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Introduction
What is Skin cancer?
Skin cancer is the irregular growth of skin cells in the epidermis, or the outermost layer of the skin.
Cancer is caused by DNA damage that remains unrepaired thereby triggering mutations. These mutations allow the skin cells to multiply rapidly and form malignant tumors. Skin often occurs in parts of the body that are exposed to the sun. Although, it is still possible for skin cancer to occur on your skin that is not exposed to the sun.
Three types of skin cancers: Basal cell carcinoma, Squamous cell carcinoma and Melanoma.
Basal Cell Carcinoma
Basal cell carcinoma (BCC) is a type of skin cancer that begins in the basal cells. This type of skin is the most common type of skin cancer and approximately 3.6 million Americans are diagnosed with it every year.
Where are they found?
Basal cells are found at the bottom of the epidermis. The cells produce skin cells when the old ones die off. As new skin cells are produced, the older cells are pushed to the skin's surface where they eventually die and fall off.
How is it found?
According to the Mayo Clinic, Basal cell carcinoma often presents itself as a small transparent bump on the skin. However, it is possible for this type of skin cancer to present itself in another way. This type of cancer is often found in parts of the skin that are exposed to the sun very often such as your face or neck. It is deemed that most Basal cell carcinomas are caused by long term exposure to ultraviolet (UV) radiation.
According to the Mayo Clinic, BCC usually appears as a change in the skin that won’t heal. Usually, these changes, also known as lesions, have one of the following characteristics.
Signs of BCC
A pearly white skin colored bump that is translucent. The lesions can rupture and scab over. Tiny blood vessels may also be visible although this varies from person to person depending on their skin tone. A brown, black, blue or a dark spotted lesion is another sign of BCC. A flat, scaly, reddish patch with a raised edge. Finally, a white, waxy, scar-like lesion without a clearly defined border is another sign of BCC.
Risk factors for BCC
Some risk factors that can increase your risk of developing a BCC include; prolonged and repeated exposure to ultraviolet radiation, radiation therapy, having fair skin, having a family history of skin cancer, being on immunosuppressive drugs, being exposed to arsenic and having sunburns.
Prevention for BCC
In order to prevent yourself from getting BCC, avoid the sun during the middle of the day, wear sunscreen, cover your skin, avoid tanning beds and check your skin regularly for any irregularities such as new moles.
Diagnosis & Treatment
In order to diagnose BCC, your doctor or a specialist will perform a physical exam along with a history by asking about changes in your skin, any signs or symptoms you have experienced and about your medical history. Your doctor will examine your skin and may do a biopsy by removing a small sample of the lesion for a test in a lab. This will allow the doctor to know if you have skin and what type if you have it.
When treating BCC, the main goal is to remove the cancer although depending on the size, type and location your treatment will change. In order to treat BCC, the cancer is removed through surgery along with some healthy skin around it. If you cannot have surgery, you may receive: tropical treatments, radiation therapy, photodynamic therapy, etc.
Squamous Cell Carcinoma
Squamous cell carcinoma (SCC) is another common type of skin cancer that develops in the squamous cells.
What are Squamous cells?
Squamous cells are the cells that make the outer and middle layer of the skin. This type of skin cancer, although not deadly, can spread rapidly and is very aggressive meaning that it can cause serious complications. SCC can occur anywhere in the body where squamous cells are found.
Causes of SCC
Similar to basal cell carcinoma, prolonged and repeated exposure to ultraviolet radiation without protection can cause it to occur and so it often occurs in parts of the body that are most exposed to the sun or other UV radiation from things like tanning beds. Around 1.8 million people are diagnosed with SCC each year.
Signs & Symptoms for SCC
According to the Mayo Clinic, some signs and symptoms of SCC include: a firm red nodule on the skin, a flat sore with a scaly crust, a new sore or raised area on an old scar or ulcer, a scaly and rough patch on your lips that could further develop into an open sore and a red sore inside your mouth.
