Skin cancer (non-melanoma)

About

Skin cancer (non-melanoma) is the most common form of skin cancer and is usually caused by sun exposure. It typically appears as a bump or discolored spot on the skin that can be red, pink, brown, or black. It can sometimes appear as a sore that will not heal. It is most commonly found on areas of the body that are exposed to the sun such as the face, hands, neck, or arms. At its earliest stages, it is usually easy to treat with simple methods such as freezing or cutting the cancerous tissue away. Early detection is important as skin cancer can become more aggressive if left untreated and can eventually spread to other areas of the body.

It is important to take precautions to protect yourself from the sun and to regularly check your skin for any changes or moles. If any suspicious changes are found, it is important to contact your doctor immediately for a professional assessment.

Symptoms

The symptoms of non-melanoma skin cancer vary depending on the type of cancer and its location, but common signs may include:

  • A change in the size, shape, or color of an existing mole
  • A patch of skin that is red, scaly, or swollen
  • A sore that does not heal
  • Itchy or tender skin
  • A lump or growth
  • A sore with a raised border and crusted middle
  • Unusual bleeding or discharge from the skin

Causes

The known causes of non-melanoma skin cancer are primarily exposure to ultraviolet (UV) radiation from the sun or other sources such as tanning beds or sun lamps. Other risk factors include age, sex, skin type, and family history. Long-term, repeated exposure to certain industrial chemicals and substances such as arsenic, coal tar, and creosote may also increase the risk of developing non-melanoma skin cancer.

Risk factors

The risk factors for non-melanoma skin cancer include:

  • Excessive exposure to ultraviolet (UV) radiation from sources such as the sun or tanning beds.
  • Having naturally fair skin, light eye color, and/or hair color.
  • A family history of skin cancer.
  • Having a weakened immune system or undergoing treatments such as immunosuppressive drugs or radiation therapy.
  • Multiple or severe sunburns, especially during childhood.
  • Certain skin conditions such as actinic keratoses, which can be a precursor to certain types of non-melanoma skin cancer.
  • Long-term, heavy use of certain chemotherapeutic or immunosuppressive drugs.
  • Chronic exposure to compounds such as arsenic, coal, paraffin, and creosote.
  • Previous treatments for other skin cancers.

Diagnosis

Skin cancer (non-melanoma) is typically diagnosed through a physical examination and biopsy of the affected area. During the physical examination, a doctor will look for any suspicious spots on the skin that may indicate skin cancer. They may also use a dermatoscope, which is a special magnifying tool, to get a closer look at the area and take pictures of any suspect spots.

A biopsy is the next step in diagnosing non-melanoma skin cancer. This involves taking a sample of cells or tissue from the suspicious area on the skin and examining it under a microscope. The doctor will check for any cancerous cells in the sample. Once the doctor has confirmed the presence of cancer, they will determine the type of skin cancer and the best course of treatment.

Sub-types

Non-melanoma skin cancer is a broad term used to refer to any type of skin cancer that is not melanoma. There are two main types of non-melanoma skin cancer; basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).

Basal cell carcinoma (BCC) is the most common form of skin cancer and typically appears as small, pearly bumps on the skin. These lesions often appear on the face and neck, but can appear anywhere on the body. They may also be found on sun-exposed areas such as the scalp and ears. BCC is easily treatable and rarely metastasizes to other parts of the body.

Squamous cell carcinoma (SCC) is the second most common type of skin cancer and appears as scaly patches or raised bumps. These lesions often form in sun-exposed areas of the body such as the face, neck, and hands. SCC is more likely to spread to other parts of the body than BCC, and therefore needs to be monitored and treated more closely.

Other types of non-melanoma skin cancer include Kaposi sarcoma, Merkel cell carcinoma, and cutaneous T-cell lymphoma. These types of skin cancer are less common but can be more aggressive and difficult to treat.

Treatments

There are several different treatment options available for non-melanoma skin cancer depending on the type, size, and location of the cancer, as well as the patient’s overall health.

