About Skin Cancer
Normally, as skin cells grow old and die, new cells form to replace them. But if something causes a change to this process, such as exposure to ultraviolet (UV) light, cells may grow more quickly. These new cells may be non-cancerous or cancerous. If not caught early, skin cancer can spread to nearby tissue or other areas of the body. Fortunately, if skin cancer is identified and treated in early stages, most are cured.
What is Skin Cancer?
Skin cancer is a type of cancer that originates in the skin cells. It occurs when there is an abnormal growth of skin cells, often triggered by damage to the DNA within these cells. This damage is most commonly caused by ultraviolet (UV) radiation from the sun or tanning beds. There are three primary types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and melanoma.
Basal cell carcinoma: is the most common form of skin cancer. It begins in the basal cells, which are found in the lower part of the epidermis, the outermost layer of the skin. This type of cancer typically appears on sun-exposed areas of the body, such as the face and neck. It often manifests as a pearly or waxy bump, a flat, flesh-colored or brown scar-like lesion, or a sore that bleeds and scabs over.
Squamous cell carcinoma: is the second most common type of skin cancer. It originates in the squamous cells, which make up most of the skin's upper layers. This cancer usually develops on sun-exposed areas like the face, ears, and hands. It can appear as a firm, red nodule or a flat lesion with a scaly, crusted surface. While it is generally more aggressive than basal cell carcinoma, it is still highly treatable when detected early.
Melanoma: is the most dangerous form of skin cancer, though it is less common than the other two types. It develops in the melanocytes, the cells responsible for producing melanin, the pigment that gives skin its color. Melanoma can occur anywhere on the body, even in areas not typically exposed to the sun. It often appears as a large brownish spot with darker speckles, a mole that changes in color, size, or feel, or a small lesion with an irregular border and multiple colors. Early detection is crucial, as melanoma can spread to other parts of the body and become life-threatening.
Skin cancer can also develop in less common forms, such as Merkel cell carcinoma and lymphoma of the skin. Merkel cell carcinoma is a rare but aggressive cancer that forms in the Merkel cells, which are found at the base of the epidermis. Lymphoma of the skin involves the lymphocytes, a type of white blood cell, and can present as patches, plaques, or nodules on the skin.
Types of Skin Cancer
Skin cancer is a broad term that encompasses several different types of cancers originating in the skin. The three most common types are basal cell carcinoma, squamous cell carcinoma, and melanoma, each with distinct characteristics and levels of severity.
Basal Cell Carcinoma
Basal cell carcinoma (BCC) is the most common type of skin cancer, originating in the basal cells, which are found in the deepest layer of the epidermis. These cells are responsible for producing new skin cells as old ones die off. BCC typically develops on areas of the skin that are frequently exposed to the sun, such as the face, neck, and arms.
The primary cause of BCC is prolonged exposure to ultraviolet (UV) radiation from the sun or tanning beds. This exposure leads to DNA damage in the skin cells, which can result in uncontrolled cell growth. People with fair skin, light hair, and light eyes are at a higher risk, as are those with a history of frequent sunburns or extensive time spent outdoors without adequate sun protection.
BCC often appears as a change in the skin, such as a growth or a sore that does not heal. It can take several forms, including a pearly or waxy bump, a flat, flesh-colored or brown scar-like lesion, or a sore that bleeds and scabs over. On darker skin, BCC may appear as a brown or glossy black bump. These lesions can vary in size and may have visible blood vessels on their surface.
While BCC grows slowly and rarely spreads to other parts of the body (metastasizes), it can cause significant local damage if left untreated. The cancer can invade surrounding tissues, including bones and nerves, leading to disfigurement and functional impairment. Therefore, early detection and treatment are crucial.
Squamous Cell Carcinoma
Squamous cell carcinoma (SCC) is a common type of skin cancer that originates in the squamous cells, which are flat cells located near the surface of the skin. These cells are part of the epidermis, the outermost layer of the skin. SCC can also develop in other parts of the body where squamous cells are found, such as the lungs, mucous membranes, and digestive tract.
The primary cause of SCC is prolonged exposure to ultraviolet (UV) radiation from the sun or tanning beds. This exposure leads to DNA damage in the squamous cells, causing them to grow uncontrollably. People with fair skin, light hair, and light eyes are at a higher risk, as are those with a history of frequent sunburns or extensive time spent outdoors without adequate sun protection.
