Skin Cancer

What is skin cancer

Skin cancer is the abnormal growth of skin cells, most often caused by ultraviolet (UV) radiation from the sun or tanning beds, but it can also occur on areas of the skin not ordinarily exposed to sunlight. Skin cancer is the most common form of cancer worldwide, but early detection and treatment usually lead to a high chance of successful treatment. There are several types of skin cancer, categorized by the type of cells they affect.

Major Types of Skin Cancer

1.Basal Cell Carcinoma (BCC):

Most common type of skin cancer.
Develops in the basal cells, which are found in the outermost layer of the skin (epidermis).
Appearance: Pearly or waxy bumps, sometimes with visible blood vessels, flat flesh-coloured or brown patches on the skin.
Common locations: Areas frequently exposed to the sun, like the face, neck, and hands.
Growth: Slow-growing and rarely metastasizes (spreads to other parts of the body), but can invade surrounding tissues if untreated.

2.Squamous Cell Carcinoma (SCC):

Second most common type of skin cancer.
Originates in the squamous cells, which make up most of the upper layers of the skin.
Appearance: Firm, red nodules or flat sores with a scaly, crusty surface.
Common locations: Sun-exposed areas like the face, ears, neck, lips, and hands, but can also develop on scars or chronic wounds.
Growth: Can be more aggressive than BCC and may spread to other parts of the body if left untreated.

3.Melanoma:

The most dangerous form of skin cancer.
Develops in the melanocytes, which are the cells responsible for producing the pigment melanin that gives skin its colour.
Appearance: Often looks like an irregular, multi-coloured mole or changes in an existing mole (asymmetry, uneven borders, multiple colours, larger than 6mm, evolving over time).
Common locations: Can occur anywhere on the body, but often appears on the back, legs, arms, and face.
Growth: Melanoma is more likely to spread to other organs and is more deadly than BCC or SCC if not detected early.

4.Merkel Cell Carcinoma:

A rare but aggressive type of skin cancer.
Originates in Merkel cells, which are found close to nerve endings in the skin.
Appearance: Fast-growing, painless nodules that can be flesh-coloured, red, or blue.
Common locations: Frequently occurs on the face, neck, and scalp.
Growth: Tends to spread quickly to nearby lymph nodes and other parts of the body.

Other Less Common Types of Skin Cancer

Kaposi’s Sarcoma: Typically affects individuals with weakened immune systems (such as people with AIDS). It causes purple or red patches on the skin or mucous membranes.
Sebaceous Gland Carcinoma: A rare and aggressive cancer that begins in the oil glands of the skin, often found on the eyelids.
Dermatofibrosarcoma Protuberans (DFSP): A slow-growing tumor that starts in the dermis (deep layer of skin) and can invade surrounding tissues.

Risk Factors for Skin Cancer

UV Radiation Exposure: Prolonged exposure to the sun’s UV rays or artificial sources like tanning beds is the primary risk factor.
Fair Skin: People with lighter skin that burns easily, freckle, or have light-coloured eyes and hair are at higher risk.
History of Sunburns: Severe sunburns, especially in childhood, increase the risk of skin cancer.
Excessive Sun Exposure: Spending long hours outdoors without proper skin protection can raise the likelihood of developing skin cancer.
Family or Personal History: A family or personal history of skin cancer can increase susceptibility.
Weakened Immune System: Individuals with a compromised immune system, such as those who have undergone organ transplants, are at higher risk.
Exposure to Radiation or Toxic Substances: Exposure to certain chemicals (like arsenic) or radiation treatment can increase the risk.

Early Detection – The ABCDEs of Melanoma:

Asymmetry: One half of the mole or spot does not match the other.
Border: The edges are irregular, ragged, or blurred.
Colour: The colour is not uniform and may include shades of brown, black, pink, red, white, or blue.
Diameter: The mole is larger than 6 millimetres (about the size of a pencil eraser), although melanomas can be smaller.
Evolving: The mole is changing in size, shape, or colour.

Prevention of Skin Cancer

Sun Protection: Use broad-spectrum sunscreen (SPF 30 or higher), wear protective clothing, wide-brimmed hats, and sunglasses.
Avoid Tanning Beds: Use of artificial tanning devices significantly increases the risk of developing skin cancer.
Seek Shade: Limit time in direct sunlight, especially between 10 a.m. and 4 p.m. when UV rays are strongest.
Self-Examinations: Regularly check your skin for any new growths, moles, or changes to existing moles. Look at hard-to-see areas like your back and scalp.
Annual Skin Exams: Visit a dermatologist for a professional skin exam, especially if you’re at high risk or have many moles.

Treatment Options

Treatment depends on the type, stage, and location of the skin cancer.

Surgical Options:

Excision: Removing the tumour and a margin of healthy tissue.
Mohs Surgery: A precise surgical technique often used for BCC and SCC, where the skin cancer is removed layer by layer while preserving as much healthy tissue as possible.
Curettage and Electrodessication: Scraping away cancer cells and using electric currents to destroy any remaining cells.

Non-Surgical Treatments:

Radiation Therapy: Used when surgery isn’t an option, especially for larger or harder-to-treat areas.
Topical Medications: Creams or gels with cancer-fighting agents (e.g., imiquimod or 5-fluorouracil).
Cryotherapy: Freezing off small, early-stage skin cancers with liquid nitrogen.
Photodynamic Therapy (PDT): Using a combination of light and drugs to destroy cancerous cells.

Systemic Treatments:

Chemotherapy: Often used for skin cancers that have spread beyond the skin.
Targeted Therapy: Drugs that target specific genetic mutations within cancer cells (commonly used in advanced melanoma).
Immunotherapy: Drugs that boost the immune system to help fight cancer, particularly effective for advanced melanoma (e.g., pembrolizumab, nivolumab).