Skin Cancer
From Risk Factors To Our Treatments
Empower yourself with essential knowledge about the different types of skin cancer, and take proactive steps towards maintaining healthy skin with Carlisle Dermatology Group.
Skin Cancer is a disease in which malignant (cancerous) cells form in the tissues of the skin. Most of these skin cancers develop on the visible outer layer of the skin (epidermis), particularly in sun-exposed areas such as the face, head, hands, arms, and legs.
With regular skin checks to examine your skin, you increase your chances of early treatment and survival.
There are different types of skin cancer, each named for the type of skin cell from which they originate.
The majority of skin cancers fall into one of the following categories:
• Cutaneous T-cell lymphoma (CTCL)
• Merkel cell carcinoma
Skin cancer is classified as low-risk when the affected cells remain confined to a single area, while it is considered high-risk when cells invade surrounding tissues. High-risk cancers necessitate more aggressive treatments.
Most skin cancers begin as small, low-risk lesions but can progress to high-risk lesions if not treated promptly. Melanoma is particularly concerning due to its tendency to invade surrounding tissues and spread (metastasize) before detection. In contrast, squamous cell and basal cell skin cancers are often identified and treated effectively before they become malignant.
Early detection of skin cancer, before it spreads, significantly increases the likelihood of a complete cure.
Skin cancer can be preceded by precancerous lesions, such as actinic keratoses (AKs), which are early forms of squamous cell carcinoma. New or changing moles and other unusual skin lesions should be monitored and discussed with your doctor. Learn more about actinic keratoses here.
Causes of Skin Cancer
- Visible light, infrared radiation, and ultraviolet (UV) radiation are components of sunlight, with UV radiation being carcinogenic. Over 90% of skin cancers are caused by long-term UV exposure.
- UV radiation damages skin DNA, impairing the body's repair mechanisms. This leads to abnormal cell replication, which can result in cancer.
- UV radiation can impair the immune system, hindering its ability to detect and eliminate cancer cells, which allows the cancer to grow unchecked.
- Family history may also play a role in a small percentage of skin cancers, especially melanomas.
Melanin helps block UV radiation, with darker skin offering better protection. Tanning increases melanin but only provides partial protection, even dark skin has limited UV defense. A tan signals skin damage and offers minimal protection from further UV harm.
There are three ways cancer spreads in the body.
When cancer spreads to another part of the body, it is called metastasis (metastatic cancer). Cancer cells break away from where initially began (the primary tumor) and travel through the lymph system or blood.
- Tissue – The cancer can spread from its original location by infiltrating and growing into the surrounding tissues.
- Lymphatic System – The cancer can spread from its original site by entering the lymphatic system. It then travels through the lymph vessels to reach other areas of the body, forming a metastatic tumor.
- Blood – The cancer can spread from its initial site by entering the bloodstream. It then travels through the blood vessels to reach and affect other parts of the body, forming a metastatic tumor.
Melanoma & Nonmelanoma
are the two main forms of skin cancer.
Nonmelanoma
The most common types of skin cancer are basal cell carcinoma and squamous cell carcinoma. Nonmelanoma skin cancers rarely spread to other parts of the body.
Squamous Cell Carcinoma & Basal Cell Carcinoma
Squamous cell carcinoma (SCC) is a type of skin cancer that develops in the squamous cells, which are thin, flat cells found in the outer layer of the epidermis. Basal cell carcinoma originates in the basal cells, which are round cells located beneath the squamous cells of the skin. While these two skin cancers can occur anywhere on the body, it is most commonly found on sun-exposed areas such as the face, neck, and hands.
These cancers often present as lesions that can be raised or flat, and may vary in texture, size, and color. They also appear as sores that will not heal.
Treatment depends on the type of skin cancer or other skin condition diagnosed.
Risk factors
- Being exposed to sunlight, natural & artificial (such as tanning beds)
- Already having actinic keratosis
- Past treatment with radiation
- Having a weakened immune system
- Having a fair complexion (Fair skin that freckles and burns easily / skin that tans poorly or not at all / has blue, green, or light-colored eyes / red or blond hair color).
