Skin cancer

Skin cancer is a type of cancer that originates in your skin. There are two types: melanoma and non-melanoma.

What is skin cancer?

The skin is the largest organ in your body and serves many important roles in keeping you healthy. It acts as a barrier that protects against germs and harmful substances, as well as regulating temperature and providing sensations like touch. 

Skin cancer is a type of cancer that originates in the skin. There are two types: melanoma and non-melanoma. When caught early, skin cancer is highly treatable.

Non-melanoma skin cancer

Non-melanoma is a type of skin cancer that develops in the upper layer of the skin (the epidermis). It is more common than melanoma skin cancer, with around 147,000 cases diagnosed in the UK every year.

There are different types of non-melanoma skin cancers, but the most common are basal cell carcinoma and squamous cell carcinoma. Non-melanoma skin cancers are less likely to spread to other areas of the body than melanomas.

There are different types of non-melanoma skin cancers, which are named after the cells they start in.

The most common type of non-melanoma skin cancer is basal cell carcinoma (BCC), which starts in the cells lining the base of the epidermis. BCC accounts for around 75 in every 100 cases of non-melanoma skin cancer.

Squamous cell carcinoma (SCC) is the second most common type of non-melanoma skin cancer, accounting for around 20 in every 100 cases.

Although not classified as non-melanoma skin cancer, Bowen’s disease and actinic keratoses are types of skin disease that may turn into squamous cell carcinoma if left untreated.

Anyone can develop non-melanoma skin cancer, but you are at a greater risk if:

  • you have fair skin
  • you have a lot of moles
  • you have a family history of skin cancer
  • you have a weakened immune system
  • you have had a lot of sun exposure over your life
  • you have a genetic condition which predisposes you to developing these types of skin cancer

The first signs of non-melanoma skin cancer include a lesion which is failing to heal, a new lump, a persistent scaly patch, or discoloured skin. Melanomas usually develop on areas of skin that are regularly exposed to the sun, such as the face, hands, shoulders, chest, and back but they can arise anywhere on the body.

Basal cell carcinoma usually appears as a small lump that may be pink or pearly white in colour, with a waxy or translucent appearance. It may also present as a flat patch of red, scaly skin.

Squamous cell carcinoma usually appears as a firm, pink lump with a crusted or scaly surface. It may feel tender, bleed easily, or develop into an ulcer.

Melanoma skin cancer

Melanoma skin cancer is less common than non-melanoma skin cancer, with around 16,000 cases per year diagnosed in the UK. It can spread quickly to other areas of the body, making it more dangerous if not caught early.

Melanoma develops when the melanocytes in the skin start to grow out of control. Melanocytes are cells located deep within the epidermis. Melanocytes produce melanin, a pigment which gives the skin its natural colour. Melanin is important, because it provides protection against the sun's UV radiation.

When the skin receives too much UV radiation, it develops sunburn – a form of damage to your DNA. Too much DNA damage can cause the development of melanoma.

There are several different types of melanomas, such as:

  • Superficial spreading melanoma – the most common type of melanoma in the UK.
  • Lentigo maligna melanoma – a type of melanoma commonly affecting older people.
  • Acral lentiginous melanoma – a type of melanoma most commonly found in people with darker skin affecting the hands and feet.
  • Nodular melanoma – the most aggressive type of melanoma, occurring in 10-15% of cases.

Anyone can develop melanoma skin cancer, but you may be more at risk if: 

  • you are elderly 
  • you have fair skin 
  • you have a history of sunburn 
  • you spend a lot of time in the sun 
  • you do not wear sun protection 
  • you have a lot of moles 
  • you have a family history of melanoma 
  • you have a weakened immune system

Melanoma could be present if you develop a new mole, or if you notice changes in a pre-existing mole. Generally, these moles are irregularly shaped and display more than one colour. They may sometimes also bleed and be itchy, but not always.

Melanomas can appear anywhere on the body, but don’t usually appear in areas protected from the sun – for example, the buttocks. Melanomas are most commonly found on the back in men, and on the legs in women.

It is important to keep an eye on any pre-existing moles and visit your GP if they begin to change in appearance or if you develop any new symptoms in your moles.

Skin cancer treatment

The most common treatment option for both melanoma and non-melanoma skin cancer is surgical excision. This involves removing the cancer and a small portion of surrounding tissues. If a significant amount of tissue is removed, you may have a skin graft or free flap surgery to restore the appearance of the area. Sometimes, non-melanoma skin cancers can be treated with creams.

If you have melanoma skin cancer, your treatment will depend on what stage you are at, and whether the cancer has spread. If your cancer has spread, you may require further treatments such as lymph node removal, immunotherapy, and radiotherapy.

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