Skin cancer occurs when there are abnormalities or uncontrolled growth of cells in the skin tissues. This uncontrolled growth is a result of mutations in otherwise healthy cells. Though skin carcinoma can occur at any location in the body, it is often found in parts that are exposed to the sun's ultraviolet rays, for example, the neck, face, arms, and legs.
As the name suggests, skin cancer refers to unwanted and uncontrolled changes in the healthy cells of the skin. The biggest risk factors for skin carcinoma include overexposure to the sun's UV rays, a weak immune system, and exposure to specific chemicals.
There are different types of skin cancer; some are common, while others are rare. Skin cancer is broadly classified into melanoma skin cancer and non-melanoma skin cancer, and non-melanoma type is further classified into basal cell carcinoma and squamous cell carcinoma.
Skin carcinoma is one of the top 20 cancers worldwide. It is not a very common type of cancer in India. Skin carcinoma can affect any age groups, however, its risk is found to increase with age. All the three main types of skin cancer are relatively more common among individuals aged above 50.
Here is detailed information on the different types of skin cancer:
There are three common types of skin cancer affecting patients: basal cell skin cancer, squamous cell skin cancer, and melanoma skin cancer.
Basal cell carcinoma, or BCC, is one of the most common skin cancer types that initiates in the epidermis' basal cells. The epidermis is the outermost layer of the human skin. BCCs are basically slow-growing tumors and rarely metastasize. However, it is important to receive appropriate treatment in order to reduce the risk of advanced-stage skin cancer. These cancerous cells appear as pinkish or flesh-colored skin patches and shiny sores, which do not heal easily. The most effective way to reduce the risk of basal cell carcinoma is to protect the skin from sunburn.
Squamous cell carcinoma, or SCC, refers to a type of skin cancer that develops from squamous cells. These squamous cells are thin and flat in appearance and are found in the human skin's outermost layer. This type of cancer is more aggressive than BCC and appears as crusty or scaly lesions on the skin. These lesions or sores can be pinkish or reddish in color and tend to grow on areas that are sun-exposed, such as the neck, arms, and back of the hands. Also, squamous cell skin cancer grows more rapidly as compared to BCC cancer and, if left untreated, can spread to nearby body parts and lymph nodes.
Melanoma is another common skin cancer type that begins in melanocytes. The melanocytes are responsible for producing melanin in the skin. Melanin is a pigment that gives color to human skin. When the DNA of the melanocyte cells is damaged, it leads to abnormal division of melanoma cells, which may, over time, lead to the formation of cancerous mass. Melanoma is an aggressive form of skin cancer. Risk factors for the growth of this particular skin cancer include overexposure to the sun's ultraviolet rays, specific genetic conditions, a history of sunburns, and a weak immune system.
In addition to the common types of skin cancer, there are some rare skin cancer types as well, and these include:
A rare and aggressive form of skin carcinoma, Merkel cell carcinoma, initiates in the Merkel cells. Merkel cells are a type of nerve cell that is located at the end of the skin's nerve endings. This type of cancer appears as painless, red-colored or flesh-colored bumps that, if not treated on time, can grow quickly and spread to other essential body organs, such as the lungs, liver, etc.
Sebaceous gland carcinoma is a rare skin carcinoma type that originates in the sebaceous glands, or oil glands, in the skin. This type of cancer mostly affects people over the age of 60 and usually appears on the eyelids, scalp, and face.
Dermatofibrosarcoma protuberans is a rare and slow-moving cancer that grows in the body's connective tissues. This type of cancer is prevalent among people who are between the ages of 20 and 40.
Kaposi sarcoma is a type of skin carcinoma that develops in the blood vessels and lymphatic vessels. This type of cancer can occur in the mouth, internal organs, and skin, and it is connected with the infection caused by the human herpesvirus 8 (HHV-8).
Getting a clear picture of the extent of the spread of skin cancer is highly useful in arriving at a definitive diagnosis and treatment of the cancer. Here are the skin cancer stages as per the staging process.
An early-stage skin cancer, stage 0 skin cancer, is considered to be an 'in situ' cancer. This is the earliest stage of skin cancer, wherein cancerous cells are confined to the skin's top layer only. Surgery is often the main line of treatment for stage 0 skin cancer.
In stage 1 skin cancer, the cancerous cells break through the topmost layer of the skin, called the epidermis, and start growing into the dermis. The dermis is the skin's deeper layer. Though stage 1 is a little more advanced than stage 0, it is still considered one of the early-stage skin cancers.
