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Non-Melanoma Skin Cancer

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Skin cancer begins in the cells of your skin and has differing causes and varying degrees of malignancy. Your skin plays an important role in your body and is your largest organ. Skin is a protective layer that performs many tasks and defends the body against injury and infection, prevents the body from losing water, provides protection from heat, makes vitamin D and protects you from ultraviolet (UV) light damage.

Squamous cell skin cancer and basal cell skin cancer are the most common types of non-melanoma skin cancers and they can usually be treated successfully by surgical removal or other chemical treatment. Basal cell carcinoma is the most common form of cancer worldwide.

Basal Cell Carcinoma

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Basal cell carcinoma (BCC) is a cancer of the epidermis, which is the outermost layer of the skin. BCC usually presents as a pink or translucent nodule that typically appears on a sun-exposed area of skin, such as the face and neck. BCC is the most common type of skin cancer, making up about 75% of all non-melanoma skin cancers diagnosed. It is rare for BCC to spread to another part of the body, but it is possible to have more than one BCC at a time. Having one BCC increases your risk of getting another.

Risk Factors

  • Exposure to ultraviolet radiation (UV).The majority of Basal Cell Carcinomas grow on parts of the body regularly exposed to the sun. People who have excessive exposure to the sun and who have had severe sunburns, are at an increased risk of developing BCC.
  • Those who have already had Basal Cell Carcinoma, have a higher risk for developing another Basal Cell Carcinoma in their lifetime.
  • Patients who have had organ transplants, with compromised immune systems
  • The incidence of Basal Cell Carcinoma increases with age with the highest prevalence of BCC in people over 60 years of age. However, these BCCs can also arise in younger people, such as teenagers and those in their early twenties.
  • People with fair skin, or those that have blonde or red hair and blue, green, or gray eyes are at the highest risk.
  • Individuals with a genetic condition known as Basal Cell Nevus Syndrome

Symptoms

  • Pink or skin-coloured nodule, which is firm, translucent, often with a pearly raised border. The bump may also have small blood vessels on the surface, giving it its pink colour. It is often confused with a mole.
  • A growth of either a pimple or a sore that bleeds, crusts over and reappears or does not heal within four weeks.
  • A small patch of scaly skin, resembling a rash, often seen on the trunk or limbs.
  • A patch of skin that resembles a scarred area that is white, yellow or waxy with poorly defined borders.

Treatment Options

Most basal cell carcinomas can be removed with surgery if they are found early, however, the course of treatment for BCC depends on the size and location of the tumour. The patient’s age, medical history and health status also needs to be considered when deciding the course of treatment. Some of these treatment options are listed below. Discuss which treatment options are best for you with your doctor or specialist.

Squamous Cell Carcinoma

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Squamous cell carcinoma (SCC) is the second most common form of skin cancer in Canada after basal cell carcinoma. It can occur on all areas of the body including the mucous membranes, but are most commonly seen in areas of the body that are exposed to the sun, such as the face, neck, bald scalp, hands, shoulders, arms, and back.

Causes
The leading cause of SCC is frequent sun exposure. People with fair skin, light hair, and blue, green, or gray eyes are at the highest risk. Patients, who have had tissue transplantations (and are on anti-rejection drugs), specifically for the kidney, liver or heart, are at a high risk of developing SCC. It can also spread to other parts of the body. On rare occasions, SCC appears on normal, healthy skin. Researchers believe this unknown origin is due to a genetic component.

Symptoms

  • Warts that grow and crust or bleed occasionally.
  • Scaly red patches, with irregular borders, which sometimes crust or bleed.
  • Sores that are open, and bleed and crust for weeks.
  • An elevated growth with a central dip that occasionally bleeds.

Treatment Options
If lesions are untreated, they may continue to grow, causing damage to the surrounding tissue. This damage could cause the lesion to spread to other parts of the body. Treatment options for SCC include surgical abstraction, or radiation therapy.

Large, recurrent tumours or tumours located near key structures, such as the nose or eyes, are more complicated to treat and require Mohs surgery. This form of surgery has the highest rate of success in curing SCC, as it is a specialized form of surgery, which isolates and removes the tumour, saving the normal skin around.