Non-Melanoma - What It Is and How to Treat It

Skin cancer is one of the most common diseases that affect at least 2 in 3 Australians before the age of 70 years with the state of Queensland being affected the most. It is mainly caused due to excessive exposure to ultraviolet (UV) radiation from the sun resulting in DNA damage to skin cells and if the skin damage is not repaired by the body’s internal DNA repair mechanism, then faulty cell replication would occur, which triggers the abnormal growth of cells, eventually leading to skin cancer.

Non-melanoma skin cancer also known as keratinocyte is a type of cancer that develops in the outermost layer of the skin. It is one of the most common cancers in the world, however, most are not life-threatening. Non-melanoma skin cancer is malignant but it is less likely to spread to other parts of the body and could be treated more easily than Melanoma.

There are two most common types of non-melanoma cancer and they are Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC). 

Basal Cell Carcinoma (BCC) accounts for about 70% of non-melanoma skin cancers. This cancer forms in the basal cells and develops on the top layer of the skin and it could appear anywhere on the body but is most likely to develop on parts of the body that receives high amounts of sun exposure such as the head, face, neck, shoulders and back.

Symptoms of basal cell carcinoma can include:-

• A shiny pink/red/pearly white waxy bump
• A flat & scaly reddish/pink patch or irritated area that may itch
• An open sore that crusts, itches, oozes or bleeds
• A scar-like, white, yellow or waxy lesion
• A pink growth with an elevated border and crusted central indentation

Squamous Cell Carcinoma (SCC) accounts for about 30% of non-melanoma skin cancers. This cancer forms in the flat squamous cells and develops in the areas which are least exposed to the sun such as the scalp, back of hands, ears and lips. These cancer cells generally grow quickly over weeks or months.

Symptoms of squamous cell carcinoma can include:-

• Scaly red patch
• Thickened red & scaly spot
• Rapidly growing lump
• Maybe tender to touch
• An open sore that persists for weeks
• A raised growth with a rough surface and a central depression

No one is immune to skin cancer but people who fall under any of the below categories are at higher risk of developing non-melanoma cancer.

• anyone who has experienced severe sun exposure
• having fair skin tone
• a history of sunburns
• a personal history of precancerous skin lesions
• a weakened immune system
• any rare genetic disorder

Occasionally irregular spots, moles or blemishes may appear on your skin but does not necessarily indicate skin cancer but you should be worried or concerned if you have spots or moles that are

• Changing in colour, shape or size rapidly
• Bleeding
• New and recently discovered
• Itching
• Having an irregular shape

then it is best to get it examined by a professional at your nearest spot check skin cancer clinic and if you are tested positive for results, the doctor will talk to you further about treatment options available. 

So what are the treatment options available for non-melanoma skin cancer?

The type of treatment available entirely depends on the type, size of skin cancer and where it is located.

1. Staging - a biopsy conducted to determine the stage of non-melanoma skin cancer. The staging system employs the TNM system which is used to describe the stage of cancer from stage I to IV.
2. Biopsy - in certain cases, a biopsy is capable of killing all cancer cells.
3. Surgery - it is the most common treatment available to treat non-melanoma cancer where cancerous cells are removed under a local anaesthetic. In more advanced cases, some of the surrounding tissue might be removed as well to make sure that all of the cancerous cells are removed.
4. Chemotherapy - most non-melanoma cancer could be treated with chemotherapy where an ointment or cream is applied to the top layer of the skin.
5. Radiation therapy - radiation therapy uses x-rays to kill cancer cells in areas of the body which are difficult to treat with surgery.

Being diagnosed with non-melanoma skin cancer could lead to difficult times in life but talking to your family & friends, raising questions and seeking answers about the information on cancer and treatment options best for you would be helpful and makes the process a little easier.