Skin Cancer

2024/05/31

What is Skin Cancer?

Skin cancer - the abnormal growth of skin cells - most often develops on skin exposed to the sun. But this common form of cancer can also occur on areas of your skin not ordinarily exposed to sunlight.

There are three major types of skin cancer - basal cell carcinoma, squamous cell carcinoma and melanoma, which is the most serious type of skin cancer.

All three types of skin cancer are on the rise, but most skin cancers can be prevented by limiting or avoiding exposure to ultraviolet (UV) radiation and by paying attention to suspicious changes in your skin. With early detection, you can receive successful treatment for most skin cancers, even the most aggressive forms.

Symptoms

Skin cancer develops primarily on areas of sun-exposed skin, including the scalp, face, lips, ears, neck, chest, arms and hands, and on the legs in women. But it can also form on areas that rarely see the light of day - the palms, beneath the fingernails, the spaces between the toes or under the toenails, and the genital area.

A cancerous skin lesion can appear suddenly or develop slowly. Its appearance depends on the type of cancer.

Basal cell carcinoma

This is the most common skin cancer. It's also the most easily treated and the least likely to spread. Basal cell carcinoma usually appears as one of the following:

A pearly or waxy bump on your face, ears or neck
A flat, flesh-coloured or brown scar-like lesion on your chest or back

Squamous cell carcinoma

Squamous cell carcinoma is easily treated if detected early, but it's slightly more likely to spread than is basal cell carcinoma. Most often, squamous cell carcinoma appears as one of the following:

A firm, red nodule on your face, lips, ears, neck, hands or arms
A flat lesion with a scaly, crusted surface on your face, ears, neck, hands or arms

Melanoma

This is the most serious form of skin cancer and the one responsible for most skin cancer deaths. Melanoma can develop anywhere on your body, in otherwise normal skin or in an existing mole that turns malignant. Melanoma most often appears on the trunk, head or neck of affected men. In women, this type of cancer most often develops on the arms or legs.

Warning signs of melanoma include:

A large brownish spot with darker speckles located anywhere on your body
A simple mole located anywhere on your body that changes in color, size or feel or that bleeds
A small growth with an irregular border and red, white, blue or blue-black spots on your trunk or limbs
Shiny, firm, dome-shaped bumps located anywhere on your body
Dark patches on your palms, soles, fingertips and toes, or on mucous membranes lining your mouth, nose, vagina and anus

Precancerous skin lesions

Precancerous skin lesions, such as an actinic keratosis, can also develop into squamous cell skin cancer. Actinic keratoses appear as rough, scaly, reddish or dark-pink patches. They're most commonly found on the face, ears, lower arms and hands of people whose skin has been damaged by the sun.

Not all skin changes are cancerous. The only way to know for sure is to have your skin examined by your doctor or dermatologist.

When to seek medical advice

If you notice any suspicious growth or change of the growth on your skin, consult your doctor right away. As with most cancers, early detection increases the chances of successful treatment

Treatment and drugs

Treatment for skin cancer and the precancerous skin lesions varies, depending on the size, type, depth and location of the lesions. Often the abnormal cells are surgically removed or destroyed with cryotherapy, electrocautery or topical medications. Most skin cancer treatments require only a local anaesthetic and can be done in an outpatient setting. Sometimes no treatment is necessary beyond an initial biopsy that removes the entire growth.

Freezing. Your doctor may destroy actinic keratoses and some small, early skin cancers by freezing them with liquid nitrogen (cryosurgery). The dead tissue sloughs off when it thaws. The treatment may leave a small, white scar. You may need a repeat the treatment to remove the growth completely.

Excisional surgery. This type of treatment may be appropriate for any type of skin cancer. Your doctor cuts out (excises) the cancerous tissue and a surrounding margin of healthy skin. A wide excision - removing extra normal skin around the tumour - may be recommended in some cases. To minimize or avoid scarring, especially on your face, you may need to consult a doctor skilled in skin reconstruction.
Laser therapy. A precise, intense beam of light vaporizes growths, generally with little damage to surrounding tissue and with minimal bleeding, swelling and scarring. A doctor may use this therapy to treat superficial skin cancers or precancerous growths on lips.
Mohs surgery. This procedure is for larger, recurring or difficult-to-treat skin cancers, which may include both basal and squamous cell carcinomas. The doctor removes the skin growth layer by layer, examining each layer under the microscope, until no abnormal cells remain. This procedure allows cancerous cells to be removed without taking an excessive amount of surrounding healthy skin. Because it requires special skill, the surgery should be done only by specially trained doctors.

Curettage and electrodesiccation. After removing most of a growth, the doctor scrapes away layers of cancer cells using a circular blade (curette). An electric needle destroys any remaining cancer cells. This simple, quick procedure is common in treating small or thin basal cell cancers.This procedure leaves a small, flat, white scar.

Radiation therapy. Radiation may be used to destroy basal and squamous cell carcinomas if surgery isn't an option.

Chemotherapy. In chemotherapy, drugs are used to kill cancer cells. For cancers limited to the top layer of skin, creams or lotions containing anti-cancer agents may be applied directly to the skin. Topical drugs can cause severe inflammation and leave scars. Systemic chemotherapy can be used to treat skin cancers that have spread to other parts of the body.

Skin Cancer Screening and Surveillance

Clinic sessions are on Monday (Female) and Friday (Male) afternoons. Female patients are screened by a female clinician.

Objectives:

Early detection of cancerous change in pre-existing or new moles with an aim to early removal of malignant melanoma, hence reducing cancer morbidity and mortality.
Screening and periodic surveillance of pre- and post-organ transplant recipients for precancerous and cancerous skin lesions with an aim to secondary prevention;
Primary preventive strategies by education and sun protection.

Doctors