Skin cancer, including melanoma
Skin cancer is common; 1 in 4 people in the UK will develop it at some point in their lives. Fortunately the most common type of skin cancer is BCC (=basal cell carcinoma) and BCCs are hardly ever a threat to a person’s general health. They can be treated by surgery, or sometimes by using creams or liquid nitrogen. Another type of skin cancer is SCC (=squamous cell carcinoma); SCCs are usually treated by surgery.
Melanoma is a dangerous type of skin cancer. Approximately half of melanomas develop from moles. Signs that can indicate a lesion may be a melanoma include getting bigger, consisting of multiple colours, having an irregular edge, bleeding, itching, or being very different from the other moles on your skin (for example, being larger or darker). If you have concerns about a mole then you should immediately see your GP (or a dermatologist). If there is concern that a lesion may be a melanoma then it is cut out and checked under the microscope. Fortunately most lesions that have concern raised about them turn out not to be melanoma.
In the UK, 1 in 54 people will be diagnosed with melanoma in their lifetime. Risk factors for melanoma include having a history of melanoma in the family, having many moles, having multiple moles that are abnormal in their appearance, having very fair skin, and having had many episodes of sunburn. Avoiding excessive sun exposure, by staying out of the sun, wearing suitable clothing and using sunscreen with a high SPF (eg. 50) reduces the risk of melanoma developing. If you are avoiding the sun to a high degree then you should consider taking oral vitamin D supplements.
Melanomas are treated by surgically removing them. They are sent to be examined under the microscope. This establishes the diagnosis for certain, and gives information regarding the exact nature of the melanoma. Usually a second procedure is then performed to remove a wide margin of normal-looking skin around the site where the melanoma was removed. After that, in most cases no further treatment is needed, but some people are referred to an oncologist for consideration of this. In many cases the patient attends appointments every few months for a few years to check there is no evidence of recurrence, particularly in the lymph nodes.
If melanoma is removed at an early stage then the prognosis is good; it will probably not cause problems in the future. The very earliest stage is called melanoma in-situ and has a 100% survival rate. However, at later stages melanoma can metastasise (=spread around the body). An important part of assessing the stage of a melanoma is measuring its thickness under the microscope (the ‘Breslow thickness’); early lesions have a low Breslow thickness.
There are many uncommon types of skin cancer, such as mycosis fungoides (=a type of lymphoma, occurring in the skin).
The website of Cancer Research UK has good information about skin cancer:
Non-melanoma skin cancer;
- 1Pearly lumps
- 3A lump sensitive to the touch
- 4Raised skin in the cancerous area
- 5Scaly skin
- 6Occasional bleeding
Dr Roy Palmer, MBBS, MA, MRCP, PhD
Dr Roy Palmer studied pre-clinical medicine at the Oxford University and qualified as a consultant dermatologist in 2002.