Some common treatments include:

  • Surgery: Surgery is usually the first line of treatment for non-melanoma skin cancer and may involve the removal of the cancerous tissue or the entire tumor.
  • Topical therapy: This type of treatment involves applying chemotherapy, immunotherapy, or other drugs directly to the skin.
  • Radiation therapy: This type of therapy uses high-energy X-rays to kill cancer cells.
  • Photodynamic therapy: This treatment uses a photosensitizing drug and a specific type of light to kill the cancer cells.
  • Cryosurgery: This type of treatment involves freezing the cancer cells using liquid nitrogen.
  • Mohs surgery: This is a specialized type of surgery that requires the removal of thin layers of cancer cells.

Prevention

  1. Avoid prolonged exposure to the sun, especially between the hours of 10 a.m. and 4 p.m. when the sun’s rays are strongest.
  2. Use sunscreen with a Sun Protection Factor (SPF) of 30 or higher whenever you are outdoors. Reapply the sunscreen every 2 hours and after swimming or sweating.
  3. Wear protective clothing, such as a long-sleeved shirt, wide-brimmed hat, and sunglasses with UV protection.
  4. Be aware of UV exposure from other sources such as tanning beds, sunlamps and other artificial light sources that can cause skin cancer. Avoid indoor tanning and use a good sunscreen even when you are indoors.
  5. Perform regular self-examinations of your skin to look for any suspicious moles or skin lesions. If you see anything that worries you, contact your doctor.
  6. Talk to your doctor about getting regular skin exams to check for signs of skin cancer.

Gender differences?

Gender-specific differences in the presentation or management of skin cancer (non-melanoma) have not been well established. However, a few studies have suggested that men may have a slightly higher risk of developing skin cancer than women, especially when the type of skin cancer is squamous cell carcinoma. Additionally, it has been suggested that women may be more likely to present with tumors that are larger in size, which may lead to a greater number of surgical treatments and a greater likelihood of requiring reconstructive surgery. Conversely, men may be more likely to receive lower doses of chemotherapy and radiation therapy than women, likely due to both the size of the tumor and the existing differences in the risk of skin cancer between genders. Finally, there is a higher prevalence of skin cancer in people of color, particularly African Americans, and it has been suggested that men of color may have lower survival rates than women of color.

Nutrition

Nutrition plays an important role in the management of non-melanoma skin cancer. Eating a balanced diet, including plenty of fruits and vegetables, can help maintain a healthy immune system, which is necessary for fighting off cancer cells. Foods that are high in antioxidants such as green tea, berries, and citrus fruits are especially beneficial for reducing cellular damage from free radicals. Additionally, omega-3 fatty acids found in fish, nuts, and some vegetable oils can help reduce inflammation and minimize tumor growth. Finally, limiting your consumption of processed foods and saturated fats can help reduce the risk of non-melanoma skin cancer.

Physical Activity

Physical activity can affect non-melanoma skin cancer in multiple ways. Studies have suggested that physical activity could reduce the risk of basal and squamous cell carcinomas. This is likely due to increased Vitamin D (from sun exposure) production and improved immune response from exercise. Additionally, physical activity can help people maintain a healthy weight, which may reduce the risk of skin cancer. Obesity has been linked to increased risk of non-melanoma skin cancer and physical activity can help reduce these risks. Additionally, physical activity can reduce oxidative stress which may reduce skin cancer risk as well.

Further Reading

  1. https://www.cancer.net/cancer-types/skin-cancer-non-melanoma/risk-factors-and-prevention
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3339125/
  3. https://www.who.int/news-room/questions-and-answers/item/radiation-ultraviolet-(uv)-radiation-and-skin-cancer
  4. https://www.cancer.org/cancer/basal-and-squamous-cell-skin-cancer.html
  5. https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/skin-cancer-non-melanoma
  6. https://www.cdc.gov/cancer/skin/basic_info/sun-safety.htm
  7. https://www.mayoclinic.org/diseases-conditions/melanoma/symptoms-causes/syc-20374884

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