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 Skin cancer
More than 60,000 people in the UK are diagnosed each year with non-melanoma skin cancer.
Basal cell carcinoma is a cancer of the cells at the bottom of the skin’s outermost layer, the epidermis. It accounts for more than three-quarters of all skin cancers in the UK. Most basal cell carcinomas are slow-growing and almost never spread. However, if they are left untreated they can erode the skin and cause an ulcer, known as a rodent ulcer. A small number of rodent ulcers come back on the same area of skin after treatment: this is known as a local recurrence.
Squamous cell carcinoma is a cancer of the outermost cells of the skin. It is the second most common type of skin cancer in the UK. One in five skin cancers (20%) are this type. If it is left untreated for a long time, squamous cell carcinoma can spread to other parts of the body. However, most people treated for squamous cell carcinoma are completely cured with simple treatment.
Another, much less common, type of skin cancer is called malignant melanoma. About 7,000 people in the UK are diagnosed with malignant melanoma each year. Melanoma behaves differently to basal cell and squamous cell carcinomas.
What are the symptoms?
One of the following, most likely to appear on face, neck or other exposed skin:
- A small lump, smooth or waxy, may bleed, may develop a crust, may be itchy
- Flat, red spot -- scaly and crusty
- Firm, red lump -- painless, growing slowly
- Lump with scaly or horny top
If you notice anything unusual on your skin which does not go away within a month, you should show it to your doctor. There are, however, many other conditions that may appear in the skin which are not cancer, particularly among older people. You may still wish to have these treated for cosmetic reasons.
Treatment
More than nine out of ten people (90%) with basal cell and squamous cell carcinomas are completely cured. Surgery is an important treatment for many skin cancers. In many cases the only treatment needed is removal of the suspect lump. Radiotherapy may be used instead of surgery, or may be given after surgery if there is a risk that some cancer cells may still be present. Chemotherapy may occasionally be used.
Surgery for skin cancer can be done in a variety of ways. Small cancers can usually be removed under local anesthetic. When larger tumours are removed, skin grafts are sometimes needed to replace the removed skin. A skin graft is a thin layer of healthy skin taken from another part of the body. This is done under general anaesthetic.
A very small number of patients with squamous cell skin cancers will have more major surgery to remove nearby lymph nodes. This is to see whether the cancer has spread into the lymph nodes.
Cryotherapy can be used to remove small skin cancers.
Radiotherapy can be a very effective alternative to surgery for basal and squamous cell carcinomas in areas of the face where surgery might cause scarring. It is also sometimes used for tumours that have grown into the deeper layers of the skin.
Chemotherapy is not often used to treat skin cancers. If it is used, it is usually as a cream that is applied directly to the cancer. More rarely, a course of chemotherapy is given by injection.
More than 90% of patients with basal cell and squamous cell carcinoma are completely cured.
If you have any questions about your own treatment don’t be afraid to ask your doctor or nurse. It often helps to make a list of questions for your doctor. You may want to take a close friend or relative with you to appointments, who can remind you of questions you wanted to ask, and afterwards help you to remember what the doctor said.
Please visit www.cancerbackup.org.uk for more information.
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