In stage 2 skin cancer, the cancerous cells grow deeper into the skin and affect the nearby tissues. However, the cancer at this stage does not affect the lymph nodes or other essential organs.
Stage 3 skin cancer is an advanced stage in which the cancerous cells are known to move away from the cancer's original site and invade the nearby lymph nodes.
Stage 4 skin cancer is known to be the most advanced stage of skin carcinoma. In this stage, the cancer cells spread to other essential organs, such as the lungs, liver, and brain. The cancer at this stage is also known as metastatic skin cancer.
Skin cancer symptoms may vary depending on the type of skin cancer that an individual has been diagnosed with. There may be a variety of changes in the skin that are indicative of skin carcinoma. It is important for one to keep an eye on these changes and promptly see a doctor when something is not normal.
The three main types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma. All three types have their own set of signs and symptoms, which also helps the doctors distinguish between them.
Also, having a clear understanding of these signs and symptoms of skin cancer can help doctors arrive at a proper diagnosis of the disease and line up an effective treatment.
Though carcinoma of the skin can affect any age group, some people are at a higher risk of getting the disease than others. Individuals who stay in the sun for long hours and are overexposed to ultraviolet rays, those with a fairer skin complexion, those with a history of skin carcinoma, and some medical conditions such as albinism are found to have a higher risk of developing skin cancer.
Here are some common signs of skin cancer that should be paid attention to, and those having these signs and symptoms should promptly see a doctor for a conclusive diagnosis.
Any unusual change in the mole, such as its size, shape, or color, is one of the most important skin cancer symptoms. It is also one of the most common melanoma symptoms. If the mole has irregular borders, has different color variations, or has an asymmetry in its appearance, it needs to be checked by a doctor.
The development of new and changing skin lesions could also be a warning sign of skin cancer. That said, not all skin growths are cancerous.
Sores that are not healing lately could also be one of the common skin cancer symptoms that should not be ignored. These non-healing or persistent sores could be a sign of a specific skin cancer type, such as squamous cell carcinoma.
Again, red-colored or scaly patches are counted as squamous cell carcinoma symptoms and need to be checked immediately.
Itching or pain can also be counted as a common skin cancer symptom, though it may be associated with other skin issues as well.
Another significant symptom of skin cancer can be a change in the already present skin lesions, such as moles.
Ulceration refers to the growth of the skin's open sore and is considered to be one of the major skin carcinoma symptoms.
Elevated bumps or any kind of raised and unusual growth on the skin are also common signs of skin cancer.
The spread of pigment within already present skin lesions or moles can be one of the most significant and concerning melanoma symptoms.
Tenderness is not a major symptom of skin cancer, especially in the early stages. However, some skin cancer types can result in tenderness in their later stages.
Here are the different types of skin cancer and their associated symptoms.
Basal cell carcinoma symptoms include any kind of new growth on the skin, flesh-colored pinkish, shiny bumps that may be similar to a pearl, raised or elevated bumps, ulceration, and a growth similar to wrath on the skin.
Squamous cell carcinoma symptoms include red or pink-colored bumps, which often resemble a sore or a wart, lesions with irregular borders, changes in already existing lesions, and scaly patches.
Melanoma symptoms include changes in the mole, such as its size and color, bleeding ulcerations, non-healing sores, changes in the texture of the mole, and the spread of pigment.
Merkel cell carcinoma symptoms include reddish or blue-colored nodules, enlarged nodules over a short span of time, firm and painless nodules, and ulcerations.
Kaposi sarcoma symptoms include red or purple-colored painless lesions, difficulty swallowing, breathing issues, and gastrointestinal symptoms.
Though it is known that the major reason for skin cancer is mutations in the skin cells, the actual cause of these mutations is not known. Thus, there is no reliable answer to the question, 'what causes skin cancer?' However, there are certain risk factors that increase the chances of skin cancer development.
Overexposure to the sun's ultraviolet rays is known as one of the potential skin cancer causes. Ultraviolet rays are known to damage the DNA of healthy skin cells, increasing the chances of getting carcinoma of the skin.
Tanning beds and lamps also expose the human skin to ultraviolet radiation, thereby increasing the chances of getting skin cancer.
Individuals with fair skin have less melanin pigment, and therefore do not get proper protection from ultraviolet rays. Thus, fair skin is also regarded as one of the possible skin cancer causes.
