SKIN CANCER
Cancer is a disorder in which the body’s cells proliferate uncontrollably. Skin cancer occurs when cancer begins in the skin.
In the United States, skin cancer is the most frequent type of cancer. Some people are more susceptible to skin cancer than others, but it can affect everyone. Overexposure to ultraviolet (UV) light, whether from the sun or from artificial sources such as tanning beds, is the greatest avoidable cause of skin cancer.
The two most frequent kinds of skin cancer are basal and squamous cell carcinomas. They begin in the skin’s basal and squamous layers, respectively. Melanoma, the third most frequent type of skin cancer, is caused by melanocytes.
What Exactly Is Skin Cancer?
The two most frequent kinds of skin cancer are basal and squamous cell carcinomas. They begin in the skin’s basal and squamous layers, respectively. Melanoma, the third most frequent type of skin cancer, is caused by melanocytes.
Image via Division of Cancer Prevention and Control
Incidence figures
In the United States, skin cancer is the most frequent type of cancer.
According to current projections, one in every five Americans will acquire skin cancer during their lifetime.
Every day, roughly 9,500 people in the United States are diagnosed with skin cancer.
Nonmelanoma skin cancer (NMSC), which includes basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), is estimated to affect more than 3 million Americans each year.
Between 1976-1984 and 2000-2010, the total incidence of BCC increased by 145%, while the overall incidence of SCC increased by 263%.
Women experienced a higher increase in incidence than males for both forms of NMSC.
Melanoma affects over 1 million Americans.
In 2022, it is expected that 197,700 new instances of melanoma would be diagnosed in the United States, with 97,920 being noninvasive (in situ) and 99,780 being invasive.
In 2022, invasive melanoma is expected to be the fifth most common cancer diagnosed in both males (57,180 cases) and women (42,600 cases).
Melanoma rates in the United States have doubled in the last 30 years, more than doubling from 1982 to 2011, however developments within the last decade vary by age.
Melanoma incidence has begun to fall among teenagers and young people aged 30 and under. Melanoma incidence, on the other hand, increased with age, with more severe rises in persons aged 80 and beyond.
After decades of rise, invasive melanoma incidence rates in those under the age of 50 fell by roughly 1% per year from 2005 to 2018.
Women have greater rates than men before the age of 50. Men have greater rates after the age of 50, and in general. When compared to other races, white folks have greater rates.
The yearly incidence rate of melanoma in non-Hispanic White persons is more than 33 per 100,000, compared to 4.5 for Hispanics and 1 for non-Hispanic Blacks.
Anyone, regardless of skin colour, can develop skin cancer.
Skin cancer is over 30 times more common among non-Hispanic White people than among non-Hispanic Black or Asian/Pacific Islander people.
Skin cancer in people with darker skin tones is frequently identified in its later stages, when treatment is more challenging.
According to research, patients with darker skin tones are less likely to survive melanoma than those with lighter skin tones.
In African American patients, 21% of melanoma cases are diagnosed when the cancer has progressed to close lymph nodes, whereas 16% are diagnosed when the cancer has gone to distant lymph nodes and other organs.
People with darker skin tones are more likely to develop skin cancer in places that are rarely exposed to sunlight, such as the palms of their hands, the soles of their feet, the groyne, and the inside of their mouth. Melanoma can also develop under their nails.
Skin cancer rates are greater in women than in males before the age of 50, but higher in men after the age of 50, which may be due to disparities in recreational and work-related UV exposure.
Melanoma is projected to impact one in every 27 males and one in every 40 women in their lifetime.
Melanoma incidence is higher in females than in males in younger age groups, while incidence rates in younger age groups overall have declined in recent years.
Rates of mortality
Melanoma accounts for the great majority of skin cancer mortality.
Every day, about 20 Americans are killed by melanoma. Melanoma is expected to kill 7,650 people in 2022, with 5,080 males and 2,570 women dying.
According to research, males with melanoma had poorer overall survival rates than women with melanoma.
Overall melanoma fatality rates fell by about 4% between 2014 and 2019.
Survival percentages
The two most frequent types of skin cancer, basal cell and squamous cell carcinomas, are generally curable if diagnosed and treated early.
Melanoma patients who are diagnosed and treated before it spreads to the lymph nodes have a 99% five-year survival rate.
Melanoma that spreads to neighbouring lymph nodes has a six-year survival rate of 68%. Melanoma with distant lymph nodes and other organs has a five-year survival rate of 30%.
