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What are Non-Melanoma Skin Cancers?

Cancer is when healthy cells in the body change and grow in an uncontrolled way. Many times, this change grows into a mass of changed cells, called a tumor. A tumor can be cancer, or it can be benign [bih-NINE], which means that it is not cancer. Even if a tumor is benign, it can grow larger, but will not spread to other parts of the body. If a tumor has cancer, it can also be called malignant [ma-LIG-nant], and can grow and spread to other parts of the body.

The skin is the largest organ of your body. The skin is made up of three layers, called the:

  • Epidermis [ep-ih-der-mus], which is the outer layer of your skin
  • Dermis, which is the inner layer of your skin
  • Hypodermis [high-po-der-mus], which is the deep layer of fat, under your inner layer of skin

Skin cancer is when any of these cells grow out of control. Although skin cancer is the most common type of cancer that doctors diagnose, if it is found early, it is relatively easy to treat and leads to less than 1% of all cancer deaths.

There are three main types of skin cancer:

  • Basal cell carcinoma [car-sin-oh-ma], which is found in the lower epidermis. Most of the time, this type of cancer grows slowly and rarely spreads to other parts of the body. Most often, it is found in the skin of the head and neck, and is caused by the sun. In some cases, it can also be caused in people who had radiation therapy as a child. Most non-melanoma skin cancers are this type.
  • Squamous (SKWAY-miss) cell carcinoma is found in cells of the outer layers of the epidermis. Most of the time, this type of cancer also does not spread to other part of the body, but it still can about 2-5% of the time, making it more likely to spread than basal cell carcinoma. Squamous cell carcinoma is caused by sun exposure, but can also develop on skin that has been chemically burned. In some cases, it can also develop on skin that has been exposed to x-rays.
  • Melanoma affects the cells called melanocytes [mell-an-oh-sites], which are found where the dermis meets the epidermis. Melanoma is created from the cells that create the pigment in your skin. Although this article does not focus on melanoma, it is the most likely cancer to spread, and spreads the fastest, making it the most serious type of skin cancer.

When to See a Doctor

You should see your doctor if you notice an irritated or unnatural-looking skin growth. You should also make an appointment to see your doctor if you notice any of the symptoms that are listed above to rule out cancer or other conditions that may have similar symptoms.

Make sure to show your doctor any skin growths that concern you so that they can be observed and treated. If you have a family history of skin cancer, or any risk factors that are common to skin cancer, you should also think about having your doctor perform a yearly skin check as part of your routine physical. This is where your doctor will check your skin for new growths, and also observe existing growths, such as moles or freckles, to make sure they are not changing.

Causes

The most common cause of non-melanoma skin cancer is too much sun, whether natural or from a tanning bed or sun lamps.

Although anyone can get skin cancer, it seems to be more common in people who:

  • Have fair skin, or light-colored hair and eyes
  • Have a family member that has had skin cancer
  • Have spent a lot of time in the sun, or in indoor tanning beds, or have been sunburned
  • Are 50 years or older

Diagnosis and Tests

Your doctor will ask you questions about how long you’ve been having symptoms.

Your doctor will also most likely take what is called a biopsy [bye-op-see], or small skin sample from the affected area, which will be sent to a lap for testing. The lab will test your skin sample to see if it contains any cancer cells. A biopsy is a simple, routine procedure that has little, if any pain. Because non-melanoma skin cancers rarely spread, a biopsy is almost always the only test that is needed to find out if you have skin cancer or not.

Your doctor will review the biopsy results with you and determine a plan for treatment, if necessary. In some cases, the biopsy may remove the entire cancer, and there will be no further treatment needed.

If your doctor finds that you have skin cancer, he/she may request additional testing to make sure that your skin cancer has not metastasized [met-tass-tih-sized], or spread to other parts of the body.

Treatments

In some cases, the biopsy procedure that is used to diagnose non-melanoma skin cancer will remove the entire cancer, and no additional treatment will be needed.

In other cases, non-melanoma skin cancer can also be treated with topical medicines that are applied to the skin. You may also be referred to see a dermatologist [der-ma-tol-oh-jist], which is a doctor that specializes in treating skin problems. A dermatologist can recommend additional procedures, such as:

  • Cauterization [CAWT-er-eyez-AY-shun], which means burning parts of the affected area off until the cancer is gone
  • Cryosurgery [cry-oh-sur-jer-ee], or freezing off parts of the affected area with liquid nitrogen until the cancer is removed
  • Laser surgery, which is when a laser is used to remove parts the affected area until the skin cancer is gone

These procedures are usually quick and painless. Talk to your doctor if you are worried about any pain.

