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Skin cancerPublished by BUPA's health information team, healthinfo@bupa.com, November 2005. This factsheet is for people who suspect they have, or have, skin cancer or people who wish to know more about it. There are two main types of skin cancer, melanoma and non-melanoma skin cancer (NMSC). Non-melanoma skin cancer is the most common cancer in the UK. Melanoma skin cancer is less common but is the most serious type as it can spread to other organs very rapidly. There is a good chance that skin cancer can be cured if diagnosed and treated early. Cancer - a general overview animation
The skinThe skin is made up of three layers:
Cancer can start from cells in any of these layers.
What is skin cancer?Skin tumours are created by an abnormal and uncontrolled growth of cells. Tumours can either be malignant (skin cancer) or benign. Skin cancer can grow and spread to other parts of your body (through the bloodstream or the lymph system) where it may grow and form secondary tumours. This is called a metastasis. There are different types of skin cancer, which are classed depending on their ability to spread to neighbouring tissues. Non-melanoma skin cancerEach year in the UK over 60,000 people are diagnosed with non-melanoma skin cancer. There are different types of non-melanoma skin cancer including those described below. Basal cell carcinoma (BCC)Also known as a rodent ulcer, this is the most common form of malignant skin cancer in people with white and fair skin. It is rare in people with dark skin. A BCC is an overgrowth of basal cells in the epidermis - usually in areas of skin that are exposed to the sun such as your head and neck. Usually, it grows slowly in the skin and does not spread to other tissues. If left untreated a BCC will slowly grow and turn into an ulcer and grow deeper into your skin and damage nearby structures. For example, BCC on the face may erode and damage your nose or one of your ears. Squamous cell carcinoma (SCC)This is the second most common malignant skin cancer in people with white and fair skin. It is rare in people with dark skin. An SCC is an overgrowth of squamous cells in the epidermis. It often occurs on areas that are exposed to the sun. An SCC can spread into the surrounding skin, and also potentially to other parts of the body but this is not common. Melanoma skin cancer (malignant melanoma)Around 7,000 people are diagnosed with melanoma each year in the UK. It affects slightly more women than men. Melanoma is uncommon in people with dark skin. Melanoma is an overgrowth of melanocyte cells in the epidermis. These are cells that make a pigment called melanin when your skin is exposed to the sun. Melanoma is the most serious form of skin cancer as it often spreads to other tissues or organs. Symptoms of skin cancerDifferent types of skin cancer can look different. Non-melanomas such as a BCC cancer, for example, can start as a small red, pink or pearly dome-shaped lump. SCCs often appear as small scaly or crusted areas of skin with a red or pink base. Melanoma symptoms usually start as a dark spot or mole on your skin. If a melanoma spreads to other parts of your body, you can develop other symptoms such as swollen lymph glands (nodes). Symptoms that may indicate skin cancer include any spot or lesion that:
Although these signs do not necessarily mean you have skin cancer, you should visit your doctor to have it checked as soon as possible. Causes of skin cancerThe cause of skin cancer isn't fully understood at present. But there are certain factors that make skin cancer more likely. The main risk factor for any type of skin cancer is exposure to the intense ultraviolet light of sunshine. Other factors that may increase your risk of skin cancer include:
Diagnosis of skin cancerYour GP will examine your skin. He or she may refer you to see a specialist, such as a skin specialist (dermatologist) or a cancer specialist (oncologist) to have further tests including those listed below.
Treatment of skin cancerYour treatment for skin cancer will depend on a number of factors such as your age and whether the cancer has spread and if so, how far. There are a number of skin cancer treatments, which are described below. Your doctor will advise you on which is best for you. SurgeryYour doctor will remove the cancer and some of the normal skin surrounding it. The amount of normal skin will vary depending on the type of cancer and how deep it is in your skin - it can be one to two centimetres around where the cancer is. Skin cancers such as BCC and SCC can also be destroyed by freezing them with liquid nitrogen. SCCs can be removed by other methods including using a drug called imiquimod (Aldara). For more information, on removing skin lesions, please see the separate BUPA factsheet: Skin lesion removal You may need more extensive surgery if a sentinel node biopsy shows cancer cells. This will remove the lymph nodes near to the cancer as well as the affected skin. Treatments following surgerySurgery may occasionally be followed by a course of radiotherapy, or you may have this instead of surgery. For more information, please see the separate BUPA factsheet: Radiotherapy Your doctor may recommend interferon alfa-2b after surgery if there is a strong chance that your cancer will come back. Interferon alfa-2b treatment is a type of immunotherapy. This means that it helps your immune system fight the cancer. A more recent development in immunotherapy is cancer vaccines, however they are only used in research trials at present and are not widely available. If the cancer has spread, you may be given chemotherapy. For more information, please see the separate BUPA factsheet: Chemotherapy Prevention of skin cancerTo reduce your risk of skin cancer, you should minimise your exposure to the sun.
If you notice any changes in your skin, you should visit your doctor as soon as possible. Further information
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