Skin Cancer

WHAT IS SKIN CANCER?

Skin cancer occurs when skin cells are damaged, for example, by overexposure to ultraviolet (UV) radiation from the sun. Between 95 and 99% of skin cancers in the UK are caused by exposure to the sun.

TYPES OF SKIN CANCER

There are three main types of skin cancer:

melanoma - the most dangerous form of skin cancer
basal cell carcinoma*
squamous cell carcinoma*

*Both basal cell carcinoma and squamous cell carcinoma are known as non-melanoma skin cancer.

EARLY DETECTION

The sooner a skin cancer is identified and treated, the better your chance of avoiding surgery or, in the case of a serious melanoma or other skin cancer, potential disfigurement or even death.

It is also a good idea to talk to your doctor about your level of risk and for advice on early detection. 
Check your skin regularly to pick up any changes that might suggest a skin cancer. Look for:

• any crusty, non-healing sores
• small lumps that are red, pale or pearly in colour
• new spots, freckles or any moles changing in colour, thickness or shape over a period of weeks to months (especially those dark brown to black, red or blue-black in colour).

If you notice any changes consult your doctor immediately. Your doctor may perform a biopsy (remove a small sample of tissue for examination under a microscope) or refer you to a plastic surgeon or dermatologist if he/she suspects a skin cancer.

TREATMENT

Skin cancers are almost always removed. In more advanced skin cancers, some of the surrounding tissue may also be removed to make sure that all of the cancerous cells have been taken out. Common skin cancers can be treated with ointments or radiation therapy. They can also be removed with surgery (usually under a local anaesthetic), cryotherapy (using liquid nitrogen to rapidly freeze the cancer off), curettage (scraping) or cautery (burning).

VITAMIN D

Vitamin D is produced by our bodies when sunlight penetrates the skin. It is important for maintaining healthy muscles and bones. 

For most people, adequate vitamin D levels are reached through regular daily activity and incidental exposure to the sun.

Here are the most commonly asked questions about skin cancer

1. What is a non-melanoma skin cancer?

There are two main types of non-melanoma skin cancer (NMSC): basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). BCC is the most common form of skin cancer. It usually develops as a small, round, raised, red, pale or pearly-coloured spot, and it may become ulcerated like a sore that will not heal. SCC is the second most common form of skin cancer. It normally appears as a thickened red, scaly spot that may later bleed easily or ulcerate. Both types of NMSC mainly develop on areas of the body that are exposed to ultraviolet radiation and are usually able to be treated if detected early.

2. What is a melanoma?

Melanoma is the least common form of skin cancer, but the most deadly. If left untreated, melanoma can spread to other parts of the body. Melanoma appears as a new or existing spot, freckle or mole that changes in colour, size or shape. A melanoma usually has an irregular or smudgy outline and can be more than one colour. A melanoma can grow over weeks to months, and can appear anywhere on the body, including areas of the body that aren’t exposed to ultraviolet radiation from the sun.

3. What is ultraviolet radiation?

Ultraviolet radiation (UVR):

(1) is the part of sunlight which causes sunburn and skin damage leading to premature ageing and skin cancer. Damage to the skin occurs as soon as skin is exposed to UVR. Sunburn is the extreme form of this damage. The effects of UVR on the skin are cumulative so the damage is building up even without burning

(2) cannot be felt or seen. It is not related to, or indicated by, heat, high temperatures or light, and therefore can be present even on a cloudy day. Light-coloured and shiny surfaces, such as sand, snow, concrete and water, all reflect UVR

(3) intensity can be measured by the Ultraviolet (UV) Index - the higher the Index value, the greater the potential for damage to your skin and risk of developing skin cancer.

4. What are the main risk factors for skin cancer?

Anyone in the UK can develop skin cancer but risk is increased for people who:

• are exposed to ultraviolet radiation (UVR) during childhood and adolescence
• have repeated exposure to UVR over their lifetime
• have episodes of severe sunburn
• have a light complexion (red or fair hair; blue or green eyes; skin that burns easily, freckles and doesn’t tan)
• are older
• have a had a previous non-melanoma skin cancer (NMSC)
• have a personal or family history of melanoma
• have a large number of moles
• have unusual types of moles (eg dysplastic naevus)
• are immunosuppressed (including organ transplant recipients)

5. Is it possible to develop skin cancer if your skin does not burn?

Yes. Anyone can develop skin cancer regardless of whether or not their skin burns. Although people with fair skin are at a greater risk of developing skin cancer, people with tanned skin are also at risk of developing skin cancer if they do not protect their skin when going outdoors.

6. Does a tan provide protection against developing skin cancer?

No. Any form of a tan which has been obtained from exposure to UVR (from natural or artificial sources) increases your chances of premature ageing and developing skin cancer. People with naturally tanned or darker skin have very limited protection to UVR (roughly equivalent to SPF2 sunscreen) and will still need to protect their skin when going outdoors. Fake tanning products do not offer protection against the risk of developing skin cancer. Some fake tanning products do contain sunscreen, but this will at most only offer protection for a few hours after application of the product.

7. Is it possible to safely obtain a tan from exposure to ultraviolet radiation?

No. Any form of a tan from UVR (whether from the sun or artificial devices such as solaria) will damage your skin and increase your risk of developing skin cancer.

8. Are solaria or sunbeds a safe way to tan?

No. Solaria and sunbeds emit UVR and increase your risk of developing skin cancer.

9. Do you only need to protect yourself from the sun when it is hot and sunny?

No. UVR, which causes sunburn and skin damage, cannot be felt or seen. It is not related to, or indicated by heat, high temperatures or light, and therefore can be present days when it is not hot and sunny (such as cloudy, hazy or breezy days).

10. Can you only be harmed by the sun during the middle of the day?

No. You can be harmed by the sun anytime during the day (especially when the UVR is high). In general, the most dangerous times to be out in the sun are 10am - 2pm, when the UVR level is at its highest.

12. Is it only old people that need to look for changes in their skin?

No. People of all ages need to regularly check their skin for changes as skin cancer does not affect only old people. In fact, melanoma is the most common cancer for the 15-24 year old age group.

Source: Cancer Council of Australia