SCC typically appears on sun-exposed areas of the body, such as the face, ears, neck, hands, and arms. It often presents as a rough, scaly red patch, an open sore, a raised growth with a central depression, or a wart-like growth. These lesions can be painful and may bleed or crust over. Unlike basal cell carcinoma, SCC has a higher potential to spread (metastasize) to other parts of the body, making early detection and treatment crucial.
Diagnosis of SCC involves a physical examination and a biopsy. During the biopsy, a small sample of the suspicious lesion is removed and examined under a microscope to confirm the presence of cancer cells. Once diagnosed, several treatment options are available, depending on the size, location, and aggressiveness of the tumor.
Melanoma
Melanoma is a serious and potentially deadly form of skin cancer that originates in the melanocytes, the cells responsible for producing melanin, the pigment that gives skin its color. Although melanoma is less common than other types of skin cancer, such as basal cell carcinoma and squamous cell carcinoma, it is far more dangerous due to its ability to spread to other parts of the body if not detected and treated early.
Melanoma can develop anywhere on the skin, but it most frequently appears on areas that have been exposed to the sun, such as the back, legs, arms, and face. However, it can also occur in less obvious places, like the soles of the feet, palms of the hands, and under the nails. In rare cases, melanoma can form in the eyes, mouth, genitals, and even internal organs.
The primary cause of melanoma is exposure to ultraviolet (UV) radiation from the sun or tanning beds, which can damage the DNA in skin cells and lead to uncontrolled cell growth. Risk factors for melanoma include having fair skin, a history of sunburns, excessive UV exposure, a family history of melanoma, and the presence of many moles or unusual moles on the skin.
Melanoma often begins as a change in an existing mole or as a new, unusual-looking growth on the skin. The ABCDE rule is a helpful guide for identifying potential melanomas: Asymmetry (one half of the mole doesn't match the other), Border (irregular, scalloped, or poorly defined edges), Color (varied shades of brown, black, or other colors), Diameter (larger than 6mm, about the size of a pencil eraser), and Evolving (changes in size, shape, or color over time).
Early detection of melanoma is crucial for successful treatment. If caught early, melanoma can often be treated effectively with surgical removal. However, if the cancer has spread to other parts of the body, treatment becomes more complex and may involve a combination of surgery, radiation therapy, chemotherapy, immunotherapy, and targeted therapy.
Skin Cancer Stages
Skin cancer is categorized into different stages based on the size of the tumor, its depth of penetration, and whether it has spread to other parts of the body. The staging system helps doctors determine the severity of the cancer and plan the appropriate treatment.
Stage 0 (Carcinoma in Situ): At this stage, the cancerous cells are confined to the outermost layer of the skin (the epidermis) and have not invaded deeper tissues. This stage is also known as carcinoma in situ. The abnormal cells have the potential to become cancerous but have not yet spread.
Stage I: In this stage, the tumor is small, typically 2 centimeters (cm) or less in diameter, and has not spread to nearby lymph nodes or other parts of the body. The cancer is still localized and has not penetrated deeply into the skin.
Stage II: The tumor is larger than 2 cm but smaller than 4 cm in diameter. It may have one or more high-risk features, such as being thicker than 2 millimeters (mm), invading the lower layers of the skin, or being located on high-risk areas like the ears or lips. However, it has not yet spread to nearby lymph nodes or distant sites.
Stage III: At this stage, the tumor is larger than 4 cm or has grown into nearby tissues, such as the bone or cartilage. It may also have spread to nearby lymph nodes but not too distant parts of the body. This stage indicates a more advanced local spread of the cancer.
Stage IV: This is the most advanced stage of skin cancer. The tumor can be of any size and may have spread to nearby lymph nodes. Additionally, the cancer has metastasized to distant parts of the body, such as the lungs, liver, or other organs. Stage IV skin cancer is more challenging to treat and often requires a combination of therapies.
The staging of skin cancer is crucial for determining the prognosis and treatment plan. Early-stage skin cancers (stages 0 and I) are generally treated with surgical removal and have a high cure rate. For more advanced stages (stages II, III, and IV), treatment may involve a combination of surgery, radiation therapy, chemotherapy, immunotherapy, and targeted therapy.