (freezing), or surgical removal, sometimes with skin grafting.

Squamous cell carcinoma: This is treated by surgical removal, sometimes combined with radiotherapy. Q Malignant melanoma: If discovered early, this is removed surgically along with a margin of normal tissue around and below the lesion. If the tumour has already spread, chemotherapy is given but is often not effective.

When should I see my doctor?

See your doctor for any changes on your skin or in a mole, such as change in shape, size or colour, itching, inflammation, crusting or bleeding.

What will the doctor do?

The doctor will examine the area and discuss your symptoms. A biopsy may be arranged. You may be referred to a dermatologist (skin specialist), plastic surgeon or cancer specialist.

What can I do myself?

Be aware of your skin and its features, such as freckles and moles. Inform your doctor if you detect any changes. Take preventive measures and reduce your risk factors.

Is skin cancer dangerous?

Although squamous cell carcinoma and malignant melanoma can be fatal if left untreated, skin cancer can frequently be cured if caught early.

What increases the risk of skin cancer?

Certain-people are more at risk of developing skin cancer, often due to the following high risk factors:

1. Having a lot of moles.
2. Fair complexion, that is, red or blond hair, blue eyes, pale skin and freckles.
3. A tendency to burn easily in the sun.
4. A history of the disease in a family member.
5. Spending a lot of time outside, such as in an outdoor job or playing a lot of sport in the open.
6. Developing solar keratoses (sun spots) on the skin due to over-exposure to sun over a period of years.

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