Risk elements
Excessive exposure to UV radiation from sunlight or indoor tanning also raises the risk of all types of skin cancer, as does a family history of the disease.
UV radiation is responsible for the vast majority of melanoma cases.
According to research, using sunscreen on a regular basis may minimise the incidence of melanoma.
Men may have higher melanoma rates due to lower rates of sun protection.
Sunburns as a child or adolescent can raise the risk of acquiring melanoma later in life.
Having five or more blistering sunburns between the ages of 15 and 20 increases the risk of melanoma by 80% and nonmelanoma skin cancer by 68%.
Tanning bed use raises the risk of melanoma, including early-onset melanoma.
If women under the age of 30 tan indoors, they are six times more likely to get melanoma.
The younger a person is when they use tanning beds, and the more indoor tanning they do each year, the greater their chance of developing melanoma and NMSC.
Skin that burns readily; blonde or red hair; a history of extensive sun exposure, including sunburns; tanning bed use; a weaker immune system; and a history of skin cancer are all risk factors for all types of skin cancer.
People who have more than 50 moles, unusual moles, or large moles, as well as those who are sun-sensitive (e.g., those who sunburn easily or have natural blonde or red hair), are at a higher risk of getting melanoma, as are those who have a personal or family history of melanoma.
When compared to the general population, melanoma survivors have an approximately eight-fold greater chance of acquiring another melanoma.
Men and women who have a history of nonmelanoma skin cancer are more likely to develop melanoma than those who do not have a history of nonmelanoma skin cancer.
White people who have had more than one melanoma are more likely to get additional melanomas as well as other malignancies, such as breast, prostate, and thyroid cancer.
What exactly is cancer staging?
Staging describes where the cancer is located, whether or not it has spread, and whether or not it is impacting other sections of the body.
Doctors utilise diagnostic tests to determine the stage of cancer, therefore staging may not be complete until all tests are completed. Knowing the stage allows the doctor to propose the most appropriate treatment and can assist estimate a patient’s prognosis, or possibility of recovery.
Basal cell and squamous cell carcinoma staging
Because basal cell and squamous cell carcinomas are typically treatable and seldom spread to other areas of the body, there is no staging classification for them. On rare occasions, a person’s lymph node(s) may be removed to determine whether the cancer has spread, a condition known as metastasis. Lymph nodes are bean-shaped structures that aid in the fight against infection. Other tests to establish the degree of the disease, such as blood tests, chest x-rays, and imaging scans of the lymph nodes and nerves, liver, bones, and brain, may be recommended by the doctor, but this is uncommon.
Merkel Cell Cancer Staging
Doctors utilise the TNM method to characterise the stage of Merkel cell carcinoma. Doctors utilise the results of diagnostic tests and scans to answer the following questions:
- Tumor (T): How big is the original tumour? Where is it?
- Node (N): Has the malignancy migrated to the lymph nodes? If so, where and how many?
- Metastasis (M): Has the cancer spread to other places of the body? If so, where and how much?
The results are pooled to identify each person’s stage of Merkel cell carcinoma.
There are five stages: stage 0 (zero), stages I–IV (1 through 4). The stage provides a common language for doctors to describe the cancer so that they can collaborate to determine the best treatments.
- Stage 0: is also known as carcinoma in situ or a precancerous lesion. Cancer cells can only be identified in the upper layers of the skin.
- Stage I: The primary tumour is 2 centimetres (cm) or less in width. The malignancy has not progressed to the lymph nodes or any other organs.
- Stage IIA: The tumour has grown to be greater than 2 cm in size and has not migrated to the lymph nodes or other regions of the body.
- Stage IIB: The tumour has spread to neighbouring tissues including muscles, cartilage, or bone. It has not spread to any lymph nodes or other parts of the body.
- Stage III: The cancer has progressed to the lymph nodes. The tumour might be any size and may have migrated to surrounding bone, muscle, connective tissue, or cartilage.
- Stage IIIA: The tumour is any size and may have spread to adjacent tissues. A biopsy or surgery revealed that the malignancy had spread to surrounding lymph nodes. The cancer has not spread to other places of the body. Alternatively, there is no evidence of a tumour, but cancer was discovered in a neighbouring lymph node during an exam or using imaging scans. Its presence was confirmed using a microscope.
