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Skin cancers
are the most common form of cancer in the West, particularly in people such as
farmers who are exposed to lots of sunlight. One form of skin cancer, malignant
melanoma, can spread to other organs very rapidly. Successful treatment depends
on catching the disease in the early stages.
Cancers
An abnormal
or uncontrolled growth of the cells that make up the skin can be benign or
malignant. If this growth is able to invade neighbouring tissues or spread to
distant organs in the body (metastasise), it is known as malignant.
Types of skin
cancer
The main
types of malignant skin cancer are:
Basal and
squamous cell carcinomas are often grouped together and referred to as
non-melanoma skin cancer. The main risk factor for any type of skin cancer is
exposure to the intense ultraviolet light of sunshine. It is particularly common
in places where the sun is strong, such as Australia, and less common in people
with dark skin.
Factors that
increase the risk tend to have:
-
a family
history of skin cancer
-
skin which
has a lot of moles
-
fair skin and
blue eyes
-
freckles
-
skin that
burns easily
-
skin that has
been badly sunburned in the last five years
-
skin exposed
intermittently to strong sunshine (or sun beds)
The three layers of skin
Normal skin
The skin is made up of three layers: the outer epidermis, the dermis below this
and the supporting subcutaneous layer of loose tissue and fat - see diagram.
Cells in any of these layers can be the origin of a cancerous growth.
Skin
growths
These are not cancers. Benign skin growths include warts, moles, or corns, which
are rarely serious problems. There are other, less common benign skin problems
that can become malignant. These include: Bowen's disease: A pre-cancerous skin
condition which looks like a red scaly area of skin, and is restricted to the
epidermis. If left untreated, it can develop into a squamous cell carcinoma.
Actinic keratosis: This is a small lump of hard skin, commonly seen in areas
exposed to the sun. The condition is usually harmless, but there is a very small
risk of them transforming into squamous cell carcinomas.
Malignant skin cancers
Basal cell carcinoma (BCC) Also known as a rodent ulcer, this is the most common
form of malignant skin cancer. A BCC arises from cells in the epidermis.
Typically it affects only small areas, grows slowly and does not spread to other
tissues. Consequently a BCC is not usually life-threatening. However, if left
untreated, the cancerous cells can grow deeper into the skin. BCCs are
associated with sun-exposure and often affect the face.
Squamous cell
carcinoma (SCC) This is the second most common malignant skin cancer, and in
rare cases it can be life-threatening. They arise from cells in the epidermis
and spread into the surrounding skin, but can also spread to nearby lymph nodes.
SCCs appear as thickened skin, nodules or lumps, or can appear as an ulcer. They
can be caused by sun exposure and certain viruses that affect the skin, and can
occur in old scars. Malignant melanoma This is a particularly dangerous form of
skin cancer and often spreads to other tissues or organs. Although it can
develop from moles in the skin, most melanomas arise from a pigment-producing
cell found in the epidermis. Melanomas resemble moles on the skin, but there are
differences. The following list of features can help distinguish a melanoma from
a normal mole.
-
asymmetry: A
melanoma skin lesion is usually an irregular shape.
-
border: The
outline of a melanoma is ragged rather than smoothly defined
-
colour: There
is a variation of colour within the lesion.
-
diameter: The
lesion is bigger than 6mm across and/or has increased in size recently.
-
elevation:
The lesion is raised above the surface of the skin.
Other
features which may indicate skin cancer include any spot that changes in size,
shape, or colour; itches, bleeds or forms an ulcer. Although these signs do not
necessarily indicate skin cancer, you should visit your doctor to have it
assessed as soon as possible.
How is skin cancer diagnosed?
If skin cancer is suspected, your doctor may recommend a biopsy, which involves
removing a sample of the skin from the affected area for examination under a
microscope. If necessary, you will be referred to a skin specialist
(dermatologist), a cancer specialist (oncologist) or a plastic surgeon. If there
is a risk that the cancer may have spread to other organs, other tests such as
CT or MRI scans, and X-rays may be needed to check for this.
Prevention
Be "sun aware". To reduce the risk of skin cancer, minimise your exposure to the
sun. Always use sunscreens, wear protective clothing and remain in the shade as
much as possible, and especially between 11a.m. and 3 p.m. when the sun is at
its strongest. Don't use sunbeds. Be vigilant: the earlier a skin cancer is
identified and treated then the better the outcome. You should show your doctor
any skin lesion, which is unusual, new or changing shape as soon as possible.
Treatment
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