Possessing moles in large quantities also increases the risk of developing skin cancer, especially melanoma.
Just like any other cancer, a family history of skin carcinoma also increases the risk of getting skin cancer.
A personal history of skin cancer is also a major factor in increasing the chances of developing it.
Individuals with a weak immune system, such as those suffering from HIV/AIDS, are also at risk of getting skin carcinoma.
Overexposure to carcinogens, such as arsenic, coal tar, certain organic solvents, etc., also increases the chances of getting skin cancer.
Exposure to radiation beams through radiation therapy is also among the possible skin cancer causes.
Though skin cancer can occur at any age, people over 50 are at an increased risk of developing it.
Regular visits to the dermatologist, especially if you have any of the risk factors for skin cancer, are effective in the early diagnosis and potential prevention of skin cancer. Also, if you have any suspicious moles or lesions on the skin or any other symptoms of skin cancer, it is necessary to see a doctor.
Skin cancer diagnosis begins with suspicion and includes certain steps doctors adopt. The diagnosis or screening for skin cancer revolves around checking whether the suspicious lesion or mass under the skin is cancerous.
An early diagnosis is always helpful in treating cancer successfully, and thus, doctors often advise getting regular screening done.
Here are some common procedures or skin cancer tests done for a detailed diagnosis.
A visual or physical examination for skin cancer diagnosis involves evaluating and assessing any kind of lesions or scars on the skin, especially non-healing sores. During the physical examination, the doctor also gathers information about the patient's overall health, medical history, and family history, if any.
Dermatoscopy implies the use of a dermatoscope, which is a device with magnifying and lighting features. The dermatoscopy helps the doctor examine the lesions and differentiate between malignant and benign ones.
A skin biopsy is a skin cancer diagnosis method that is used to determine the presence of cancerous cells, if any. Also, a skin biopsy is useful for knowing the type and stage of skin cancer. There are five main types of skin biopsy:
A shave biopsy involves the use of sharp instruments such as scalpels or razors to shave off the topmost layer of the skin lesion for diagnosis purposes.
A punch biopsy involves making use of a small, circular tool that is used to collect samples of tissue from the lesions for proper diagnosis.This procedure can also be used to obtain samples of deeper skin layers.
An excisional biopsy involves removing the entire skin lesion along with a small portion of surrounding healthy tissues
An incisional biopsy involves removing only a portion of the lesion and examining it.
The sentinel lymph node biopsy is used to determine whether the skin cancer has spread to the lymph nodes or not. During this procedure, a radioactive tracer is injected into the area near the cancer, which then travels to the nearby lymph nodes. The doctor then removes the sentinel lymph nodes and examines them under a microscope.
In addition to the skin biopsy, doctors may even go for imaging tests to get a clear demarcation of the cancerous skin lesion. These imaging tests help in determining the type and stage of skin cancer.
A CT scan makes use of X-rays to create detailed cross-sectional images of the human body and is helpful in determining the extent of the spread of cancer.
X-rays are not used for skin cancer diagnosis but can be helpful in knowing the extent to which the skin cancer has spread in the body.
MRI uses magnetic fields as well as radiowaves to create elaborate images of the human body. An MRI is helpful in knowing if the cancer has spread to body parts such as the brain or spine.
Molecular testing involves assessing and analyzing the molecular and genetic aspects of the cancerous cells to get detailed information about the type, size, and possible effective treatment for the skin cancer.
Microscopic examination involves studying and examining the tissue samples gathered through skin biopsy or excisions for an effective skin cancer diagnosis.
There are basically no specific skin cancer blood tests available. Reports suggest that advanced melanoma can alter certain blood parameters, and therefore, in such cases, certain blood tests may be recommended to evaluate these parameters.
Lymph node evaluation is an integral step in skin cancer diagnosis, especially melanoma. This examination is used to check whether the cancer has spread from the primary lesion to the lymph nodes or not.
In some cases, genetic testing may be recommended for skin cancer diagnosis. Genetic testing is done to look for any kind of mutation or abnormality in skin cells that could indicate skin cancer. Genetic testing plays a significant role in melanoma diagnosis.
There are multiple skin cancer treatments available for the effective management of the disease. However, the adoption and success of each of these treatments depend upon the size, shape, and extent of cancer's spread in the body.
Topical treatments involve the use of medications that are applied directly to the skin to treat different types of skin cancer.
