Non-melanoma skin cancer Symptoms, Signs, Causes and Treatments

Summary

• Non-melanoma skin cancer is the most common type of skin cancer.
• The two types of non-melanoma skin cancer are basal cell carcinoma and squamous cell carcinoma.
• Common symptoms of non-melanoma skin cancer include changes in the skin, such as new growths or sores that don't heal.
• Early detection is important, and signs to look out for include changes in the size, shape, or colour of a mole or other skin lesion.
• Prevention strategies include wearing protective clothing and sunscreen, avoiding tanning beds, and staying out of the sun during peak hours.

Understanding Non-Melanoma Skin Cancer: An Overview

Non-melanoma skin cancer is a group of cancers that develop in the skin's outermost layer. Unlike melanoma, which originates from pigment-producing cells called melanocytes, non-melanoma skin cancer primarily affects basal and squamous cells. Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the two most common types of non-melanoma skin cancer.

The prevalence and incidence rates of non-melanoma skin cancer vary across different regions and populations. However, it is generally more common in individuals with fair skin, those with excessive sun exposure, and older adults. Other risk factors include a family history of skin cancer, a weakened immune system, exposure to certain chemicals or radiation, and a history of previous skin cancer.

The Two Types of Non-Melanoma Skin Cancer: Basal Cell Carcinoma and Squamous Cell Carcinoma

Basal cell carcinoma (BCC) is the most prevalent type of non-melanoma skin cancer, accounting for approximately 80% of cases. It typically appears as a small, shiny bump or a pinkish patch on the skin. BCC grows slowly and rarely spreads to other parts of the body. However, if left untreated, it can invade nearby tissues and cause disfigurement.

Squamous cell carcinoma (SCC) accounts for about 20% of non-melanoma skin cancer cases. It often manifests as a scaly, red patch or a firm, raised nodule. SCC tends to grow more rapidly than BCC and has a higher risk of spreading to nearby lymph nodes or distant organs. Early detection and treatment are crucial to prevent its progression.

Common Symptoms of Non-Melanoma Skin Cancer

Recognising the symptoms of non-melanoma skin cancer is vital for early detection and prompt medical intervention. Some common signs to look out for include

• Red or pink patch: A flat, scaly and rough patch that may itch or bleed
• Bump or notes: le A firm, raised and smooth bump that may have a pearly or waxy appearance
• Open sore: A sore that doesn't heal or keeps coming back
• Scar-like area: A white or yellowish area that looks like a scar but doesn't go away
• Tender or painful area: An area that may be painful to touch or feel tender

In some cases, non-melanoma skin cancer can cause other symptoms, such as swollen lymph nodes near the affected area or general fatigue. It is important to note that these symptoms may vary depending on the type and stage of the cancer. If you notice any unusual changes in your skin or experience persistent discomfort, it is crucial to consult a healthcare professional for further evaluation.

The Importance of Early Detection: Signs to Look Out For

Early detection plays a pivotal role in successfully managing non-melanoma skin cancer. By recognising the signs and seeking medical attention promptly, individuals can increase their chances of receiving timely treatment, minimising the potential complications associated with advanced stages of the disease.

Some key signs to look out for include any new growths or sores that do not heal within a few weeks, changes in the size, shape, or colour of existing moles or birthmarks, and persistent itching, tenderness, or bleeding in a particular skin area. If you notice any of these signs or have concerns about your skin's health, you should schedule an appointment with a dermatologist or healthcare provider.

Risk Factors for Non-Melanoma Skin Cancer: Who is at Risk?

Several factors can increase an individual's risk of developing non-melanoma skin cancer. While anyone can develop this condition, certain characteristics and behaviours may heighten the likelihood of its occurrence. Some of common risk factors include:

• Advanced age is a significant risk factor, as the skin's ability to repair itself diminishes over time.
• Men are more likely than women to develop non-melanoma skin cancer, possibly due to occupational sun exposure or less frequent use of sun protection measures.
• Fair-skinned individuals, particularly those with red or blonde hair and blue or green eyes, have a higher risk due to their reduced ability to produce protective melanin.
• Family history also plays a role, as individuals with close relatives who have had skin cancer are more likely to develop the condition themselves.
• Additionally, exposure to ultraviolet (UV) radiation from the sun or artificial sources, such as tanning beds, significantly increases the risk of non-melanoma skin cancer.
• Other factors, such as a weakened immune system and exposure to certain chemicals or radiation, may also contribute to an individual's susceptibility.

