Skin cancer may initially appear as something new, changing, or not healing on your skin.
The talk: The most common type of cancer, skin cancer often develops in hard-to-find locations which makes their identification even harder. However, regular screenings and early detection make the majority of cases treatable.
What's brewing: Researchers have been working on a new artificial intelligence pipeline that uses deep convolutional neural networks (DCNNs) to analyze suspicious pigmented lesions (SPLs), which can be an indication of skin cancer — all through your smartphone's camera.
Melanoma cells are highly angiogenic, meaning is highly capable of forming blood vessels needed for the tumor to grow. Additionally, melanoma cells that pass through the before entering the bloodstream spread and form new tumors more readily than cells that directly enter the bloodstream.
Image by the National Cancer Institute/Unsplash
Skin cancer occurs when irregular growth of skin cells occurs. Caused by damage to the DNA, these mutated skin cells multiply rapidly to form tumors. Dermatologists study these cells to identify the type of skin cancer.
There are three major types of skin cancer – basal cell carcinoma, squamous cell carcinoma, and melanoma. Identifying each type gives you the best chance at early detection of skin cancer, providing you with chances of more successful treatment.
Skin cancer can appear in a number of shapes, sizes, and forms. The most common types of skin cancer are basal cell carcinomas (BCC), squamous cell carcinomas (SCC), and melanomas, while actinic keratosis is the most common precancerous condition.
The talk: Basal cell carcinoma is the most common type of skin cancer. It begins in the basal cells, found at the bottom of the epidermis – the outermost layer of the skin. Basal cells are the ones that produce new skin cells.
Basal cell carcinoma (BCC) accounts for nearly 90 percent of skin cancer cases in the U.S., and develops primarily due to exposure to UV light. However, about 20 percent of BCC cases arise without sun-exposure. It typically presents itself as a shiny, pink, or flesh-colored papule or nodule, which may form into an ulcer over time.
Image by the National Cancer Institute
What to look for: Basal cell carcinomas most commonly develop in areas exposed to the sun, especially the face, scalp, neck, and shoulders. These are caused by the combination of intense short-term exposure and cumulative long-term exposure to UV radiation from the Sun.
In most cases, basal cell carcinoma does not spread to other areas of the body. In rare occurrences, however, these can be life-threatening.
Squamous cell carcinoma arises from the squamous cells of the epidermis. These are the cells located near the surface of the skin, appearing like fish scales.
Squamous cells are also found in the lining of hollow organs, the lungs, and mucous membranes. These cells can also turn cancerous. To differentiate the two, squamous cell carcinoma of the skin is called cutaneous squamous cell carcinoma.
Cumulative, long-term exposure to the sun’s UV radiation is the most common cause of this type of cancer. They are most common in areas of constant sun exposure, like the face, neck, or head.
Caused due to the uninhibited, accelerated growth of squamous cells, squamous cell carcinoma (SCC) typically appear as scaly red patches, raised growths with a central depression, or open sores.
Image by the National Cancer Institute
By the numbers: According to the American Cancer Society, squamous cell carcinomas are the second most common type of skin cancer (in the US), with about 3.3 million annual cases.
While untreated squamous cell carcinomas can grow into deeper layers of the skin and spread to other parts of the body, they are usually easily treated. Nearly 15,000 deaths occur due to this cancer each year in the U.S.
Melanomas (also called malignant or cutaneous melanoma) are often confused with moles, and may even arise from them.
What to look for: Melanomas can appear in any area of your body but are more likely to start on the chest and back for men and on the legs in women.
This type of cancer begins in cells known as melanocytes, which give your skin its color. Noncancerous moles are formed by melanocytes.
Melanoma often occurs in hard-to-spot places on the body, and may be pinkish, reddish, white, or even clear, making them hard to recognize. Melanomas are typically characterized as dark spots that stand out from your other moles.
Image by the National Cancer Institute
Melanomas are treatable when detected early. However, they can metastasize (spread) without treatment, becoming more complicated. This type of cancer is also more likely to spread to other parts of the body compared to basal and squamous cell cancers.
Actinic keratosis is the most common precancer (a condition associated with an increased risk of developing into cancer), caused by skin damage by chronic exposure to ultraviolet rays. An estimated 58 million Americans have one or more actinic keratoses.