Causes for SCC
Similar to BCC, SCC occurs as a result of mutations in your DNA. These mutations are caused by long term exposure to ultraviolet radiation. The risk factors of SCC are similar to BCC. Having fair skin can increase your risk of developing SCC as you have less melanin in your skin which in turn means that you have less protection against ultraviolet radiation. However, this does not mean that having darker skin will completely protect you from developing SCC as anyone can develop it.
Risk factors of SCC
Having a history of sunburns, using tanning beds, excessive sun exposure, weakened immune system, certain genetic disorders and a family history of skin cancer can increase your risk of developing SCC.
Treatments & Diagnosis for SCC
In order to reduce your risk of developing SCC, avoid tanning beds, wear sunscreen, cover your skin when going outside as much as possible and avoid the sun during the middle of the day.
To diagnose SCC, your doctor will use a special tool to cut off a piece of the lesion and perform a biopsy to determine if it indeed is a SCC. Most SCC’s can be removed with minor surgery or even medicine that is applied to the affected area. The treatment that you may receive depends on your overall health, the size of the cancer, how aggressive it is and it’s location.
For smaller skin cancers you may receive Curettage and Electrodessication (C & E) treatment which removes the surface of the cancer with a special tool and then searing the base with an electric needle.
You may also receive laser therapy, freezing of photodynamic therapy.
If you have a larger cancer, you may receive radiation therapy, Mohs surgery (removing the cancer layer by layer) or a simple excision (removing the cancer through a surgery).
If the cancer has spread to other parts of the body then you may receive chemotherapy, targeted drug therapy, immunotherapy or a combination of these depending on what suits your best.
More further insight into the the treatment by Mayo Clinic.
Melanoma
Melanoma is the most serious type of skin cancer. It develops in the cells called melanocytes.
The purpose of these cells is to produce melanin (the pigment that gives your skin color).
Where is it found?
Melanoma can form in any parts of the body although it is most commonly found in parts of the body most exposed to the sun like other types of skin cancer. Although the exact cause of melanoma is unknown, being exposed to UV radiation can increase your risk of developing a melanoma. In 2021, over 200 000 Americans will have developed melanoma. Although Melanoma is the most dangerous and serious type of skin cancer, it can be treated when diagnosed early.
Signs of Melanoma
According to the Mayo Clinic, the first few signs of a Melanoma are a change in an existing mole or the development of a new pigmented or unusual growth on your skin. Melanoma does not necessarily develop as a mole; it can also develop on normal looking skin. Normal moles are generally the same color throughout, have a border from other parts of your skin, smaller than 6mm in diameter and form until the age of about 40. Most people have anywhere between 10-40 moles on their body.
If a mole is asymmetrical meaning that it has 2 different halves, then it may be a Melanoma.
If a mole has different colors and doesn't have a distinct border from the surrounding skin, it may be a Melanoma. If it is larger than 6mm in diameter and changes frequently over time then it may be a sign of a Melanoma.
Sometimes, melanomas develop in areas that aren’t exposed to the sun, these are called hidden melanomas. Usually, melanoma occurs when there is a problem with the cells that produce melanin. Through a combination of many different factors, DNA damage may occur and your cells may begin to grow and form cancerous cells.
Risk factors of Melanoma
The risk factors of melanoma are almost identical to that of BCC and SCC. Some differences are that if you live at a higher elevation or closer to the equator, you are at a higher risk of developing a melanoma and if you have many moles or unusual moles, then you have an increased risk of developing melanoma. The prevention methods are also almost the same as those of BCC and SCC. A difference would include being familiar with your body and recognizing changes on your skin.
Diagnosis
Once again, to diagnose Melanoma, your doctor will take a physical exam and a biopsy. If you are diagnosed with Melanoma, your doctor will determine the stage of the cancer. In order to do this, your doctor will determine the thickness of a melanoma by examining it under a microscope.
In general, when the tumor is thicker, the disease is more serious. Your doctor will also check to see if the cancer has spread to your lymph nodes and check for signs of cancer other than the skin. For early stage melanomas, the melanoma can be removed during the biopsy or with small surgery if it is small enough. If the melanoma has spread, you may need to have your affected lymph nodes removed, receive chemotherapy, immunotherapy, radiation therapy or targeted therapy.
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