Skin cancer is malignant skin changes that show up as scaly patches, veiny nodules or dark, multicolored elevations. Skin cancer can be divided into two types: white and black skin cancer. The light skin cancer types basal cell carcinoma and squamous cell carcinoma are common, black skin cancer, also called melanoma, is rarer, but all the more dangerous because it quickly forms secondary tumors (metastases). Skin cancer is generally surgically removed.
Skin Cancer Causes
The skin is made up of several layers: the epidermis, the dermis and the hypodermis. The epidermis consists mainly of the thick layer with the prickly cells (keratinocytes), which is bounded below by the basal membrane or basal cell layer in the direction of the dermis. The basal cell layer also contains the pigment cells (melanocytes), which produce melanin, which gives the skin its tone and which, to a small extent, can also block UV rays. The most important cause of skin cancer is UV radiation from the sun and solarium.
UV radiation damages the genetic material in the skin cells. Even if the external symptoms of sunburn such as redness or pain subside - the skin never forgets. After a few years, the damage accumulates, so that skin cancer can develop. Especially in light skin cancer, long-term UV radiation is the most important cause. This is shown by the fact that areas of skin exposed to the sun, the so-called sun terraces, are particularly affected by actinic keratoses, basal cell carcinomas and spinal cell carcinomas. In the case of melanoma, on the other hand, it is mainly sunburn in childhood that significantly increases the risk of its occurrence.
Skin Cancer Symptoms
Skin cancer is not always easy to recognize for laypeople, since it involves very different skin changes and often appears inconspicuous. Specialists can recognize basal cell carcinomas, for example, by their yellowish-reddish color, a pearly edge and small blood vessels that shine through on the surface. Squamous cell carcinomas (also called spinalioma), in turn, form palpable nodules that have a firm scaly layer or crust on the top.
Both types of white skin cancer appear preferentially on the areas of the body known as "sun terraces": These are the areas that are particularly intensively exposed to UV rays in the sun. This includes forearms and backs of hands and on the face the bridge of the nose, forehead, the edges of the auricles and the lower lip. In men, the scalp with little hair or the bald head are also areas where spinalioma develops.
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| Skin cancer symptoms |
Black skin cancer, also known as melanoma (Greek: melanos = black), is also found in these places. This can also often occur on the upper body in men and on the arms and legs in women. Melanomas form dark, differently colored patches without a clear border. They develop when the so-called melanocytes, the pigment cells of the skin, degenerate.
Nine out of ten skin cancer sufferers have either a basal cell carcinoma or a squamous cell carcinoma, with the former being three to four times as common as this. Men suffer slightly more often from the malignant skin changes than women.
Types of skin cancer at a glance
- Precancerous stages: Actinic keratosis and Bowen's disease are among the precancerous stages. They usually appear as harmless cornifications of the skin. Actinic keratosis usually presents as a reddish or tan-colored scaly skin lesion that is more palpable than visible. Bowen's disease is a flat, sharply demarcated, but irregularly shaped, reddish-scaly elevation. If left untreated, one in ten sufferers will develop actinic keratosis into squamous cell carcinoma, and one in 20 will develop Bowen's disease. Therefore, both skin changes should be removed by a dermatologist. Whether creams or gels are an option or whether the doctor resorts to physical or surgical measures such as laser therapy or curettage depends on where the skin changes are located.
- White skin cancer: Skin cancer that originates primarily in the skin epithelium is also called light or white skin cancer. These include basal cell carcinoma (basalioma) and squamous cell carcinoma (spinalioma). Both types of cancer occur mainly in older people and are mainly triggered by UV light. They develop on the so-called sun terraces on the face, forearms and hands. Precursors are actinic keratosis and Bowen's disease. Secondary tumors (metastases) practically never develop due to a basalioma, a spinalioma can very rarely spread. Treatment is usually by surgical removal of the carcinoma.
- Black skin cancer: Black skin cancer, also called melanoma or malignant (cancerous) melanoma, is a highly malignant tumor of the pigment cells. It can spread at an early stage and then forms metastases in lymph nodes or more distant organs such as the liver, skin, lungs, brain or skeleton. Melanomas are surgically removed as far as possible. Flat melanomas with a penetration depth of one millimeter are usually easy to heal. In the case of black skin cancer, which has already formed metastases, immunotherapy and targeted therapies («targeted therapy») lead to the best successes today.
- Red skin cancer (alternatively also skin lymphoma, cutaneous malignant lymphoma): Red skin cancer is a generic term for rare forms of skin cancer that develop when lymph cells (lymphocytes) accumulate in the skin and grow out of control. In Switzerland, around 100 patients are newly diagnosed every year. Solar radiation plays no role in this, the known cause is a high dose of radioactive radiation. There are many treatment options for skin lymphoma, including cream treatments, light therapy, and surgical removal.
- Kaposi's sarcoma: Kaposi's sarcoma occurs primarily in the case of immunodeficiency due to HIV infection or drug suppression of the immune system. These are brownish, knotty skin changes that usually first appear on the legs and can later develop on the mucous membranes and internal organs (e.g. intestines). There is no standard approach to treatment. Surgical removal, radiation or cold therapy, but also antiretroviral therapy can help.
Prevention
Especially for very light-skinned people, it is advisable to avoid intensive UV rays from the sun and solarium. Other precautionary measures are:
- Avoiding the midday sun (between 11 a.m. and 3 p.m.)
- Refrain from going to the solarium
- When outdoors in good weather seek shade, wear sun protection clothing and a sun hat
- Apply sunscreen with a high sun protection factor or UV-A and UV-B protection
- Pay attention to sun protection, especially for children
- Support sun protection for outdoor jobs (sun sails, reducing working hours in the midday sun)
- Every six months: self-check
- Every two years: skin cancer screening