Imiquimod, or Aldara, is a topical cream that is used for treating basal cell carcinoma and helps stimulate the body's immune system to recognize and kill cancerous cells.
5-Fluorouracil, or 5-FU, is a cream that is responsible for interfering with the uncontrolled growth of cancerous cells.
Surgery is often the first line of treatment for localized skin cancers and involves the surgical removal of cancerous cells from the skin.
Excision surgery involves the surgical removal of cancerous skin lesions along with a portion of nearby healthy tissues (margin).
Another commonly adopted line of skin cancer treatment is Mohs surgery, which involves the removal of cancerous cells layer by layer. An effective type of Mohs surgery is Mohs micrographic surgery, which makes use of a microscope to examine the tissues that have been removed. This helps the doctor examine the edges of the cancerous cells in a precise manner.
Curettage and Electrodesiccation are two effective skin cancer treatment methods that are used for treating non-melanoma skin cancers. Curettage implies scraping the skin cancer cells, while Electrodesiccation implies using electric current to destroy the remaining cancerous cells and stop bleeding.
Lymph node removal is a treatment that involves removing one or more of the affected lymph nodes. This line of skin cancer treatment is adopted when it is found that the cancer has spread to the nearby lymph nodes and other nearby organs.
As the name suggests, radiation therapy uses radiation to target and then destroy cancerous cells present on the skin. This skin cancer treatment is used primarily for basal cell carcinoma and squamous cell carcinoma.
Cryotherapy is a skin cancer treatment that uses extreme cold conditions to freeze and then destroy the cancerous skin cells.
Photodynamic Therapy, or PDT, makes use of a photosensitizing agent and a special light to target the cancerous cells present on the skin.
Topical treatments involve the use of medications that are applied directly to the skin to treat different types of skin cancer.
Imiquimod, or Aldara, is a topical cream that is used for treating basal cell carcinoma and helps stimulate the body's immune system to recognize and kill cancerous cells.
5-Fluorouracil, or 5-FU, is a cream that is responsible for interfering with the uncontrolled growth of cancerous cells.
Targeted therapy makes use of drugs to interfere with the genetic or molecular abnormalities that are responsible for cancerous cell growth.
Immunotherapy makes use of the human body's immune system to target and kill cancerous cells on the skin. It is primarily used for treating melanoma by boosting the body's ability to destroy cancer cells.
Chemotherapy is a line of treatment that uses drugs to target and kill cancerous cells. Chemotherapy for skin cancer is highly effective in treating cancer that has spread to other parts of the body. Chemotherapy for melanoma has also been found to have good clinical outcomes.
Biological therapy works by targeting certain molecules present in cancerous cells to increase the body's ability to fight cancer.
Precision medicine implies using tailored medical approaches toward skin cancer treatment while emphasizing the genetic, molecular, and clinical aspects of each patient.
Enrolling in skin cancer treatment clinical trials can help patients access the latest skin cancer treatments that are not yet available to the general public. The clinical trials include studies and research on new medications, therapies, drugs, and treatment options that can be helpful in skin cancer treatment. Clinical trials can be helpful for patients who have exhausted their treatment options.
When it comes down to making a choice for an effective skin cancer diagnosis and getting the right advice regarding a successful treatment, it is important to choose the right specialist. At HCG, we have a dedicated team to diagnose, treat, and manage skin cancer cases. We use new-age diagnostic and treatment protocols to diagnose and treat skin cancer appropriately. Along with providing the best treatment, we also help patients manage the side effects of the treatment and improve their quality of life in every way possible.
Skin cancer is a result of mutations and damage in the DNA of the otherwise healthy cells of the skin. However, what leads to these mutations is not known to date. However, there are some skin cancer risk factors that can increase the chances of getting the disease. These risk factors imply different conditions that can favor the development of cancerous cells in the skin and lead to skin cancer.
Getting a clear understanding of these risk factors helps to find an effective solution for 'how to avoid skin cancer.'
Here are some of the most common skin cancer risk factors that go a long way in designing a productive line of treatment for each individual.
Exposure to the ultraviolet rays coming from the sun is known to be a significant risk factor for skin carcinoma. These UV rays can penetrate the outer layer of the skin and cause damage to the DNA of the skin cells. In addition, these UV rays can lead to the creation of DNA lesions, which then interfere with the DNA's normal functioning. Also, these UV rays possess the power to suppress the human body's ability to recognize and damage cancerous cells.
