Skin cancer is common in the UK, and the risk increases with age, particularly for non-melanoma skin cancers. Most skin cancers are linked to ultraviolet exposure from the sun or sunbeds, although individual risk varies according to factors such as age, skin type, sun exposure, family history and previous skin cancer. Around 48% of new non-melanoma skin cancer cases in the UK are diagnosed in people aged 75 and over.
For most, though, there is uncertainty as to what skin cancer actually looks like. Which blemish is of no concern, which one might signify cancer and then which type of skin cancer might it be?
If the surface of the skin has changed, is that cause for concern, which parts of the body should someone particularly focus on if looking for any evidence of problems?
In this post, Anca Breahna, a plastic and cosmetic surgeon with specialist knowledge in the field of skin cancer and its treatment, will provide some key information.
Basal Cell Carcinoma, also known as Rodent Ulcer, is the most common type of skin cancer, accounting for around 80% of cases. Basal Cell Carcinoma develops in the basal cells, which are responsible for producing new skin cells as old ones die off. Basal Cell Carcinoma usually grows slowly and only rarely spreads to distant parts of the body, but it can damage surrounding tissue if left untreated and therefore still requires appropriate medical assessment and treatment.
Squamous Cell skin cancer is the second most common form of skin cancer, accounting for about 20% of cases. Squamous Cell Carcinoma develops in the squamous cells, which make up the middle and outer layers of the skin. Squamous Cell Carcinoma poses a greater risk to health than Basal Cell Carcinoma because it can grow larger and spread to other parts of the body if left untreated. Treatment for SCC depends on factors such as its size, location, depth and whether it has spread, and early assessment can help guide appropriate management.
Melanoma is the most serious and aggressive type of cancer affecting the skin, accounting for about 1% of all skin cancer cases. However, it is responsible for the majority of skin cancer deaths. Melanoma develops in the melanocytes, the cells that produce the pigment that gives skin its colour. Melanoma can spread beyond the skin, so a new or changing pigmented lesion that raises concern should be assessed promptly. Diagnosis may involve examination and biopsy or excision, with further management guided by the pathology result and specialist team.
The ABCDE system is a simple and effective method for self-assessment of moles and other skin lesions to help identify potential signs of melanoma, the most serious form of skin cancer. This system focuses on five key characteristics: Asymmetry, Border, Colour, Diameter, and Evolution.
– Asymmetry refers to the shape of the mole. If you were to draw an imaginary line through the centre of the mole, the two halves should match. If they don’t, this asymmetry could be a warning sign of melanoma.
– Border irregularity is another important factor. Benign moles typically have smooth, even borders, while melanomas often have ragged, notched, or blurred edges.
– Colour variations within a mole can also be a cause for concern. Benign moles usually have a single, uniform colour. Melanomas, on the other hand, may display a range of colours, including shades of black, brown, tan, red, white, or blue.
– Diameter is the fourth characteristic to consider. Moles larger than 6mm in diameter (about the size of a pencil eraser) are more likely to be melanomas. However, it’s important to note that melanomas can be smaller than this, so don’t ignore a mole just because it’s small.
– Finally, Evolution refers to changes in a mole over time. Benign moles typically remain stable, while melanomas may change in size, shape, colour, or texture. They may also begin to itch, bleed, or crust over.
Using the ABCDE system may help you notice changes in a mole or skin lesion that warrant medical assessment. If you notice a new or changing lesion, or one that bleeds, crusts, itches or looks different from your other moles, contact a doctor or appropriately qualified clinician for assessment.
The ABCDE system can help identify changes worth checking, but it cannot diagnose melanoma and not every melanoma follows all five features.
Yes, there are several additional factors and warning signs beyond the ABCDE system that individuals should be aware of when checking their skin:
If you notice any concerning changes in your skin, it’s essential to consult a specialist for a thorough evaluation. Depending on the assessment and diagnosis, biopsy or surgical treatment may be appropriate.
Sun exposure or exposure to UV light is a significant risk factor for all skin cancer types for darker skin tones and light skin. Priority should be given to checking areas that receive the most sun exposure, such as the face, arms, legs, and the backs of hands where cancer cells can occur.
If you notice a new, changing, bleeding, crusting or non-healing skin lesion, contact your GP or another appropriately qualified clinician for assessment. Depending on the findings, you may be referred for specialist review, biopsy or surgical treatment.
Miss Anca Breahna provides skin cancer surgery and lesion excision where surgical treatment is appropriate following assessment.
Actinic keratosis is a precancerous skin condition characterised by rough, scaly patches on sun-exposed areas of the skin. This scaly skin patch is caused by long-term exposure to ultraviolet (UV) radiation and can develop into squamous cell carcinoma if left untreated. Actinic keratosis is an early warning sign of potential skin cancer, and individuals with this condition should be monitored closely by a doctor.
Yes, individuals with a history of carcinoma have a higher risk of skin cancer development in the future. This is because their skin has already shown a susceptibility to the damaging effects of UV radiation, and they may have underlying genetic or environmental risk factors. If you have a history of skin cancer, it’s essential to be vigilant about sun protection, perform regular self-exams, and schedule frequent skin checks with a specialist.
Yes, different types of skin cancer can originate in different layers of the skin. Basal cell carcinoma develops in the basal cell layer of the epidermis (the outermost layer of skin), while squamous cell skin cancer arises from the squamous cells in the upper layers of the epidermis. Melanoma, the most serious type of skin cancer, develops in the melanocytes, which are found in the lower part of the epidermis.
Normal moles are typically symmetrical, with smooth borders and a uniform colour. They are usually smaller than 6mm in diameter and do not change over time. Moles that are asymmetrical, have irregular borders, display multiple colours, are larger than 6mm, have an abnormal growth or change in size, shape, or colour over time may be indicative of melanoma. If you notice any atypical moles that deviate from the appearance of your normal moles, consult a specialist for a professional assessment as they could be signs of skin cancer.
Abnormal cells that lead to skin cancer are primarily caused by damage to the DNA in skin cells due to exposure to UV radiation from the sun or tanning beds. Other factors that can contribute to the development of abnormal cells include genetic predisposition, a weakened immune system, exposure to certain chemicals or toxins, and chronic inflammation or irritation of the skin. When these abnormal cells grow and divide uncontrollably, they can form a cancerous tumour in the affected layer of the skin.
As one of the very few female Plastic Surgeons in her region, she is able to offer that unique female perspective, with empathy, attention to detail and personalised care.
Anca Breahna’s surgical training has been largely undertaken within the United Kingdom. She began a rigorous training programme in Plastic and Reconstructive Surgery in 1999, after achieving her medical degree from the University of Bucharest. Miss Breahna attained her PhD degree at the same university in 2007 for her medical research. She then relocated to the UK to further extend her qualifications and training.
Anca’s NHS practice is now focused on Breast Reconstructive Surgery, Skin Cancer Surgery, Hand Surgery and soft tissue reconstruction. Over the last 15 years, through her pursuit of further training and education, Anca has developed a special interest and expert practical experience in a range of Aesthetic Breast and Body Surgery.
It is Anca’s true dedication and commitment to her field, that sets her aside from her peers. Her extensive surgical training means that you are in safe hands. She is renowned for providing exceptional care, support and helping achieve realistic goals for her patients.
Anca will treat you in a straightforward manner, with respect, consideration and empathy to ensure you are comfortable with your choice.