These often appear as small dry, scaly, or crusty patches of lesions on sun-exposed areas like the face, scalp, forearms, and neck.
If left untreated, these can develop into squamous cell carcinomas.
Merkel cell cancer is a rare, aggressive form of cancer with about 3,000 cases diagnosed in the U.S. annually.
Its incidence has been steadily increasing and is expected to keep doing so. It is caused by the overgrowth of Merkel cells – a specialized cell found right below the epidermis and often termed “touch receptors.”
What to look for: Merkel cell cancer is usually found in the head and neck region, being especially common in elderly white males. They often appear as firm, painless lesions on a sun-exposed area, resembling pimples.
These grow rapidly and have a high risk of recurring and spreading to other body parts.
Lymphoma is a type of cancer that starts in white blood cells called lymphocytes. These cells are part of the immune system’s defense against diseases and infections. Lymphomas are of two main types:
When a non-Hodgkin lymphoma starts only in the skin, it is called a skin lymphoma or cutaneous lymphoma.
Scientists don’t clearly understand the causes of skin lymphoma. It is suggested that certain DNA mutations might cause such cancers. They also believe that people with weakened immune systems have a greater chance of developing skin lymphoma.
According to the American Cancer Society, there were nearly 80,500 new cases of skin lymphoma in the U.S. in 2022, with an estimated 20,250 deaths.
Kaposi sarcoma is a cancer that develops from the cells lining lymph or blood vessels, often appearing as tumors on the skin. These tumors look like purple, red, or brown patches on the skin.
The skin lesions of Kaposi sarcoma most often appear on the legs or face, which may sometimes cause the legs or feet to swell painfully.
Kaposi sarcoma is of four different types:
These usually don’t show any symptoms. However, if the lesions are formed in the lungs, liver, or digestive tract, they can cause serious internal bleeding and even death.
DFSP is a rare skin cancer that begins in the dermis – the middle layer of the skin. They first appear as a small patch on the skin, looking like a pimple or a rough patch of skin.
Dermatologists found that black people were more likely to get DFSP compared to whites, although they don’t yet know of a definitive cause.
DFSP has a low instance of spreading and a high survival rate, but timely treatment is crucial. If left unattended, these can grow into fat, muscle, or even bone.
Sebaceous carcinoma is an aggressive skin cancer that develops in the sebaceous gland. The gland is found on most areas of our skin, producing sebum to keep the skin moisturized.
Sebaceous carcinoma tends to develop in and around the eyes, as the area has the greatest concentration of sebaceous glands.
While most growths do not spread, there have been cases of deaths caused due to its metastasizing. Therefore, immediate diagnosis and treatment should be sought.
The most common signs of skin cancer include:
Skin cancers come in various appearances, many of which might not be identifiable or even visible. Any unusual change in your skin can be a sign of caution, and you should seek an immediate medical diagnosis in such cases.
Checking areas most commonly exposed to the sun is most important when checking for basal cell carcinomas. However, they may also occasionally develop in other places.
According to the Skin Cancer Foundation, two or more of the following symptoms appear as a sign of a BCC tumor:
Basal cell carcinomas are the most common type of skin cancer.
A squamous cell carcinoma can take various appearances according to the ADD, and could look like any of the following:
Squamous cell carcinomas usually appear on the skin with cumulative, long-term sun exposure, like the face, scalp, ears, or neck. It can also be a result of indoor tanning.
The easiest way to recognize the warning signs of melanoma is through the “ABCDE” signs:
Any unusual or rapid changes in a mole or lesion on your skin could be a sign of melanoma, and you should seek a dermatologist immediately.
The stage refers to the extent of severity of cancer, and it depends upon the following factors:
For cancer staging, skin cancers are divided into two main groups: non-melanoma skin cancer and melanoma.
Stages of non-melanoma skin cancers.
Melanoma is most often staged by the American Joint Committee on Cancer (AJCC) TNM system, based on tumor, nodes, and metastasis. Once a person’s T, N, and M categories have been determined; the information is combined in a process called stage grouping to assign an overall stage.