Indoor tanning is also one of the major skin cancer risk factors that should not be ignored. People who start tanning at a younger age via tanning beds and booths are at a higher risk. These indoor tanning platforms radiate UV rays, which can damage the DNA of healthy skin cells.
Fair skin's sensitivity to the sun's ultraviolet rays and lower levels of melanin make it a high-level risk factor for skin carcinoma. Also, fair skin is more susceptible to the DNA damage inflicted by ultraviolet rays.
As overexposure to the sun's ultraviolet rays is a significant risk factor for developing skin cancer, so is a history of sunburns. Sunburns imply that the individual's skin has been subjected to excessive ultraviolet ray exposure.
Family history is also among the known skin cancer risk factors, as inherited genetic mutations make individuals more vulnerable to the disease. Also, shared environments and hereditary skin types, such as fair skin, contribute to the increased chances of getting the carcinoma.
Individuals who have a history of skin cancer and sunburns also have increased chances of getting carcinoma of the skin. The history of skin cancer makes the human immune system weak, which can increase the chances of getting the disease back, especially melanoma.
Though most moles, also called nevi, are benign and pose no threat of cancer, some moles that undergo changes, such as atypical nevi, can increase the risk of getting cancer. Atypical moles are those with irregular shapes, sizes, and colors and are susceptible to developing skin cancer.
A weak immune system implies that the body's ability to fight infections and cancerous cells is compromised. Many diseases, such as HIV/AIDS, can lead to a weak immune system, which can further become a risk factor for skin cancer.
Certain skin cancer types, such as basal cell carcinoma and squamous cell carcinoma, are associated with increased age. As people age, their skin becomes more susceptible to exposure to the sun's ultraviolet rays, which can lead to the development of cancerous cells.
Another skin cancer risk factor is geographic location, as it can lead to variations in exposure to ultraviolet radiation. Places that are closer to the equator get more sunlight as compared to others, and places located at a higher altitude get more UV exposure.
Another skin cancer risk factor is ionizing radiation exposure, which involves different sources of radiation. For example, medical procedures, such as X-rays and CT scans, occupational exposure, such as nuclear energy and radiography, and environmental radiation, such as the presence of radiation in the soil and water, also increase the risk of developing skin cancer.
Chemical exposure, especially in cases where there may be exposure to certain carcinogenic chemicals, is also considered one of the most important skin cancer risk factors. For example, arsenic, polycyclic aromatic hydrocarbons, or PAHs, aromatic amines, and chemicals that hold the potential to absorb ultraviolet rays are harmful and should be avoided.
HPV, or Human Papillomavirus, is a group of viruses that can lead to the development of genital warts. These genital warts are a major risk factor for squamous cell carcinoma.
Merkel cell polyomavirus, or MCV, is also associated with increasing the risk of getting Merkel cell carcinoma, or MCC.
Specific medications that make the skin more vulnerable to ultraviolet radiation from the sun, known as photosensitivity, can also be a risk factor for developing carcinoma of the skin.
Although there is no exact answer to 'how to prevent skin cancer,' there are some measures that one can take to reduce their skin cancer risk. It is important to note that these measures do not prevent skin cancer but only reduce its risk.
As ultraviolet rays from the sun are considered a major risk factor for skin cancer, getting adequate skin protection can significantly help.
An effective way of getting adequate protection from the sun's ultraviolet rays is by using sunscreen. It creates a barrier that reduces the risk of damage induced by the sun's rays to the skin.
Seeking shade whenever there is a high risk of getting exposed to the sun's harmful UV rays is an effective way of protecting the skin against cancer.
Lastly, one may opt for wearing proper and protective clothes to prevent the skin from getting damaged by the sun's ultraviolet rays.
As tanning beds emit dangerous ultraviolet rays, it is recommended to avoid these beds altogether as a potential skin cancer prevention method.
If an individual has any of the skin cancer risk factors, it is advisable to go for skin cancer screening every year.
As proper hydration is effective in maintaining healthy skin, it can indirectly help in possible skin cancer prevention, too.
Smoking introduces many harmful toxins into the body, which can have an adverse effect on the organs, including the skin. Refraining from smoking can be helpful in reducing the risk of skin cancer.
Skin cancer is one of the most common types of cancer and often requires immediate medical attention. Depending on the cell type that it originates from, skin cancer is classified into various types. Some skin cancer types are more aggressive than others. Thus, it is advisable to consult a doctor as soon as any of the symptoms of skin cancer appear.
