There are thousands of new skin cancer incidences in the world. Some are slow-growing and colonize the upper layer of skin, and are known as nonmelanoma skin cancer.
Nonmelanoma cancers are different from melanoma skin cancers, which are less common and grow deeper in the skin. In this category of nonmelanoma cancer, the most reported types of tumors include squamous and basal cell carcinoma.
Generally, surgery is among the definitive measures against cancer. Additional treatment nonetheless depends on the origin of the tumor.
Clinical features of nonmelanoma cancer
The initial sign of nonmelanoma skin cancer is a change in the pigmentation of the skin or a lump that grows over months or years. The abnormality changes from being precancerous into a tumor.
Bowen’s disease is not cancer but has the potential to transform into a squamous cell carcinoma. It is sometimes referred to as squamous cell carcinoma in situ. It is non-aggressive and responsive to treatment.
It usually starts as a red scaly rash with an itch. While it typically appears on lower legs, it also can develop on any part of the skin. Statistically, it affects older women more. But even if it’s not invasive, if left unchecked, it will grow into a squamous cell carcinoma.
Also called actinic keratoses, this skin condition is a result of decades of solar damage leading to overgrowth of keratin. This causes hard, dry patches of skin that may appear red or brown with variable sizes.
The neck, face, and forehead are usually affected. These spots develop scaly patches that can look like horns or spikes. Just like Bowen’s disease, actinic keratoses are precancerous cells and can change into squamous cell carcinoma if not resolved.
What causes nonmelanoma skin cancer?
The origin of most skin cancers is sun damage by ultraviolet light (UV). UV light can alter the way in which DNA is reproduced.
The three main types of UV light are:
- ultraviolet A (UVA)
- ultraviolet B (UVB)
- ultraviolet C (UVC)
UVC doesn’t penetrate the atmosphere. This means that UVB and UVA are what damages skin and increases the risk of developing skin cancers and more prolonged exposure to UVB increases the risk of nonmelanoma skin cancer.
Other artificial sources of UV light, like tanning beds and sun lamps, also predispose you to skin cancer. Ultraviolet light, from both artificial sources or sunlight, causes sunburns that increase the risk of nonmelanoma skin cancers.
Other risk factors implicated in the development of skin cancer include:
- taking drugs that depress your immune system
- chronic medical conditions that lower your immune response
- a family history of skin cancer
- a large number of freckles or moles
- a personal account of nonmelanoma skin cancer
- pale skin that burns easily
Diagnosing nonmelanoma skin cancer
There are two broad procedures your doctor can perform.
First, a general inspection of your skin. If a large mole, rash, pimple, or lump on your skin seems ominous, you will be referred to a dermatologist for further examination. Slow growing basal cell cancers don’t require immediate referral; however, a specialist should examine your skin in 18 weeks.
A biopsy will also be ordered to know the stage of the cancer. In this procedure, a sample of the affected skin is removed and taken to the lab for analysis.
Treating nonmelanoma skin cancer
Surgery is preferred in managing nonmelanoma skin cancer. A surgeon carves off the tumor with some healthy cells around it (safe margin).
Common modalities for nonmelanoma skin cancer include radiotherapy, cryotherapy (freezing with liquid nitrogen), photodynamic therapy (PDT – a form of light treatment), and anticancer creams. These interventions can be used alone or as a combination depending on the origin of the cancer, its size, and location.
Unlike other skin cancers, nonmelanoma skin cancers are benign, rarely metastasize to nearby or distant tissues, and have a better prognosis after treatment. Close to 90% of all reported cases go into full remission (successfully cured).
Small cell carcinoma (SCC) is slow-growing but can be large enough and spread to tissues and lymph nodes (5% chance of metastasis). On the other hand, a basal cell carcinoma (BCC) remains typically confined to their original spot.
Even in their benign nature, both BCC and SCC can be hard-hitting and damage your skin if the cancer is not looked at by your healthcare practitioner.
There are some complications you may experience during the course of management. Such include:
- A nonmelanoma skin cancer might recur on the same spot that originated, especially if it reached a higher stage (stage III and IV). In this case, where the management team feels that the tumor can return, more checkups will be required.
- Having a history of skin cancer predisposes you to develop the same or different skin cancer in the future.
Ideally, you should check your skin occasionally for new tumors.
Preventing nonmelanoma skin cancer
While it is not easy to prevent nonmelanoma skin cancer, there are some ways you can protect yourself from UV light:
- Put on some sunscreen on exposed areas
- Wear long-sleeved clothes and hats
- Reduce time spent outside in the scorching sun
Sunbeds and sunlamps should also be avoided
Frequently checking your skin for abnormal spots will make it easier to diagnose and successfully treat skin cancer.
What is the Difference Between Melanoma and Nonmelanoma Skin Cancer?
Melanoma skin cancer develops from melanocytes, while nonmelanoma skin cancer is any cancer that originates from basal, squamous, or Merkel cells of the skin.
Melanoma skin cancer
Melanocytes (cells that produce melanin) that lose their structure and function develop into melanomas. Melanomas can develop both on spots of skin damaged by UV light or sections that don’t receive sunlight. You should immediately consult your dermatologist if you notice signs of melanoma. Initially, it may be a mole that:
- Has various pigments – brown, black, or tan
- Is not a perfect circle – has rugged edges
- Does not have the same size, shape, or color to other moles on your body
- Changes color and shape
The main point in this article is to immediately report all moles, even those that don’t fit the description, to your dermatologist because melanomas are very aggressive and dangerous
At the Hale Road Medical, our specialists will talk with you about your diagnosis in candid language and offer other alternatives after reviewing your biopsy results and images.