- Having Gorlin syndrome
Signs & symptoms
Check with your doctor if you have any of the following:
• A raised lump on skin
• A sore that does not heal
• Areas of the skin that are:
- small, raised, smooth, shiny, and waxy
- small, raised, and red or reddish-brown
- flat, rough, red or brown, and scaly
- scaly, bleeding, or crusty
- similar to a scar and firm
Melanoma
Melanoma is a less common but particularly aggressive type of skin cancer that arises from malignant cells in melanocytes, the cells responsible for skin pigmentation.
While it can develop anywhere on the skin, the common areas affected may differ between men and women. In men, it is often found on the trunk (area from the shoulders to the hips), or the head and neck. For women, melanoma often forms on the arms and legs.
Risk factors for melanoma include unusual moles, sun exposure, and individual health history. Key signs of melanoma include changes in the appearance of moles or pigmented areas. Unlike other types of skin cancer, melanoma is more prone to invade surrounding tissues and metastasize to other parts of the body. It can also develop in mucous membranes, which are the thin, moist layers of tissue lining surfaces such as the lips.
Risk factors
- Having a fair complexion (Fair skin that freckles and burns easily / skin that tans poorly or not at all / has blue, green, or light-colored eyes / red or blond hair color).
- Being exposed to natural sunlight or artificial sunlight (such as from tanning beds).
- Being exposed to certain factors in the environment (in the air, your home or workplace, and your food and water). Some of the environmental risk factors for melanoma are radiation, solvents, vinyl chloride, and PCBs.
- Having a history of many blistering sunburns, especially as a child or teenager.
- Having several large or many small moles.
- Having a family history of unusual moles (atypical nevus syndrome).
- Having a family or personal history of melanoma.
- Light skin tone (having a fair-light skin complexion increases the risk of melanoma, but anyone can get it, including people with darker complexions).
- If have a weakened immune system.
- Having certain changes in the genes that are linked to melanoma.
After melanoma has been diagnosed, your doctor may have tests done to find out if cancer cells have spread within the skin or to other parts of the body.
Signs of melanoma include a change in how a mole or pigmented area looks. *Contact your doctor if you have any of the following:
• A mole that...
- The thickness of the tumor & its location in the body
- How quickly the cancer cells are dividing
- Whether there was bleeding or ulceration of the tumor
- How much cancer is in the lymph nodes
- The number of places cancer has spread to in the body
- The level of lactate dehydrogenase (LDH) in the blood
- Whether the cancer has certain mutations (changes) in a gene called BRAF
- The patient's age & general health
• A change in pigmented (colored) skin
• Satellite moles (new moles that grow near an existing mole)
Actinic Keratoses (AKs)
An actinic keratosis is a dry, scaly patch on a sun-exposed area of the skin.
Most people with one actinic keratosis (AK) lesion are likely to develop additional ones. These lesions are the most well-known and common early indicator of skin cancer, and often precede the development of squamous cell carcinoma.
Actinic keratoses are usually scaly, feel like sandpaper, and range in color from skin-toned to reddish-brown. They may be small as the head of a pin or as large as a quarter (or bigger if left untreated). Areas it usually develops on are the scalp, face, forearms, and back of hands.
These lesions can appear in clusters, and many may go unnoticed. They might occasionally itch or become tender, particularly after sun exposure.
When occur on the lip, they are referred to as "actinic cheilitis" and appear as cracking, dried lips, often around the border of the lip.
Because 40-60% of squamous cell skin cancers originate from untreated actinic keratoses, your doctor will carefully diagnose, treat, and monitor your lesions. Actinic keratoses result from chronic sun exposure, so there is an increased risk of developing other types of skin cancers, including basal cell carcinoma and melanoma if you have these lesions.
*An actinic keratosis, a new or changing mole (nevi), and other unusual lesions on your skin should be carefully monitored and brought to the attention of your doctor.
Risk factors
- Usually develops in people with light-colored skin and hair (blond or red hair), have freckles, and years of excessive sun exposure.
- Most common in men and women over the age of 40, but younger people can still develop them (including darker skin tones) if they live in a very sunny climate.
- People with weakened immune systems due to underlying illness or the use of immunosuppressive medications (like chemotherapy) are much more likely than others.
