Skin (Dermal) Cancer: What It Is, Symptoms, Diagnosis, and Treatment

Skin cancer, contrary to popular belief, is a common type of cancer. Research has shown that nearly one in five people will develop skin cancer at some point in their lives (1). Moreover, if diagnosed early, the disease can be completely treated. Common treatment methods include excision, cryotherapy, chemotherapy, radiation, and Mohs surgery. Appropriate treatments can be applied based on the type or stage of the disease. In some cases, a combination of several treatment methods may be used. Early diagnosis is crucial for complete treatment, so it is important to pay attention to any changes in the skin. To avoid skin cancer, it is important to have a dermatology check-up at least once a year.

What is Skin Cancer?

Cancer is a disease that causes cells in tissues or organs to grow and multiply uncontrollably. It is often named according to the tissue or organ where it occurs. Skin cancer develops when skin cells grow or multiply uncontrollably. In a healthy human body, a new skin cell is formed to replace a dying or aging skin cell. This cycle may be disrupted for various reasons. When this cycle is disturbed, new cells may be produced before healthy cells have disappeared. This situation leads to cancer.

The most common cause of skin cancer is prolonged exposure to ultraviolet (UV) rays from the sun. Therefore, it is recommended to take precautions, especially during the summer months when the sun is at its strongest. Otherwise, the skin is directly exposed to UV rays, which can alter the structure of the skin cells, leading to cancer.

Skin cancer is more common in areas of the body that are most exposed to sunlight. These areas include the face, ears, neck, lips, arms, chest, upper back, legs, and hands. However, skin cancer can also occur in areas that are less exposed to the sun, such as between the fingers, genital areas, and the soles of the feet.

What Causes Skin Cancer?

The primary cause of skin cancer is burns resulting from excessive sun exposure. Particularly, when the body burns enough to form blisters, it is a risky situation for skin cancer. UV rays from the sun can damage the DNA of the skin cells. Cells with damaged DNA become abnormal, growing and multiplying faster than they should. This leads to cancer in the affected area.

Other known causes of skin cancer include frequent exposure to substances like tar and coal. Additionally, certain conditions increase the risk of developing skin cancer, including:

• Living in sunny or high-altitude areas
• Frequent use of tanning beds
• Having light-colored eyes, fair skin, or freckles
• A family history of skin cancer
• Having previously undergone organ transplants
• Having diseases that weaken the immune system or taking medications that suppress the immune system
• Exposure to UV rays used in the treatment of skin conditions such as psoriasis and eczema (1).

Types of Skin Cancer

Some of the most common types of skin cancer include melanoma, basal cell carcinoma, and squamous cell carcinoma. However, there are also less common types. These are called Kaposi's sarcoma, Merkel cell carcinoma, and sebaceous gland carcinoma (2).

Basal Cell Carcinoma
Basal cell carcinoma is a type of skin cancer that causes lesions or nodules to form in the outer layer of the skin (epidermis). These lesions and nodules are most likely to appear in areas of the skin most exposed to the sun. With early diagnosis, it can be treated effectively.

Squamous Cell Carcinoma
Squamous cell carcinoma is a type of skin cancer that can develop due to the excessive production of squamous cells in the epidermis. Excessive exposure to UV rays is a factor that increases the risk of this disease.

Melanoma
Melanoma is the most dangerous type of skin cancer. If left untreated, it can lead to death. However, if diagnosed early, it can be completely treated. People with fair skin, blonde or red hair, and light-colored eyes are more likely to develop melanoma than others.

Kaposi's Sarcoma
This rare type of skin cancer develops in the blood vessels of the skin and causes red or purple spots.

Merkel Cell Carcinoma
This type of skin cancer causes firm and shiny nodules to form on or just beneath the skin, often in hair follicles. It is commonly seen on the neck, head, and torso.

Sebaceous Gland Carcinoma
This rare and aggressive type of skin cancer originates in the sebaceous glands of the skin. It is most commonly seen on the eyelids and leads to painless, hard nodules.

Symptoms of Skin Cancer

There are many types of skin cancer, and the symptoms vary depending on the type. Some of the most common symptoms of basal cell carcinoma include:

• Formation of wax-like lumps on the skin,
• Flat, skin-colored or brownish, wound-like lesions,
• Crusty wounds that heal but bleed again.

Squamous cell carcinoma, commonly found on the face, hands, and ears, has the following typical symptoms:

• Red, firm nodules,
• Flat lesions that may have both a scaly and crusted surface.

Melanoma, a type of skin cancer, presents different symptoms. Some of these include:

• Large or irregularly shaped dark spots or patches with a brownish tint,
• Bleeding lumps or ulcerated sores,
• Itchy, burning, or painful lesions,
• Dark lesions on mucous membranes anywhere on the body (2).

Diagnosis Methods for Skin Cancer

To diagnose skin cancer, it is important to consult a dermatologist. The examination begins with checking for any increase or growth in existing moles, freckles, or other spots on the body. Then, the dermatologist may examine the entire body, including the scalp and genital areas. If a suspicious lesion is present, a biopsy may be performed. If cancerous cells are found in the tissue sample, the most appropriate treatment method can be determined.

Skin Cancer Treatment

The course of treatment varies depending on the stage of the disease. Skin cancer is staged from 0 to 4, with higher stages indicating that the cancer has spread further. In the case of early diagnosis, the cancer tissue is usually confined to a small area, and a biopsy may be enough to remove all the cancerous cells. However, more advanced stages may require different treatment methods.

Cryotherapy
This treatment involves exposing the cancerous tissue to very low temperatures, freezing it, and then removing it from the body. Argon gas or liquid nitrogen is used to freeze the cancerous tissue.

Excisional Surgery
The goal of this surgery is to completely remove the cancerous cells from the body. To ensure this, a portion of healthy tissue around the cancerous area is also removed.

Mohs Surgery
In this surgical method, cancerous tissue is removed layer by layer. After each layer is cut, the tissue is examined, and the process continues until all the cancerous tissue is removed. The advantage of this method is that it minimizes damage to healthy tissues. It is especially useful for visible areas, making it an important cosmetic treatment.

In addition to these common treatments, curettage and electrodessication may be applied in the treatment of basal cell carcinoma and squamous cell carcinoma. For advanced skin cancer that has spread to multiple areas of the body, chemotherapy, immunotherapy, and radiation therapy may be used.

To prevent skin cancer, you can protect yourself from the harmful rays of the sun and sunburns. In case of any concerning symptoms, do not hesitate to get a check-up for early diagnosis and treatment to regain your health.