The cancer is usually staged using the pathological or surgical stage. However, if surgery is not possible, the cancer is given a clinical stage, based on the results of physical exams, biopsies, and imaging methods.
Stages of melanoma.
Although each person’s cancer experience is unique, cancers at similar stages tend to have a similar treatment method.
The talk: The exact cause of cancer remains unclear. Researchers believe there is no single cause for cancer. The interaction of many factors leads to cancer, which could be genetic, environmental, or behavioral.
Current perspectives: Like other types of cancer, skin cancer is caused due to DNA damage and genetic mutations in your skin cells. The mutated cells grow uncontrollably, forming a mass of cancer cells known as a tumor.
Most skin cancers are a result of overexposure to UV rays in sunlight. It can be observed that basal and squamous cell carcinomas tend to occur on sun-exposed parts of the body.
The most common sources of UV light are:
UV radiation is divided into 3 main groups: UVA rays, UVB rays, and UVC rays. Of these, UVB rays are the most associated with skin cancers, although each type can play a role in developing it.
The extent of damage from UV exposure depends on multiple factors, like the strength of the rays or the duration of exposure. It is, therefore, key to protecting yourself from these damaging rays.
What to know: Skin cancer can run in families. According to the Skin Cancer Foundation, about 10 percent of patients diagnosed with melanoma have a family history of the disease. If one or more close biological relatives of yours had melanoma, you are at an increased risk.
A family history of basal cell carcinoma is also associated with an increased risk of early onset. According to a study, the sharing of certain lifestyle factors among close relatives might be the reason behind this association.
Following through: If you have a family history of skin cancer, you should take the following steps:
Regular visits to your dermatologist or talking with someone in your family who experienced skin cancer can also help you.
Moles don’t always indicate skin cancer, but people with multiple of these small brown marks are at an increased risk of developing melanoma.
Most melanomas develop in normal skin, and only about 20 to 30 percent of melanomas arise from pre-existing moles. Atypical moles and many moles put you at an increased risk, and require you to regularly inspect new or changing moles.
Although anyone can get skin cancer, even if they do not easily get sunburned, people with fairer skin have a higher risk.
People with lighter-colored skin, especially with blond or red hair, blue eyes, and freckles are at an increased risk of developing melanoma. Additionally, people who get easily sunburned rather than getting tanned are at a higher risk.
If your immune system is weakened as a result of medical treatments like chemotherapy, an organ transplant, or if you have a medical condition like HIV, you are at a higher risk of developing skin cancer.
If you’ve had skin cancer before, you are at a higher risk of the cancer reoccurring. This risk is associated with melanomas, basal cell, and squamous cell carcinomas.
Between 30 to 50 percent of people with non-melanoma skin cancer develop a second non-melanoma skin cancer within 5 years. Regular follow-ups and self-examinations are key for preventing and catching second skin cancers.
People of all colors can get skin cancer. Even if you never get sunburns, you are not completely safe from skin cancer.
Here are some stats for cancer in people of color:
Dark skin has larger melanocytes, producing more melanin. This protects the deeper layers of the skin from UV damage from the sun. Although people of color are less likely to become afflicted with skin cancer, they are much more likely to die from it due to delayed detection.
No two skin cancer patients are the same, and the recommended treatment for each individual varies. Treatment for skin cancer depends upon the following factors:
After a healthcare team considers the following factors, they may recommend one or more of the following treatments:
Cancers are generally treated by dermatologists. Depending on its stage, however, it may be treated by another type of doctor, like:
It is important to think over your options for treatment by giving yourself some time to think. It is also important to clear any concerns of yours with a medical professional.
The most common complications of skin cancer include:
Skin cancers can be more or less complicated based on their type, location, and size among other factors. The health of the patient also plays an important role in treatment. You are also at a heightened risk of developing cancer again if you had it previously, with many cancers returning within 5 years of treatment.
Prevention of skin cancer requires extensive attention to protection from the sun’s damaging UV rays, especially for extended periods. Ultraviolet rays cause DNA damage and genetic mutations in your skin cells, which leads to skin cancer.
The following tips can reduce your risk of skin cancer:
Regular examinations from a dermatologist are key in reducing this risk. You can also have someone in your family examine your skin for any unusual changes, especially in areas not clearly visible, like the back.