If the cancer is large or has spread, your doctor may recommend surgery to remove the affected area. Most of the time, the surgery only needs a local anesthetic (where you are not completely knocked out). Your doctor will inject pain relievers into your skin and apply pain relieving creams until you can no longer feel the affected area so it can be removed without any pain. Most of the time, no additional treatment will be needed.

In very extreme cases, your doctor may recommend radiation therapy, which uses high-energy rays to destroy cancer cells. Radiation therapy can be a stand-alone treatment, or may be used in addition to other treatments to help make sure that they cancer does not return.

In the very rare cases where non-melanoma cancer has spread so much that it cannot be completely removed surgically or by any other means, chemotherapy [key-moe-there-uh-pee] may be recommended. However, this is very uncommon with non-melanoma skin cancer.

If you have skin cancer, be patient. Your treatment may be very quick or take some time. Make sure to talk to your doctor about any symptoms you have during treatment, whether new or old, so they can make sure your treatment plan is the best plan for you.

Talk to your doctor about your treatment plan, including any side effects, and how to prepare for them. Take your time to learn about your options and ask any questions to help you make the best decision for yourself.

After you have skin cancer once, you will need to have your doctor regular check your skin to make sure you don’t get it again. Once someone has skin cancers, they more likely to get it again. They may get it again in the same part of the body, or somewhere else. Make sure to follow-through with our regular checkups, even after your cancer is in remission [re-mish-un], which means you no longer have symptoms or cancer cells in your body. Going to your regular checkups will help make sure that, if you get skin cancer again, you catch it early and can begin treatment early.

Prevention

The main risk factor to getting non-melanoma skin cancer is excessive or unsafe exposure to the sun – whether natural (outside) or fake (indoor tanning beds).

Try to avoid indoor tanning as much as possible, and make sure to wear sunscreen with a good sun protection factor (SPF) anytime you will be outside to help prevent non-melanoma skin cancer. A minimum SPF of 30 is recommended, although anything higher than that will offer better protection.

You can also prevent non-melanoma skin cancer by wearing clothing that protects you anytime you need to go out into the sun, such as hats, or clothes that have a built-in UV protection factor (UPF).

You can also try to avoid going outside in the midday sun, which is when the sun is the harshest and causes the most damage. Even if you avoid the midday sun, it is important to always wear sunscreen when you go outside to help protect the skin.

Sun damage builds up over time, so it is important to make sure that you are properly protected every time you go outside.

Also, take care to regularly check your skin for any strange or unusual growths or changes. Making sure to regularly check your skin can help you catch skin cancer early. Generally, the earlier you begin skin cancer treatment, the easier it is to get into remission.

Symptoms

Non-melanoma skin cancer can be hard to diagnose because it can have many different symptoms, or no symptoms at all. In some cases, that symptoms of non-melanoma skin cancer can also by symptoms of a different condition.

Make an appointment to see your doctor if you notice any changes in your skin that occur and grow quickly. Although these may not mean you have cancer, one of the most common symptoms of skin cancer is fast and rapid changes in the skin. One type of fast change is a mole or freckle that develops quickly and changes very fast, although this is not the only type of skin change that could be a symptom of cancer.

If you have any of the following symptoms, which could be symptoms of non-melanoma skin cancer, try to see your doctor as soon as you can.

For basal cell carcinoma, see your doctor if you have two or more of the symptoms listed below:

  • A bump on your skin that is shiny pink, red, pearly white, or see-through, that does not seem to heal or go away over time
  • An open sore that does not heal over several weeks, although it may bleed, ooze, or crust
  • A reddish, raised patch of skin that may by itchy, but not painful. This patch may also look crusty, like very dry skin
  • A yellow, white, or waxy-looking area of the skin with a very unclear border. It may also look like a scar, and is often found on the face, although it can be found anywhere on the body
  • A pink growth that is raised on the border, but has a crusty dent in the middle

For squamous cell skin cancer, see your doctor if you notice any of the following symptoms:

  • A scaly red patch with unclear borders that may bleed heavily or easily, and does not seem to heal over time
  • An open sore that does not heal for weeks
  • A wart-like bumpy growth that may also look like a skin-colored mole or cyst
  • A raised bump or growth that has a rough, somewhat patchy-looking, surface and an indent in the center

Although less common, some types of skin cancer can spread along the nerves. When this happens, it can cause pain, itching, or a pins-and-needles feeling in the skin. You may also notice bumpy growths under the skin in certain areas, like the armpit, neck, or groin.