Non-melanoma skin cancer

Main

Non-melanoma skin cancer is a type of cancer that develops in the upper layers of the skin, most commonly in areas exposed to the sun. The two main types are:

1. Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC):

   • BCC appears as a painless, shiny, raised area with small blood vessels. It is the most common type of skin cancer, originating in the basal cells of the epidermis, and rarely spreads to other parts of the body.

   • SCC may look like a red, scaly patch or a sore that doesn't heal. It is the second most common type of skin cancer, arising from the squamous cells in the epidermis, and can spread to other parts of the body if left untreated.

Causes:

• Prolonged exposure to ultraviolet (UV) light from the sun or tanning beds

• Weakened immune system

• Exposure to certain chemicals or radiation

Risk factors:

• Fair skin that burns easily

• Excessive sun exposure or tanning bed use

• Personal or family history of skin cancer

• Older age

• Male gender

Treatment options:

• Surgery (wide excision, Mohs surgery)

• Local destruction of tumor cells (cryotherapy, electrodesiccation and curettage, laser therapy)

• Topical medications (5-fluorouracil, imiquimod, photodynamic therapy)

• Systemic therapies (chemotherapy, targeted therapy, immunotherapy) for advanced cases

While non-melanoma skin cancers are more common than melanoma, they are generally less aggressive and have a lower risk of spreading to other parts of the body. However, early detection and treatment are still important to prevent complications and disfigurement.

Terms

• Cancer: A disease characterized by the uncontrolled growth and spread of abnormal cells in the body.

• Epidermis: The outermost layer of the skin, providing a protective barrier against the environment.

• Melanoma: A less common but more aggressive type of skin cancer that develops in the melanocytes (pigment-producing cells) of the skin. It has a higher risk of spreading to other parts of the body.

• Skin cancer: A group of cancers that develop in the cells of the skin, including non-melanoma (basal cell carcinoma and squamous cell carcinoma) and melanoma.

• Tumor: An abnormal mass of tissue that results from uncontrolled cell growth. Tumors can be benign (non-cancerous) or malignant (cancerous).

• Ultraviolet (UV) light: Invisible radiation from the sun or artificial sources like tanning beds that can damage skin cells and lead to cancer.

Analogy

Non-melanoma skin cancer is like a leaky roof. Just as a small leak in your roof can gradually cause damage to your home if not repaired, a small skin cancer can grow and invade nearby tissues if left untreated. Regular check-ups with a dermatologist are like inspecting your roof for leaks, helping to identify and fix any problems before they lead to more extensive damage.

Misconception

Many people believe that non-melanoma skin cancer is not serious because it is often treatable. However, if left untreated, these cancers can grow, spread, and cause disfigurement or even death in rare cases. For example, a person might ignore a small, scaly patch on their ear, thinking it's just dry skin. Over time, the patch could grow into a large, invasive tumor that requires extensive surgery to remove.

History

1. 1800s: First descriptions of non-melanoma skin cancers in medical literature.

2. 1960s: Mohs micrographic surgery developed for precise removal of skin cancers.

3. 1980s: Increased awareness of the link between sun exposure and skin cancer.

4. 2000s: Topical medications and photodynamic therapy become more widely used for treating early-stage non-melanoma skin cancers.

5. 2010s-present: Targeted therapies and immunotherapies developed for advanced cases of non-melanoma skin cancer. Continued emphasis on sun protection and early detection.

How to use it

1. A 45-year-old woman notices a small, pearly bump on her cheek that has been growing slowly for a few months. She sees her dermatologist, who diagnoses it as a basal cell carcinoma. The dermatologist performs a simple surgical excision to remove the tumor, and the woman is cured.

2. A 60-year-old man with a history of sun exposure notices a scaly, red patch on his scalp that doesn't heal. His dermatologist biopsies the lesion and diagnoses squamous cell carcinoma. The man undergoes Mohs surgery to remove the cancer while preserving as much healthy skin as possible.

3. A 35-year-old woman with fair skin and a family history of skin cancer visits her dermatologist annually for skin checks. During one visit, the dermatologist identifies a suspicious lesion on her nose and biopsies it, revealing an early-stage basal cell carcinoma. The woman is treated with topical medication and avoids more invasive treatments by catching the cancer early.

Facts

• Non-melanoma skin cancer affects over 3 million Americans each year.

• Basal cell carcinoma accounts for about 80% of non-melanoma skin cancers.

• The risk of developing non-melanoma skin cancer doubles with every 10 years of indoor tanning bed use.

• People who have had one non-melanoma skin cancer have a 40-50% chance of developing another within 5 years.

• The incidence of non-melanoma skin cancer has increased by 77% between 1994 and 2014.