What types of skin cancer are there and how to treat them?

There are different types of skin cancer that can manifest themselves in different ways and each of them has a very different prognosis and treatment.

According to the World Health Organization (WHO) each year more than 5,000 cases of melanoma are diagnosed in Spain and more than 70,000 cancers of the non-melanoma type.Ref The good news is that 99% of cases are curable if diagnosed and treated early. 

Recently, in an article published by our research group, we published an article on research at Hospital Clínic de Barcelona,Ref we observe that in Catalonia the incidence of melanoma skin cancer continues to increase every year. Because of this, it is necessary that you know what types of skin cancer exist in order to prevent it or, if it occurs, to detect it as early as possible.

Diagram showing the different types of skin cancer

What will I talk about in this article?

Why do the different types of skin cancer occur?

At the cellular level, skin cancer is due to the uncontrolled growth of neoplastic cells in the epidermis, the outermost layer of the skin. 

Its main cause is due to the cellular damage to DNA (mainly from ultraviolet light) which triggers oncogenic mutations. These mutations lead skin cells to multiply rapidly and form various malignant skin tumors.

What types of skin cancer are there?

The type of skin cancer that each person can have is determined by the cell type where the cancer starts. In this way we will see that sf the cancer starts in skin cells called basal cells, the person will develop basal cell skin cancer (basal cell carcinoma or squamous cell carcinoma). 

On the other hand, when melanocytes (cells in charge of coloring the skin) become cancerous, melanoma will develop.

Diagram showing histologically the different types of skin cancer.
Mayo Clinic diagram showing microscopically the 3 main types of skin cancer.

The main types of skin cancer are basal cell carcinomathe squamous cell carcinomathe melanoma. Also, there are other rarer subtypes such as Merkel cell carcinoma, cutaneous lymphomas, atypical fibroxanthoma or dermatofibrosarcoma, which I will not discuss in this post.

So before discussing each of them, it is important to be clear about how we classify skin cancer in broad terms:

  • Non-melanoma skin cancer: the vast majority of skin cancers are due to the basal cell carcinoma (basal cell carcinomas) and to al squamous cell carcinoma (squamous cell carcinoma or squamous cell carcinoma). Although they are malignant, they are very unlikely to spread to other parts of the body if treated early. The problem is that they can be locally disfiguring if not treated in time.
  • Melanoma skin cancer: A small but significant number of skin cancers are malignant melanomas.. This type of skin cancer can be aggressive and spread to other parts of the body in advanced stages, fortunately nowadays most of them are curable. Although the frequency of carcinomas is lower, due to the potential for dissemination, we invest more time in prevention and prevention campaigns. using advanced tracking techniques for early diagnosis.

What causes skin cancer?

The two main causes of skin cancer are the sun's harmful ultraviolet (UV) rays and the use of tanning booths. Recent research studies have shown that the use of tanning booths during adolescence increases up to 2 times if you have done more than 10 sessions in your lifetime.

Photodamaged woman with freckles on her face and risk of developing skin cancer
Young woman with significant photodamage to the skin. This is characterized by the appearance of sun spots (solar lentigines) in photoexposed areas.

In addition to the previously described factors, there are also other risk factors such as:

  • Having more than 50 moles on the whole body or more than 3 moles with atypical characteristics.
  • Genetic factors (i.e., mutations in certain genes or family history)
  • History of radiotherapy
  • Certain conditions that suppress the immune system
  • Exposure to high levels of arsenic

Melanoma

Melanoma is a malignant tumor that develops from melanocytes, specialized skin cells whose main function is the production of melanin (tanning). Melanin is our defense mechanism against ultraviolet rays of the sun. Due to its high malignant potential it is responsible for more than 90% of the deaths resulting from skin cancer.

This tumor mainly affects the skin, but it can also develop in the mucous membranes (vaginal, oral, conjunctival) and also inside the eye. Melanomas usually develop on healthy skin and approximately 20-30% of the time they may develop on a pre-existing mole (nevus).

Photos of melanoma

Here are some images of this skin cancer to give you an idea of what melanoma looks like.

The lesions can be detected by the patients and that is why learning to identify the signs and symptoms of melanoma is key to early detection. In addition, it is very important to always maintain adequate sun protection and know how to use sunscreens.

Want to know more?

Basal cell carcinoma

Basal cell carcinoma is the most common cancer in humans. This carcinoma usually grows in parts of the skin that have received too much sun. This type of cancer starts as small, shiny papules or bumps, usually on the nose or other parts of the face. But you can get it anywhere on the body, including the trunk, legs and arms. If you have light skin and eyes, you are more likely to get this skin cancer.

Basal cell carcinoma usually grows very slowly and often does not appear for many years after intense and/or prolonged exposure to the sun. You can get it at a younger age if you get a lot of sun exposure or use tanning beds.

The good news is that it is very unlikely that this cancer will spread from the skin to other parts of the body.The skin cancer can be treated with local anesthesia, but it can produce an invasion to the local tissues. In the vast majority of cases with surgery under local anesthesia we are able to cure this type of skin cancer.

Photos of basal cell carcinomas

Below I will also leave you some images of this skin cancer so that you will be able to identify it:

Squamous carcinoma

Squamous cell carcinoma is another type of skin cancer. It is the second most common cause and is usually found on areas of the body damaged by UV rays from the sun or tanning beds. 

Squamous cell carcinoma usually grows quite slowly and locally. In rare cases when it has been a long time evolving or we have risk factors (immunosuppression, transplant patients) it can spread to nearby tissues, bones and lymph nodes, where it can be difficult to treat. However, most cases are detected early and are easy to treat.

Photos of squamous cell carcinomas

How is skin cancer treated?

The good news is that if the malignant skin tumors are detected earlyIf the lesions are not treated, the dermatologist can treat them, leaving little or no scarring and with a high probability of eliminating them completely. 

Often, the specialist can even detect the neoplasm at a precancerous stage (in situ) and apply minimally invasive treatments or even creams to cure it. It is therefore very important that you know the different types of skin cancer in order to be able to offer you a curative treatment.

 

Early detection of skin cancer can save your life.

Most basal cell derived carcinomas will be treated with local surgery and we will achieve a cure in most cases. 

On the other hand, melanoma will require specific treatment based on the size of the tumor and the involvement it may have had in other organs. 

I have a lesion like the one in the pictures! What do I do?

First of all, calm down. Most of the time when we see patients worried about this issue we end up making other diagnoses of benign lesions. But without a doubt, if you have a lesion of recent appearance and that does not heal you need to make an appointment with a dermatologist.

Request a visit with me

References

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Sebastian Podlipnik - Skin cancer

Sebastian Podlipnik

Dermatology Blog

I am a dermatologist and cum laude MD and author of multiple research studies. I specialize in skin cancer, laser technologies and cosmetic dermatology. The intention of this blog is to bring you closer to topics of interest in dermatology and research.

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