Wednesday 24 January 2018

Most skin cancers treatable if detected early

By Dr Michelle Cooper

Dr Michelle Cooper. Photo Eye Focus
Dr Michelle Cooper. Photo Eye Focus

Skin cancer, one of the most common forms of cancer in the Ireland, can be divided into the following different types:

- Melanoma (malignant melanoma).

This type of skin cancer develops from melanocytes.

- Non-melanoma.

These are about 20 times more common than melanomas and are further divided into two main types: Basal cell carcinoma (BCC) - skin cancer which develops from basal cells; Squamous cell carcinoma (SCC) - skin cancer which develops from cells known as keratinocytes. BCC and SCC occur mainly in white and fair-skinned people, rarely occurring in dark-skinned people.


The first sign of a BCC is often a small red, pink or pearly lump which appears on previously normal skin. Although the lump is often dome-shaped, BCC's can vary in shape and colour. They usually grow very slowly and it can take many months for one to grow to a centimeter or more. In time, the lump on the skin may crust over, ulcerate or bleed. BCC's very rarely spread (metastasise) to other parts of the body. However, untreated, they will continue to grow locally and can cause damage to nearby structures. For example, a BCC on the face may erode and damage the nose or ear.


Like BCC's, SCC's are more common in older people. A SCC typically develops on the face - most commonly on or around the ears or lips. However, any area of skin can be affected. They typically start as a small crusted or scaly area on the skin. They may grow into a lump which may look like a wart. A SCC may ulcerate or bleed from time to time. As a SCC grows larger and deeper, it damages nearby structures. A SCC may also spread (metastasise) to other areas of the body. However, this is uncommon in the early stages and most SCC are treated before any spread occurs.


Melanomas are the least common form of skin cancer. They are, however, the most serious form as they are the most likely form to spread to other parts of the body. Melanoma is twice as common in young women as it is in young men. A typical melanoma usually starts as a small dark patch on the skin (similar to a mole). It can develop from a normal part of skin, or from an existing mole. A melanoma is often different to a mole in one or more of the following ways (summed up as ABCD) - that is:

- Asymmetry - the shape of a melanoma is often uneven and asymmetrical, unlike a mole which is usually round and even.

- Border - the border or edges of a melanoma are often ragged, notched or blurred. A mole has a smooth well-defined edge.

- Colour - the colour (pigmentation) of a melanoma is often not uniform. It may contain 2-3 shades of brown or black. A mole usually has one uniform colour.

- Diameter - the size of a melanoma is usually larger than a normal mole.

It is important to note that some melanomas are not dark, and some melanomas are not typical in how they look. As a melanoma grows on the skin it may itch, bleed, crust or ulcerate.


FOR NON-MELANOMA SKIN CANCERS: The overall cure rate is over 95%, even for ones which have been present for a long period of time. The larger they grow, however, the more difficult they are to treat. More extensive surgery or other localised treatments may be needed if they grow large or deep before they are treated.

FOR MELANOMAS: The risk of spread to other parts of the body is high. This is why urgent, early treatment is vital. An operation is usually required to remove the melanoma. If it has already spread to other areas of the body then there is less chance of a cure. Treatments such as chemotherapy, radiotherapy or immunotherapy may be used for melanomas which have spread.


Most skin cancers are caused by excessive exposure to the sun. We should all limit our sun exposure in the summer months (or all year when in hot countries nearer to the equator) by:

- Staying indoors or seeking the shade as much as possible between the hours of 11am and 3pm.

- Covering up with clothes and a wide-brimmed hat when you are out in the sunshine.

- Applying sunscreen of at least sun protection factor (SPF) 15 (SPF 30 for children or people with pale skin) which also has high ultraviolet A (UVA) protection.

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Wexford People

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