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Skin Cancer: Causes, Symptoms and Treatment

Skin cancer is one of the most common cancers worldwide, caused by the uncontrolled growth of skin cells. Early detection significantly improves treatment outcomes and survival rates.

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Things worth knowing about "Skin Cancer"

Skin cancer is one of the most common cancers worldwide, caused by the uncontrolled growth of skin cells. Early detection significantly improves treatment outcomes and survival rates.

What is Skin Cancer?

Skin cancer refers to a group of malignant tumours that develop from the cells of the skin. It is among the most prevalent cancers globally. The skin is the body's largest organ and serves as a protective barrier against external factors. When skin cells are damaged and begin to grow uncontrollably, skin cancer can develop.

Types of Skin Cancer

There are three main types of skin cancer:

Basal Cell Carcinoma (BCC): The most common type of skin cancer. It grows slowly and rarely spreads to other parts of the body, but can damage surrounding tissue if left untreated.
Squamous Cell Carcinoma (SCC): Arises from the upper layers of the skin and can metastasise if not treated promptly.
Malignant Melanoma: The most dangerous form of skin cancer. It originates in the pigment-producing cells (melanocytes) and has a high tendency for early metastasis.

Causes and Risk Factors

The primary cause of skin cancer is exposure to UV radiation from sunlight or tanning beds. Additional risk factors include:

Fair skin, light eyes, and light hair
History of sunburns, especially during childhood
Family history of skin cancer (genetic predisposition)
Immunosuppression (e.g., after organ transplantation)
Exposure to chemical substances such as arsenic
Chronic skin conditions or scarring
Advanced age

Symptoms

Symptoms of skin cancer vary depending on the type of tumour. Common warning signs include:

New or unusual skin growths or changes
Moles that change in colour, shape, size, or border
Sores that do not heal
Itching, bleeding, or crusting at a skin site
Shiny, pearly nodules (typical of basal cell carcinoma)

When examining moles, the ABCDE rule is a useful self-assessment tool: Asymmetry, Border (irregular), Colour (multiple shades), Diameter (larger than 5 mm), Evolution (changes over time).

Diagnosis

Skin cancer is diagnosed through the following methods:

Dermatoscopy: A non-invasive examination using a dermatoscope (epiluminescence microscope) to assess suspicious skin lesions in greater detail.
Biopsy: A tissue sample is taken for histological (laboratory) examination to confirm the diagnosis.
Imaging procedures: Ultrasound, CT, or MRI scans are used when metastasis is suspected.

Regular skin cancer screening is recommended, particularly for individuals with risk factors. Many healthcare systems offer structured screening programmes.

Treatment

Treatment depends on the type, size, and stage of the tumour:

Surgical excision: The most common treatment method. The tumour is removed with a margin of healthy tissue.
Radiation therapy: Used when surgery is not possible or as an adjunct to surgery.
Immunotherapy: Particularly relevant for malignant melanoma, where checkpoint inhibitors activate the immune system to target and destroy cancer cells.
Targeted therapy: Medications that attack specific mutations within the tumour (e.g., BRAF inhibitors for melanoma).
Chemotherapy: Less commonly used for skin cancer today, but may be an option in advanced cases.
Cryotherapy and topical treatments: For precancerous lesions (e.g., actinic keratosis), cryotherapy or topical creams (e.g., imiquimod) may be applied.

Prevention

Skin cancer can often be prevented through consistent sun protection:

Use of sunscreen with a high sun protection factor (SPF 30 or higher)
Avoiding intense sunlight between 11 a.m. and 3 p.m.
Wearing protective clothing, hats, and sunglasses
Avoiding the use of tanning beds
Regular self-examination of the skin and participation in skin cancer screening programmes

References

World Health Organization (WHO): Ultraviolet radiation and the INTERSUN Programme. Geneva, 2023.
American Academy of Dermatology (AAD): Skin Cancer - Overview and Guidelines. 2023.
National Cancer Institute (NCI): Skin Cancer Treatment (PDQ) - Health Professional Version. Bethesda, 2023.

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