Causes of Non-Melanoma Skin Cancer: Sun Exposure, Genetics and More

Sun exposure is the primary cause of non-melanoma skin cancer. Prolonged exposure to UV radiation damages the DNA in skin cells, leading to genetic mutations that can trigger the development of cancerous cells. The cumulative effects of sun exposure over time increase the risk of developing non-melanoma skin cancer.

In addition to sun exposure, genetic factors can influence an individual's susceptibility to non-melanoma skin cancer. Certain inherited conditions, such as xeroderma pigmentosum and basal cell nevus syndrome, predispose individuals to develop multiple skin cancers throughout their lifetime. Environmental factors, such as exposure to certain chemicals or radiation, may also contribute to the development of non-melanoma skin cancer in some cases.

The Link Between Non-Melanoma Skin Cancer and UV Radiation

UV radiation is a significant contributor to the development of non-melanoma skin cancer. When the skin is exposed to UV radiation from the sun or artificial sources, such as tanning beds, it can cause DNA damage in the skin cells. Over time, this damage can accumulate and lead to the formation of cancerous cells.

UV radiation consists of UVA, UVB, and UVC rays. UVA rays penetrate deep into the skin and contribute to premature ageing and wrinkling. UVB rays are responsible for sunburns and play a key role in developing skin cancer. UVC rays are mostly absorbed by the Earth's atmosphere and do not reach the surface.

To protect your skin from UV radiation, it is essential to take preventive measures such as seeking shade during peak sun hours, wearing protective clothing, applying broad-spectrum sunscreen with a high SPF, and wearing sunglasses blocking UVA and UVB rays. These measures can significantly reduce your risk of developing non-melanoma skin cancer.

Prevention Strategies: How to Reduce Your Risk of Non-Melanoma Skin Cancer

Reducing your risk of non-melanoma skin cancer involves adopting various preventive strategies that minimise exposure to UV radiation and maintain overall skin health. Here are some tips to help protect your skin:

• Seek shade: When the sun's rays are strongest (usually between 10 am and 4 pm), stay in shaded areas or create shade using umbrellas or wide-brimmed hats.
• Wear protective clothing: Cover your skin with long-sleeved shirts, long pants, and wide-brimmed hats. Opt for tightly woven fabrics that provide better sun protection.
• Apply sunscreen: Use a broad-spectrum sunscreen with a sun protection factor (SPF) of 30 or higher. Apply it generously to all exposed skin, including your face, neck, ears, and hands. Reapply every two hours or more frequently if you are swimming or sweating.
• Avoid tanning beds: Artificial sources of UV radiation, such as tanning beds, can significantly increase your risk of developing skin cancer. It is best to avoid them altogether.
• Examine your skin regularly: Perform regular self-examinations to check for any changes in your skin's appearance. Consult a healthcare professional promptly if you notice any suspicious growth or changes.
• Stay hydrated: Proper hydration helps maintain healthy skin and supports its natural protective functions. Drink plenty of water throughout the day to keep your skin hydrated.
• Eat a balanced diet: A diet rich in fruits, vegetables, whole grains, and lean proteins provides essential nutrients that promote skin health. Antioxidant-rich foods like berries and leafy greens may offer additional protection against UV damage.

By incorporating these preventive strategies into your daily routine, you can significantly reduce your risk of developing non-melanoma skin cancer and maintain the overall health of your skin.

Diagnosis of Non-Melanoma Skin Cancer: What to Expect

If you suspect you may have non-melanoma skin cancer or have noticed any concerning changes in your skin, it is crucial to seek medical attention for a proper diagnosis. A dermatologist or healthcare professional will perform a thorough examination of your skin and may recommend further tests or procedures to confirm the presence of cancerous cells.

During the examination, the healthcare professional will carefully inspect any suspicious areas on your skin, noting their size, shape, colour, and texture. They may use a dermatoscope—a handheld device with magnification and light—to examine the lesions more closely. They may also perform a skin biopsy, which involves removing a small sample of the affected skin for laboratory analysis.

The skin biopsy is then examined under a microscope to determine whether cancerous cells are present and, if so, to identify the type and stage of the cancer. This information is crucial for developing an appropriate treatment plan tailored to your specific needs Options for Non-Melanoma Skin Cancer.

Non-Melanoma Skin Cancer: Surgery, Radiation and More

The treatment options for non-melanoma skin cancer depend on various factors, including the type, size, location, and stage of the cancer, as well as the individual's overall health. The primary goal of treatment is to remove or destroy the cancerous cells while preserving as much healthy tissue as possible.

