Understanding Skin Cancer: Causes, Prevention, and Early Detection

It was a sunny Monday morning, and I was settling into my clinic when Mr. Andrew Mills, a retired gardener in his late 60s, arrived for his annual health check-up. He looked fit and tanned, but I noticed a small, scaly patch on his left forearm. “Dr. Priya,” he began, “it doesn’t hurt, but this spot hasn’t healed in months. Should I be concerned?”

His question set the stage for an important discussion about skin cancer—one of the most common and preventable cancers worldwide.

What Is Skin Cancer?

Skin cancer develops when skin cells grow abnormally, often due to damage from ultraviolet (UV) radiation. There are three main types of skin cancer, each with unique characteristics:

Basal Cell Carcinoma (BCC)

• Most common and least dangerous type of skin cancer.
• Usually appears on sun-exposed areas like the face and neck.
• Easily treated if detected early.
• Often affects people over 50 years of age.

Squamous Cell Carcinoma (SCC)

• More dangerous than BCC but still treatable when caught early.
• Typically occurs on sun-exposed areas such as the hands, forearms, and face.
• First sign: A thick lump with a crust.
• Risk factors: Prolonged sun exposure, older age, fair skin, and certain occupational hazards.

Melanoma

• The rarest but most dangerous form of skin cancer.
• Can develop in moles or appear as dark, irregular patches anywhere on the body.
• Early detection is critical, as melanoma spreads rapidly.

Who Is at Risk?

Andrew listened intently as I explained the risk factors for skin cancer. “Your history as a gardener likely puts you at higher risk,” I added gently.

High-Risk Groups:

• Older adults: The risk increases with age.
• Fair-skinned individuals: Especially those with freckles or a history of sunburns.
• Outdoor workers: Such as farmers, construction workers, and, yes, gardeners.
• People with a family history of skin cancer.

Interestingly, darker-skinned individuals are less prone to skin cancer but are at risk of late detection, especially for melanoma in areas like the soles of the feet.

What Causes Skin Cancer?

Primary Cause:

The sun’s ultraviolet (UV) rays are the main culprit. Prolonged exposure damages skin cells and triggers abnormal growth.

Other Causes:

• Chemical exposure: Substances like arsenic and polycyclic hydrocarbons.
• Radiation therapy: Previous treatment for other conditions may increase the risk.

I also shared a study published in The Lancet, which revealed that individuals who used tanning beds before age 30 had a 75% higher risk of developing melanoma. This sparked an important conversation about the dangers of artificial tanning.

How Can Skin Cancer Be Prevented?

“Prevention is always better than cure,” I told Andrew. Together, we reviewed practical steps:

Sun Safety Tips:

1. Avoid peak sun hours: Stay indoors between 10 a.m. and 3 p.m. when UV rays are strongest.
2. Wear protective clothing: A wide-brimmed hat, sunglasses, and long-sleeved shirts can shield your skin.
3. Use sunscreen: Apply SPF 30 or higher on all exposed areas, and reapply every two hours.
4. Seek shade: Especially during outdoor activities.

Andrew nodded as I handed him a brochure with these tips. “I wish I’d known this earlier,” he said wistfully.

What Are the Symptoms of Skin Cancer?

Recognizing early signs of skin cancer is crucial for effective treatment. I explained to Andrew that he should look out for:

• Basal Cell Carcinoma (BCC): A shiny bump or a pinkish patch.
• Squamous Cell Carcinoma (SCC): A thick lump with crusting or a sore that doesn’t heal.
• Melanoma: A mole that changes in size, shape, or color, or a new dark spot on the skin.

To help Andrew remember, I introduced the ABCDE rule for spotting melanoma:

• Asymmetry: One half doesn’t match the other.
• Border: Edges are irregular or blurred.
• Color: Multiple colors within the same spot.
• Diameter: Larger than 6 mm (pencil eraser size).
• Evolving: Changes in size, shape, or symptoms like itching or bleeding.

Early Detection: A Lifesaver

Andrew seemed concerned. “What should I do if I find something unusual?” he asked.

I reassured him that early detection is key. “The earlier we identify skin cancer, the easier it is to treat,” I said.

Steps for Early Detection:

1. Perform a monthly skin self-exam. Pay attention to hard-to-see areas like the back and scalp.
2. Take photographs of moles to track changes over time.
3. Schedule an annual skin check with your doctor, especially if you’re in a high-risk group.

What Should Be Done If Skin Cancer Is Suspected?

“If you notice a suspicious lump or lesion,” I told Andrew, “visit your doctor promptly.” Here’s what typically happens:

1. Physical Examination: A detailed look at the lesion.
2. Biopsy: A small sample of the affected area is sent for laboratory testing to confirm the diagnosis.
3. Treatment Plan: Depending on the type and stage, treatment options may include surgery, cryotherapy, or radiation therapy.

Treatment Options and Prognosis

Most cases of skin cancer are highly treatable when detected early. I explained to Andrew that:

• Surgery is often the first step, especially for small, localized cancers.
• Radiotherapy or cryotherapy may be used for more extensive lesions.
• Melanoma may require additional treatments, including immunotherapy or targeted drugs.

The good news? With prompt treatment, over 99% of patients achieve full recovery for non-melanoma skin cancers.

Andrew’s Resolution

A week later, Andrew returned for his biopsy results. Thankfully, his lesion was a benign keratosis, not cancer. Relieved, he pledged to adopt sun-safe habits moving forward.

“I’ve been lucky this time, Dr. Priya,” he said. “But I’ll be more careful now. And I’ll spread the word to my friends in the gardening club!”

His proactive approach reminded me of the importance of education and vigilance.

FAQs About Skin Cancer