Skin cancer is a medical condition marked by the uncontrolled growth of abnormal skin cells as a result of DNA damage, typically from exposure to ultraviolet radiation. This damage triggers mutations or genetic defects in the cells, which, in turn, lead them to multiply rapidly and develop into malignant tumors. There are three especially common types of skin cancer—basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. Each of these comes with its own unique characteristics and associated risks.
Understanding skin cancer involves more than recognizing its physical manifestations; it is equally important to acknowledge the causative factors. The primary risk factor for skin cancer is extended exposure to ultraviolet light, such as from sunlight or tanning beds. Individuals with fair skin that burns easily, a family history of skin cancer, or poor immune system health may also be especially susceptible to the disease. However, it’s possible to mitigate these risks by taking protective measures such as covering one’s skin with appropriate clothing and applying broad-spectrum sunscreen when one needs to be out in the sun for extended periods.
The aim of this quick guide is to describe the standard treatments associated with each type of skin cancer, thereby providing readers with a basic understanding of their options should they face a diagnosis. In the following sections, we will explore the typical methods of skin cancer removal and management.
Basal Cell Carcinoma (BCC)
Basal cell carcinoma is the most prevalent form of skin cancer and arises from the basal cells situated in the deepest layer of the epidermis. Appearing as a change in the skin, such as a growth or sore that won’t heal, BCCs frequently manifest on areas frequently exposed to the sun, like the face, neck, and arms. Though it rarely metastasizes or spreads to other parts of the body, BCC can become quite extensive if left untreated, penetrating deeper into the skin and sometimes affecting the bones.
The approach to treatment for BCC is primarily surgical. Among the techniques at the forefront is Mohs micrographic surgery, renowned for its precision and high success rate. This procedure involves meticulously removing the cancerous tissue one layer at a time. The patient’s skin is then immediately examined under a microscope until only cancer-free tissue remains. This method both guarantees complete cancer removal and also spares as much healthy tissue as possible, a crucial consideration when dealing with lesions on the face.
Healthcare providers may also recommend less invasive treatments for superficial BCCs, depending on the patient’s specific needs and circumstances. These can include the following:
- Topical Medications – Creams or ointments containing anti-cancer agents can be applied directly to the skin to kill cancer cells.
- Photodynamic Therapy (PDT) – This involves the application of a photosensitizing agent to the skin, which is then activated by a specific wavelength of light that destroys cancer cells.
- Cryotherapy – This treatment uses liquid nitrogen to freeze and destroy the abnormal cells.
- Laser Therapy – High-intensity light is used to vaporize or remove the cancerous growths without the need for cuts or incisions.
- Electrodesiccation and Curettage (ED&C) – This is a procedure where the tumor is scraped away with a curette and the base is seared with an electric needle.
Squamous Cell Carcinoma (SCC)
Squamous cell carcinoma, the second most common type of skin cancer, is distinguished by the abnormal growth of squamous cells found in the skin’s outermost layers. This form of skin cancer is typically more aggressive than basal cell carcinoma and can spread to other parts of the body if not treated promptly. SCC often presents as red, scaly patches, open sores, or elevated growths with a central depression, and it may crust or bleed. It typically occurs on areas of the skin that have been exposed to significant amounts of UV radiation over time, such as the rim of the ear, the face, and the backs of the hands.
Treatment for SCC is usually surgical, and the choice of technique is often contingent on the tumor’s size, depth, and location. Simple excision, for instance, involves removing the cancerous lesion and some surrounding tissue. This method is generally sufficient for small, well-defined tumors. For larger or more aggressive SCCs, Mohs surgery may again be employed to minimise tissue loss while making certain that all cancer tissues are excised.
In instances where surgery is not an option, due to either the size or location of the tumor or the patient’s health, alternative treatments are available. Doctors might employ radiation therapy, directing focused beams of radiation at the cancer to destroy the abnormal cells. Cryotherapy could again be a choice for smaller lesions. For advanced SCC, systemic treatments such as chemotherapy or targeted therapy drugs are another option. The overarching goal is to eradicate the cancer while preserving function and appearance as much as possible.
Melanoma
Melanoma is a less common form of skin cancer than basal and squamous cell carcinomas. It is, however, significantly more dangerous due to its potential to metastasise or spread to other organs. This type of skin cancer originates in the melanocytes, the cells responsible for producing pigment in the skin. Melanomas can develop in existing moles or appear as new, unusual growths, and they can occur anywhere on the body, not only on areas exposed to the sun.
The ABCDE guide highlights the features of suspicious moles that may warrant evaluation by a dermatologist:
- Asymmetry – One half of the mole or birthmark does not match the other.
- Border – The edges are irregular, ragged, notched, or blurred.
- Colour – The colour is not the same all over and may include shades of brown or black, sometimes with patches of pink, red, white, or blue.
- Diameter – The spot measures more than 6 millimeters in diameter—around the size of a pencil eraser—though smaller melanomas are also possible.
- Evolving – The mole is changing in size, shape, or colour.
When detected early, melanomas can typically be treated effectively with surgery. Most melanomas are removed via wide excision, which involves removing the melanoma along with a margin of normal skin to ensure that no cancer tissues are left behind. In cases where the melanoma has spread, treatment becomes more complex and may include lymph node dissection, targeted therapy, immunotherapy, or chemotherapy. These treatments can be used individually or in combination, depending on the stage and location of the melanoma as well as the patient’s overall health. Prevention and early detection are critical for melanomas, as the success of treatments depends significantly on the stage at which healthcare providers are able to catch the cancer.
Healthcare providers and their patients can gain critical ground in the fight against skin cancer through early detection and tailored treatments, as well as by recognising the importance of prevention and education. Understanding the various forms of skin cancer and their respective treatment methods reinforces the power of informed choices and vigilant skincare practices in safeguarding individual health.