• Surgery is one of the most common treatment approaches for non-melanoma skin cancer. It involves removing the cancerous growth along with healthy tissue to ensure complete removal. The extent of surgery depends on the size and location of the tumour. In some cases, Mohs surgery—a specialised technique that allows for precise removal of cancerous cells while sparing healthy tissue—may be recommended.
• Radiation therapy is another treatment option for non-melanoma skin cancer. It involves using high-energy X-rays or other types of radiation to kill cancer cells or prevent their growth. Radiation therapy may be recommended if surgery is not feasible or if there is a high risk of recurrence.
• Other treatment modalities for non-melanoma skin cancer include cryotherapy (freezing the cancer cells), topical medications (creams or gels applied directly to the skin), photodynamic therapy (using light and a photosensitising agent to destroy cancer cells), and laser therapy (using focused light energy to destroy abnormal cells).

Treatment choice depends on various factors, and your healthcare provider will work with you to determine the most appropriate approach based on your circumstances.

Mohs Surgery: A Highly Effective Treatment for Non-Melanoma Skin Cancer

Mohs surgery is a specialised surgical technique used to treat non-melanoma skin cancer, particularly when preserving healthy tissue is crucial, such as the face, ears, or hands. It offers a high cure rate while minimising the removal of healthy tissue.

During Mohs surgery, the surgeon removes thin layers of the cancerous tissue one at a time and examines them under a microscope. This process allows for real-time analysis of the margins, ensuring that all cancer cells are removed while sparing as much healthy tissue as possible. The procedure continues until no cancer cells are detected.

Mohs surgery offers several benefits, including a high cure rate (up to 99% for certain types of skin cancer), minimal scarring, and the ability to preserve critical structures, such as nerves and blood vessels. However, it is a specialised procedure that requires expertise and may not be suitable for all cases. Your healthcare provider will determine whether Mohs surgery suits your situation.

As with any surgical procedure, there are potential risks and complications associated with Mohs surgery. These may include bleeding, infection, scarring, nerve damage, or allergic reactions to anaesthesia or medications. Discussing these risks with your surgeon before undergoing the procedure is essential.

Topical Treatments for Non-Melanoma Skin Cancer: Creams and Gels

Topical treatments are an alternative option for non-melanoma skin cancer, particularly for superficial or early-stage lesions. These treatments involve applying creams or gels directly to the affected area to destroy cancer cells or prevent their growth.

The most commonly used topical treatment for non-melanoma skin cancer is imiquimod cream. Imiquimod stimulates the immune system to attack and destroy cancer cells. It is typically applied to the affected area several times a week for several weeks or months, depending on the severity of the condition.

Another topical treatment option is 5-fluorouracil (5-FU) cream. 5-FU works by interfering with the growth of cancer cells. It is applied to the affected area once or twice daily for several weeks. This treatment may cause temporary skin irritation, redness, and crusting.

Other topical medications, such as ingenol mebutate gel and diclofenac gel, may also be used in specific cases. These treatments have varying effectiveness and side effects, and your healthcare provider will determine the most appropriate option based on your circumstances.

Radiation Therapy for Non-Melanoma Skin Cancer: How it Works

Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells or prevent their growth. It is a non-invasive treatment option for non-melanoma skin cancer that can be used when surgery is not feasible or if there is a high risk of recurrence.

During radiation therapy, a machine delivers targeted radiation to the affected area. The treatment is typically administered in multiple sessions over several weeks. Each session lasts only a few minutes, and the procedure is painless.

Radiation therapy damages the DNA of cancer cells, preventing them from dividing and growing. Over time, the damaged cells die off, reducing or eliminating the size of the tumour. Radiation therapy may be used as the primary treatment or in combination with surgery or other treatment modalities.

While radiation therapy is generally well-tolerated, it can cause some side effects. These side effects can vary depending on the treated area and the radiation dose. Common side effects include fatigue, skin changes, and hair loss in the treated area. Other possible side effects include nausea, vomiting, and diarrhoea. In some cases, radiation therapy can also cause long-term complications such as organ damage or secondary cancers. However, these risks are generally low, and the benefits of radiation therapy in treating cancer often outweigh the potential side effects. Patients need to discuss any concerns or potential side effects with their healthcare team to ensure they receive appropriate support and management throughout their treatment.