- Stage IIIB: The tumour might be any size and has spread to adjacent tissues. The cancer has migrated through the lymphatic system, either to a regional lymph node near the site of origin or to a cutaneous site on the way to a lymph node, a process known as “in-transit metastasis.” These other lymph nodes may have been affected by metastases in transit. The lymphatic system is a component of the immune system that drains fluid from bodily tissues via a network of tubes or arteries.
- Stage IV: The tumour has migrated to distant organs such as the liver, lung, bone, or brain.
Symptoms and Warning Signs
Skin changes are the most common early warning symptom of skin cancer. Because each type of skin cancer manifests differently, it is critical to consult with your doctor if you observe any changes in your skin. The skin characteristics that commonly develop are described below.
- Two or more of the following characteristics may be present in basal cell carcinoma:
- An open wound that bleeds, oozes, or crusts for several weeks.
- A reddish, raised patch of skin or an inflamed area that may crust or itch but rarely hurts.
- A bulge that is glossy pink, crimson, pearly white, or translucent.
- A pink growth with a raised border and a crusty central indentation.
- A scar-like, white, yellow, or waxy patch with a smudged border.
- A scar-like patch of colour that is flat white, yellow, or waxy.
Image via Basal Cell Carcinoma
- Squamous cell carcinoma frequently crusts, bleeds, and manifests itself as:
- a growth that resembles a wart.
- A persistent, scaly red area with irregular edges that is prone to bleeding.
- An open wound that lasts for several weeks.
- A rough-surfaced elevated growth with a central depression.
- A persistent, scaly red area with irregular edges that crusts or bleeds at times.
Image via Squamous Cell Carcinoma
- Merkel cell cancer is frequently manifested as:
- Skin lumps that are painless, firm, and shiny.
- These lumps might be red, pink, or blue in colour.
Data Visualization Tool for Cancer Statistics in the United States
The Data Visualizations tool allows anybody to easily examine and use the most recent official federal government cancer data from the United States Cancer Statistics. It contains the most recent cancer statistics for the entire population of the United States.
How is skin cancer treated?
The most prevalent methods of therapies for non-melanoma skin cancer are listed here. Your treatment plan will also include treatment for symptoms and side effects, which is an important element of cancer care.
- Surgery
- Radiation therapy
- Other local therapies
- Chemotherapy
- Targeted treatment
- Immunotherapy
- Cancer’s physical, social, and emotional repercussions
- Skin cancer that has spread or has advanced
- Remission and the likelihood of recurrence.
Image via Chris Woolston
Prevention
Different forms of cancer are caused by different circumstances. Researchers are still investigating what variables cause non-melanoma skin cancers, as well as techniques to prevent them. Although there is no established technique to avoid skin cancer entirely, you may be able to reduce your risk. Speak with your health care team to learn more about your personal cancer risk.
Reducing UV radiation exposure, particularly by limiting time spent in the sun and avoiding indoor tanning, reduces the chance of acquiring skin cancer. This is critical for people of all ages, but especially for those who have other risk factors. Sun damage accumulates over time. Sunburn can be avoided by taking the following precautions:
- Limit or avoid direct sun exposure between 10:00 a.m. and 4:00 p.m.
- Wear sun-protective clothes, especially a hat with a wide brim to shade your face, neck, and ears. Clothes made of UV protection factor (UPF) branded fabric may provide superior protection. Sunglasses with UV protection are also advised.
- Throughout the year, apply a broad-spectrum sunscreen with an SPF of 30 or higher that protects against both UVA and UVB radiation. Apply at least 1 ounce of sunscreen to your entire body every 2 hours, or every hour if you’ve been sweating heavily or swimming.
- Avoid sunbathing for fun.
- Sunlamps, tanning beds, and tanning clinics should all be avoided.
- Check the skin on a frequent basis. This should involve both professional and self-examinations.
- According to one study, taking 500mg of nicotinamide, a type of vitamin B3, as a tablet twice daily reduced the risk of skin cancers other than melanoma by 23% in patients who had two or more previous skin cancers. Before beginning any supplement regimen, consult your doctor.
Limiting your sun exposure may lower your body’s production of vitamin D, while some study says that most people only need 15 minutes of sunshine exposure each day to create enough vitamin D. People who get little sun should consult their doctor about how to get enough vitamin D in their diet, which may involve taking supplements. A simple blood test can be used by your doctor to determine your vitamin D levels.