Non-Melanoma Skin Cancer

Non-melanoma skin cancer (NMSC) refers to a group of cancers that originate in the skin, excluding melanoma. It is the most common type of cancer worldwide and includes several types, with basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) being the most prevalent.

Types of Non-Melanoma Skin Cancer

• Basal Cell Carcinoma (BCC): The most common type of skin cancer, accounting for about 80% of all NMSC cases. BCC typically appears as a small, shiny bump or nodule on the skin, often on sun-exposed areas such as the face, ears, and hands.
• Squamous Cell Carcinoma (SCC): The second most common type of skin cancer, accounting for about 20% of all NMSC cases. SCC typically appears as a firm, red nodule or flat sore on the skin, often on sun-exposed areas such as the face, ears, and hands.
• Merkel Cell Carcinoma: A rare and aggressive type of skin cancer that originates in the Merkel cells, which are found in the top layer of the skin.
• Kaposi's Sarcoma: A rare type of skin cancer that forms in the blood vessels or lymph vessels, often associated with immune system dysfunction or infection with human herpesvirus 8 (HHV-8).

Causes and Risk Factors

The primary cause of non-melanoma skin cancer is exposure to ultraviolet (UV) radiation from the sun or artificial sources such as tanning beds. Other risk factors include:

• Fair skin that burns easily
• Light hair and eye color
• Family history of skin cancer
• Weakened immune system
• Exposure to certain chemicals, such as arsenic or coal tar
• Previous radiation therapy

Symptoms and Diagnosis

The symptoms of non-melanoma skin cancer vary depending on the type and location of the tumor. Common symptoms include:

• A new growth or bump on the skin
• A sore that does not heal
• A change in the size, shape, or color of a mole or other skin lesion
• Bleeding or oozing from a skin lesion

Diagnosis is typically made through a combination of physical examination, biopsy, and imaging tests such as X-rays or CT scans.

Treatment Options

Treatment for non-melanoma skin cancer depends on the type, size, and location of the tumor, as well as the patient's overall health. Common treatment options include:

• Surgical excision: Removal of the tumor and surrounding tissue
• Mohs surgery: A specialized surgical technique that removes the tumor layer by layer, examining each layer under a microscope until all cancerous cells are removed
• Radiation therapy: Use of high-energy rays to kill cancer cells
• Topical creams and ointments: Application of creams or ointments to the affected area to treat superficial tumors
• Systemic therapies: Use of medications that target specific molecules involved in cancer growth and development

Prevention and Screening

Prevention is key in reducing the risk of non-melanoma skin cancer. Measures include:

• Avoiding prolonged exposure to UV radiation, especially during peak sun hours (10am-4pm)
• Using protective clothing, such as hats and long-sleeved shirts
• Applying sunscreen with a Sun Protection Factor (SPF) of at least 30
• Avoiding tanning beds and artificial UV radiation sources
• Conducting regular skin self-exams to detect any new or changing skin lesions

Screening for non-melanoma skin cancer typically involves a yearly skin examination by a healthcare professional, especially for individuals with a history of skin cancer or those at high risk.