Skin cancer

How common is skin cancer?

Skin cancer is extremely common. In the US alone, more than 1,000,000 people develop skin cancers each year. Skin cancer is divided into three main categories: basal cell carcinoma, squamous cellcarcinoma and melanoma. Basal cell carcinoma and squamous cell carcinoma originate in the structural cells of the outer layer of the skin, the epidermis. Melanoma originates from melanocytes, the cells that produce melanin, the pigment that gives the skin its colour. Basal cell carcinoma grows slowly and almost never metastasizes. Squamous cell carcinoma is more aggressive and more likely to spread, but the most aggressive of the three types is melanoma, which often metastases to distant organs. Basal cell carcinoma is the most common cancer seen in people of the white race. Squamous cell carcinoma, accounts for 20% of skin cancers while melanoma is a rarer disease but the most serious skin malignancy. Melanoma accounts for 80% of deaths from skin cancer.

Who are more likely to get skin cancer?

The vast majority of skin cancer cases are caused by exposure to solar radiation. Total exposure to UV radiation during childhood appears to be particularly aggravating. Risk factors are also light skin, tanning beds and immunosuppression (e.g. due to drugs or HIV).

Is there screening for skin cancer?

A careful examination of the skin by the patient or dermatologist is the first and most important step in diagnosing skin cancer. A better overview of a skin lesion can be obtained with a dermoscope, which can visually increase the size of the lesion by at least tenfold. All dermatological lesions in the patient should be closely monitored for changes in their appearance once they have been identified and, if suspicious, removed for histological examination. The same applies to new skin lesions that do not heal or show any of the above mentioned suspicious features.

Are there any symptoms indicative of skin cancer?

Skin cancer is easy to spot because the skin malignancies are visible. Basal cell carcinoma usually occurs in areas exposed to sunlight, such as the face and ear flaps. Its usual characteristics are a solid form, smooth surface and red colour, and it often shows ulceration with poor healing. Squamous cell carcinoma is usually found on the head and limbs and is usually characterised by a hard lump, sensitive to palpation, which may bleed. Melanoma appears in the form of a new mole or a change in the characteristics of an existing mole (change in size, shape, colour, bleeding, pain, itching). Common locations are the trunk (back, chest), limbs and face.

How is skin cancer diagnosed?

To make a diagnosis of the disease, a biopsy and histological examination of a section of the suspected skin area must be performed.

What are the treatments available today?

Radical treatment of skin cancer is entirely feasible with surgical removal of the lesion as long as the disease has not spread, so early diagnosis is essential. In cases of metastatic disease, treatment options include immunotherapy, newer biological therapies and chemotherapy, which can significantly improve patient survival.