Skin Cancer

NHS information

What is Skin Cancer?

Melanoma is a type of skin cancer that can spread to other areas of the body.

There are three main types of skin cancer:

basal cell carcinoma (BCC)
squamous cell carcinoma (SCC)
malignant melanoma.

BCCs and SCCs are different from melanoma. They are called non-melanoma skin cancers.

Symptoms of Skin Cancer

Symptoms of basal cell carcinoma (BCC)

BCCs are more likely to develop on skin that is regularly exposed to the sun, especially on the face, head and neck.

BCCs may appear as:

smooth and pearly-white
waxy
a firm, red lump or may look sunken in the middle
a pearly brown or black lump if you have darker skin
a flat, red spot that is scaly and crusty
a pale non-healing scar.

BCCs may also:

begin to heal but never completely heal
feel itchy and bleed sometimes
develop a crust or scab
develop into a painless ulcer.

Symptoms of squamous cell carcinoma (SCC)

SCCs usually develop in areas that have been damaged by sun exposure.
In people with pale skin, they are mainly found on the face and neck, bald scalps, shoulders and arms, back of hands and lower legs.
In people with darker or black skin, SCCs are more likely to affect areas that have less, or no direct sun exposure. These include the lower legs, torso, genitals and areas where there has been long-term scarring – for example, after a burn to the area.

SCCs may:

look scaly
have a hard, crusty scab
look pink or red
have a raised area of skin
feel tender to touch
bleed sometimes.

Causes of Skin Cancer

Most skin cancers are caused by skin damage that happens from exposure to the sun. The damage can happen from sun exposure over a long period of time or from a history of getting sunburnt.

People with a history of sunburn or overexposure to the sun in childhood also have a greater risk of developing both basal cell carcinoma and squamous cell carcinoma. Because people are living longer, they are exposed to more sun over their lifetimes.

Diagnosis of Skin Cancer

You usually begin by seeing your GP. If your GP thinks your symptoms could be linked to cancer they refer you to a specialist skin doctor (a dermatologist) at your local hospital. Sometimes, a specially trained GP may be able to remove the affected area of skin first.

Your GP decides how quickly you need to be seen based on your symptoms and national guidelines.

If they think you have an SCC, they refer you to see the dermatologist within 2 weeks. If the GP thinks you have a BCC, you will usually see the dermatologist within 18 weeks. This is because nearly all BCCs are slow-growing and unlikely to change during this time. Sometimes, you will be seen sooner. Your GP can explain the referral process to you.

At the hospital
The dermatologist will do the following:

Examine the affected area of skin. They may use an instrument called a dermatoscope, which looks like a magnifying glass with a light.
Ask how long you have had it and if you have noticed any other changes.
Check the rest of your skin for any other unusual areas.

Treatment for Skin Cancer

Melanoma skin cancer can often be treated. The treatment you have will depend on:

where the cancer is
if it has spread
your general health

Surgery is the main treatment for melanoma. Radiotherapy, medicines and chemotherapy are also sometimes used.

The specialist care team looking after you will:

explain the treatments, benefits and side effects
work with you to create a treatment plan that's best for you
discuss the chances of the melanoma coming back and how it will be treated if it does

You'll have regular check-ups during and after any treatments. Depending on the stage of your melanoma, you may have tests and scans.

If you have any symptoms or side effects you're worried about, talk to your specialists. You do not need to wait for your next check-up.

After Skin Cancer Treatment

After surgery for BCCs and very early-stage SCCs you may not need long-term follow-up care. But your doctor may want you to have regular check-ups for a time. This is to make sure your treatment has been successful and the cancer has not come back.

Once you have had a skin cancer you have a higher risk of:

developing it again in the same area (a recurrence)
getting another skin cancer somewhere else on your skin.

You should check your skin regularly for any new symptoms or changes that could be cancer. You could use a mirror if there are areas like your back you cannot see easily or ask a relative or friend to help.

If you have problems or notice any new symptoms in between check-ups, tell your doctor straightaway.

After treatment for skin cancer it is very important to protect your skin from the sun. This can help prevent further skin cancers. Being exposed to a small amount of sunshine without getting red or burning, helps our bodies make vitamin D. If you are not exposed to the sun often, you can ask your dermatologist or GP to check your vitamin D levels and for advice on getting enough vitamin D.