Skin cancer Dr Rob Hicks Skin Cancer is one of the most common cancers in the UK. Each year in the UK there are more than 76,500 cases of non melanoma skin cancer and more than 9,500 new cases of melanoma skin cancer.

In this article

What is skin cancer? Symptoms

Causes and risk factors Treatment and recovery

Over the last 25 years, rates of melanoma skin cancer in Britain have risen faster than any other common cancer.

There are two main types of skin cancer: melanoma (or malignant melanoma) and non-melanoma.

Non melanoma skin cancers include basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).

Non melanoma skin cancers are usually slow growing and occur on sun exposed areas of the skin. These cancers rarely spread.

BCC affects all sun exposed areas of the body. The main symptom is a small painless lump, pink/brownish-grey in colour, with a smooth surface with blood vessels and a waxy or pearl-like border. The lump grows, developing a central depression with rolled edges.

SCC usually affects the face. The main symptom is an area of thickened, scaly skin and develops into a painless, hard lump, reddish brown in colour with an irregular edge. The lump becomes a recurring ulcer and doesn’t heal.

Melanoma skin cancer can occur anywhere on the body and is more dangerous. The main symptom is a quick-growing, irregular, dark-coloured spot on previously normal skin or in an existing mole that changes size, colour, develops irregular edges, bleeds, itches, crusts or reddens.

Occasionally, melanoma skin cancer may present with swollen lymph glands or rarely in unusual places including the sole of the foot, mouth or eye.

Skin cancer is caused by overexposure to the sun’s harmful UV rays. A suntan isn’t healthy; in fact it’s a sign of skin damage. The results of sunbathing are skin that ages more quickly and an increased risk of cancer.

Non melanoma skins cancers result from prolonged sunlight exposure over many years.

The main cause of melanoma skin cancer is exposure to short periods of intense sunlight: the kind of exposure people get on a two week holiday.

Diagnosis of skin cancer can usually be made by your GP or hospital specialist by simple skin examination. Sometimes, the skin cancer will need to be removed by a small operation or biopsy; both for treatment and lab testing. Other routine tests, including X-rays and scans aren’t usually required.

Non-melanoma skin cancers are usually treated by surgical removal or freezing (cryotherapy). Occasionally, special creams (chemotherapy or immunotherapy) can also be advised, particularly if the cancers are multiple or recur.

Melanoma skin cancer is treated by surgery. This also involves removing additional healthy skin, the amount dependent on the thickness of the melanoma. In some instances this may also require a small skin graft to cover the area and help healing. Occasionally a small biopsy of a lymph node may also be taken at the same time, defining future risks of recurrence.

Most melanoma skin cancers can be cured with surgery if caught early. Some melanoma skin cancers can spread to other parts of the body. Where melanoma has spread beyond the skin or local lymph nodes, the treatment approach is very individualised and aimed at controlling the disease while minimising side effects and improving symptoms.

Chemotherapy, radiotherapy, biological therapy and surgery may all be used in various combinations.

It’s quite common to be invited to enter a trial comparing one treatment approach with a newer approach to see if this improves results or reduces side effects. All trials are very carefully scrutinised by independent ethics committees to ensure to ensure they meet current best standards of care.

Most skin cancers are easily treated and cured when detected early. Melanoma skin cancer remains the most dangerous subtype because of the risk of spread. About 1,800 people die from melanoma skin cancer annually in the UK. Even so, nearly 80 per cent of men and over 90 per cent of women are alive at five years following treatment.

Prevention

The best way to prevent skin cancer is to avoid too much time in the sun.

You don't have to be sunbathing to get burned. You can get too much sun while walking to the shops, driving a car with the windows down, even under light cloud cover.

Time of day and location are important too. The intensity of UV radiation increases during the middle of the day, between April to September, nearer the equator and at higher altitudes.

How to protect yourself and your children:

• Stick to the shade between 11am and 3pm
• Cover up with clothes, a wide brimmed hat and sunglasses
• Apply a high-factor sunscreen (minimum SPF15 and three stars) regularly
• Drink plenty of water to avoid overheating
• Avoid using sun lamps or sunbeds

Watch those moles

Many moles aren't cancerous, but it's vital to keep an eye on any you have. Watch out for moles that change shape or colour, become bigger, itchy or inflamed, or that weep or bleed. If you notice any changes or are worried, get them checked by a doctor.

This article was last medically reviewed by Dr Ernie Marshall of the Clatterbridge Centre for Oncology in March 2009.