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All about Skin Cancer

The incidence of skin cancer, and of melanoma in particular, has increased substantially over the last few decades. Knowledge about early detection and skin cancer symptoms are essential. Actinic keratosis (AK) is the most common warning signal of skin cancer in fair-skinned people. Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer. Skin cancer mainly affects areas of the skin that have been exposed to the sun.  

Disease overview

Description

Skin cancer is a general term for diseases in which skin cells lose control over how they grow and proliferate. There are several different types of skin cancer, depending on which skin cells are involved.
These skin cells include keratinocytes present throughout the epidermis, and melanocytes present in the basal layer between keratinocytes.

When melanocytes become cancerous, and this leads to melanoma. Melanoma is relatively rare, but is the most serious type of skin cancer.

Other types of skin cells may also transform into cancerous cells. The transformation of basal cells originating from hair follicles leads to basal cell carcinoma (BCC), and the transformation of squamous cells  originating from the uppermost layer of the skin – the epidermis leads to squamous cell carcinoma (SCC). These two types of skin cancer are collectively referred to as nonmelanoma skin cancer. BCC is the most common form of skin cancer, but very rarely leads to serious disease. SCC is less common, but it may progress and invade other parts of the body, making it potentially very serious.

Diagnosis

Each type of skin cancer has a different appearance. A dermatologist may be able to make a diagnosis simply by examining the skin. Dermoscopy, a technique involving a hand-held instrument that magnifies the skin surface, can help to differentiate skin cancer from other skin disorders; in some cases, a physician will take a histological section of the skin to confirm the diagnosis. When caught early, skin cancer is often treated with a very high success rate—so early diagnosis is very important for both melanoma and nonmelanoma skin cancers.
Melanoma is the most serious form of skin cancer, it is therefore especially important for it to be diagnosed accurately. Many patients at risk for melanoma will have moles on their body that are not dangerous, but may look like melanoma to the untrained eye. Doctors have several tools at their disposal to correctly diagnose a case of melanoma, but it may help to be aware of new and suspicious-looking moles in order to let your doctor know at the earliest possible time. The ‘ABCDEs’ of melanoma describe the key features in an easy-to-remember list: Mackie 2009

A

Asymmetry

B

Border irregularity

C

Colour variation

D

Diameter > 6 mm

E

Evolving characteristics

Moles that may potentially be melanoma are asymmetric, have an irregular border, have varied colors, are relatively large (>6 mm), or have changed in their appearance. If you notice one or more suspicious moles, talk to your doctor about whether these may be melanoma.

For nonmelanoma skin cancer, key warnings signs are: ACS 2007

  • New growths
  • Spots that get larger
  • Visible sores that do not heal after 3 months

KEY MESSAGES:

IMPORTANT FACTS ABOUT Skin Cancer ACS 2007 :

  • Being aware of suspicious lesions can help you to seek medical advice when it is appropriate
  • Not all types of skin cancer are the same! Some are relatively common but do not pose serious risks, while others are relatively uncommon but are dangerous if left untreated
  • Limiting exposure of unprotected skin to the sun can help reduce your chances of developing skin cancer
  • If skin cancer does occur, early detection is the best defense. Skin cancer can be treated successfully in most instances—even very serious types of skin cancer such as melanoma

Risk Factors

Exposure to UV rays from the sun increases your risk of developing skin cancer. In the case of melanoma, childhood exposure seems to be especially important. High sun exposure before the age of 10 increases the risk of developing melanoma later in life. Some types of nonmelanoma skin cancer occur mostly in areas that receive the most sunlight, showing the importance of sun exposure in these types of cancer as well.

For melanoma, other risk factors include:

Family History

· People with a family history of melanoma are more likely to develop it themselves, which in some cases may imply a genetic predisposition

Exposure

· People who have had severe blistering sunburns or have used sunbeds (especially before age 30) are more likely to develop melanoma

· People with exposure to some pesticides are potentially at increased risk

Complexion

· People with fair or Caucasian skin, especially those with red or blond hair, are more susceptible to developing melanoma

· Number of nevi/ dysplasic nevi

Number of lesions

· People with greater numbers of lesions on their skin, especially abnormal ones, are at a greater risk of melanoma

 For nonmelanoma skin cancer, other risk factors include:

Complexion

· As with melanoma, people with fair skin are more likely to develop nonmelanoma skin cancer

Family History

· Nonmelanoma skin cancer also shows a genetic predisposition and family history may increase one’s risk

Age

· Older people are much more likely to develop nonmelanoma skin cancers

Male Gender

· Men are more likely to develop nonmelanoma skin cancer than women

Precancerous skin lesions

· People who have had skin lesions that were not cancerous, but had the potential to progress to cancer, are more likely to develop nonmelanoma skin cancer

Chronic inflammation

· People who have conditions that result in chronic inflammation of their skin are at an increased risk of nonmelanoma skin cancer

Immunosuppression

· People who have a weakened immune system (for example, transplant patients who are taking immunosuppressive drugs to prevent rejection of transplanted organs) are more likely to develop nonmelanoma skin cancers.

Ionizing radiation

· People with increased exposure to ionizing radiation (like X-rays) are more likely to develop nonmelanoma skin cancers

This is a global website focused on educating the public and patients about skin conditions and the different types of treatments that are available to treat and manage these diseases. This site is not intended as a substitute for medical advice from your doctor, and may include discussions about therapies or treatment options that may not be available in your country. We encourage you to use the information contained in this site to educate yourself about your disease and allow better communication between you and your healthcare professional.

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