Skin Cancer

Skin cancer may arise in cells other than the melanocytes, where it causes malignant melanoma (see melanoma in the skin section). The most common tumour (indeed the most common tumour of the Western World) is called a basal cell carcinoma, and it arises from cells in the epidermis in areas of the body which have been exposed to sunlight, such as the tips of the ears and the bridge of the nose. Initially these have a pearly edge with a central area that scales and does not heal. They can persist and invade underlying tissue such as cartilage, and are often termed a rodent ulcer. They can be treated by surgery or radiotherapy. Bowen's disease is regarded as a form of low-grade cancer, or carcinoma in situ. This usually appears as a single well-demarcated red scaly patch, often on the calf or the shin, and can look like eczema or dermatitis.

Since it often occurs in areas which have not been exposed to sunlight, its relationship to sun exposure is uncertain. It can be treated by surgery or radiotherapy.

Squamous cell carcinoma arises in areas that have been subject to chronic exposure to the sun (like the top of a bald head) and some are thought to develop from solar keratoses (described above). It can arise, in cigarette smokers, on the lower lip. It may resemble the more benign basal cell carcinoma; both should be treated.

Mycosis fungoides is a condition causing well demarcated and red scaly patches on the trunk and limbs, which may be present for many years. This is not a Cancer of skin cells but of white blood cells called T lymphocytes, which are deposited in the skin. It may respond to treatment with steroids or ultraviolet light, but some cases go on to become frank leukaemia.

While skin cancer may not be the most aggressive, and therefore amenable to treatment if detected sufficiently early, it would seem sensible to try to prevent its occurrence by limiting exposure to sunlight - in both those who are young, and those who were once.
 
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