
Skin cancer is the second most common cancer in the UK with over 40,500
new cases every year. There are three main types of skin cancer: basal
cell carcinoma (BCC), squamous cell carcinoma (SCC) and malignant
melanoma (MM). Due to certain similarities basal cell and squamous
cell carcinoma are often grouped together and referred to as non-melanoma
skin cancer. The prevalence of BCC in the population is 2.1%. BCC
is twice as common as SCC. MMs account for 1-in-10 skin cancers.
Types and Causes
Basal cell carcinoma arises from the cells in the base of the skin
and is the most common skin tumour in the UK. It is usually seen
in caucasians, particularly those with fair complexion, fair hair
and blue eyes. The type of skin affected is almost always hair bearing
skin, though occasionally basal cell carcinoma is found on the soles
of the feet. Most basal cell carcinomas are slow growing and do
not spread. However, if left, they can erode the skin and cause
an ulcer, known as a rodent ulcer.
Squamous cell carcinoma starts in the surface cells of the skin
and is the second most common type of skin cancer in the UK. This
is a slow growing cancer but may spread to other parts of the body
if left untreated. Like basal cell carcinoma, squamous cell carcinoma
tends to occur in caucasians or white skinned people, with more
males than females being affected.
Malignant melanoma, although not the most common form of skin cancer,
does cause the greatest concern as it is curable if found early,
but can be very difficult to cure if it has spread into the deeper
layers of the skin. MM develops in cells known as melanocytes, which
are responsible for the colour of our skin. This type of cancer
usually starts in the skin. Rarely it can arise in other parts of
the body, such as the eye, the mouth, or in the internal organs.
There is strong evidence that ultraviolet (UV) rays from the sun
or sun beds can damage the skin and cause cancer. The likelihood
of developing a skin cancer increases with age and non-melanoma
skin cancer is more common in those over 40 years old.
Certain risk factors have been identified. These include people
who are fair skinned, burn easily in the sun, are red-haired with
freckles, have sunspots (solar keratoses), have had previous skin
cancer and those who work or spend long periods outdoors. The risk
of developing skin cancer can be reduced by cutting down on exposure
to ultraviolet light and increasing protection measures. These include
wearing protective clothing, wide brimmed hats and using a strong
sun block (minimum SPF 15). Children and young adults who are over-exposed
to the sun and suffer blistering or burning are at increased risk
of developing a MM in later life. Very rarely, malignant melanoma
may be due to a genetic or familial tendency to the disease.
Symptoms
Both basal and squamous cell skin cancers can appear anywhere on
the body but are more likely to appear on exposed skin, especially
the face, neck, arms, hands and lower legs. They can appear in a
variety of forms: a small lump on the skin (which is smooth and
pearly or waxy in appearance, or which bleeds, crusts and does not
heal, or is wart-like in appearance); a flat red spot or a firm
red lump.
Most MMs start in normal skin. Others may develop in existing moles.
If it does develop from a mole, changes include: a change in size;
altered shape; change in colour; itching, crusting or bleeding.
People should be encouraged to report any unusual marks on the skin
which last more than a few weeks or an existing mole which shows
any of the above signs.
Many people feel overwhelmed when told they have a diagnosis of
skin cancer. The impact can be particularly devastating if the cancer
is on a prominent part of the body, such as the face, neck or arms/hands.
The prospect of potentially disfiguring treatment can be hard to
cope with. People in this situation need accurate information and
sensitive support to help them understand what is happening.
Treatments
Treatment options include: surgery; electrocautery; cryosurgery;
lymph gland removal; radiotherapy; chemotherapy and, immunotherapy
(for MM). These treatments may be used alone or in combination.
Most people with non-melanoma skin cancer are cured, whilst the
prognosis for MM depends on the depth of the cancer in the skin.
It is important to report a MM early.
For further information contact:
Cancer Research UK PO Box 123 London WC2A 3PX Tel: 020 7242 0200
www.cancerresearchuk.org
Specialist information nurses: 020 7269 3142
Patient information website www.cancerhelp.org.uk
Registered charity number: 1089464
Cancer Research UK is dedicated to research on the causes, treatment
and prevention of cancer.
Have a look at our SunSmart website http://www.cancerresearchuk.org/sunsmart/
for useful information on the dangers of sun damage, and what you
can do to protect yourself.
Wessex Cancer Trusts Marcs Line, Marcs Line Resource
Centre, Dermatology Treatment Centre, Level 3, Salisbury District
Hospital, Salisbury, SP2 8BJ.
Tel: 01722 415071.
Website: http://www.wessexcancer.org/
(part of the Wessex Cancer Trust Cancer Information Network)
For more information and resources for both healthcare professionals
and patients, please visit:
Information reproduced by kind permission of The Skin Care Campaign.
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