While many of us are quick to use sun protection in the hot weather, others neglect to take the necessary precautions, and this puts them at a higher risk of developing skin cancer. As a result of not wearing sun protection, some people may notice their skin changing, specifically mole changes and other marks appearing as a result of the high temperatures. Searching these symptoms online can often be misleading and even dangerous, therefore it is strongly advisable for all patients who have noticed changes in their skin to visit a specialist for a check-up.
This article gives in-depth detail about the signs, symptoms preventions and treatments of skin cancer in the hope to raise awareness and educate people on how to protect themselves. The content has been compiled by a number of skin cancer specialists at The McIndoe Centre.
Symptoms of Skin Cancer
Skin cancer can present itself in a few varied forms, the most common being changes to moles, freckles or simply a small patch of skin. People who know their skin will be aware of any sudden changes to their pigmentation or freckles and/or moles, whereas those who don’t may not notice a problem until it’s too late. If you’re concerned about any area on your body that you can’t reach, ask your partner or friend to check these areas for any signs of concern.
The symptoms of skin cancer may appear as:
- Spots and sores
- Red skin patches
- Flat, red spots (scaly and crusty)
Other symptoms to look out for include:
- Scabbing of the skin
- Itchy patches
- Heals but then returns
- Occasional bleeding
- Slowly develops into a painless ulcer
If you have experienced any of these symptoms, it’s strongly advised that you visit your nearest GP for a check-up or with a skin cancer specialist. Additionally, if you have noticed any sudden changes to your skin (moles appearing, changing shape, spreading etc) again, it’s advised that you get them checked.
Melanomas are commonly identified as the appearance of a new mole, or a mole that's changed colour, shape or general appearance. If melanomas are left untreated, they can become a threat to your health as the cancer found inside these melanomas has the potential to spread and damage other organs in your body. This is why it is incredibly important to wear sun protection and also keep track of any changes to your skin. Common areas of the body which often get overlooked are the ears and back as they are difficult to see. Remember to check yourself in a mirror or ask someone you trust to check for you.
Spotting Signs of Skin Cancer
If you’re leaving your skin exposed and unprotected against the sun, you’re at a higher risk of developing non-melanoma skin cancers. The easiest way to spot skin cancer early is to know how your skin usually looks. For example, if you notice a new mole, spot or patch of skin that has suddenly appeared and doesn’t go away or heal within 4 weeks, it’s advised you see your doctor to confirm it’s nothing serious.
The ABCDE Rule
The ABCDE rule helps patients understand and identify any changes to their skin and/or moles. While it is a good system for identification, it’s important to remember that not all melanomas fall within the ABCDE guidelines. If you are concerned, or notice a change to your skin or mole, it’s strongly advised that you seek the advice of a dermatologist.
The ABCDE rule is as follows:
A – asymmetry
B – border irregularity
C – colour variations
D – diameter over ¼ inch (6mm)
E – evolution (or change)
However, what most people don’t know is that melanomas have very different features. It’s important to understand that certain melanomas may have no colour at all, which makes them even harder to spot. Physicians refer to these melanomas as ‘amelanotic’ melanomas. The reason being because they are missing melanin (the dark pigment that usually helps identify moles and melanomas). Although they initially appear colourless during the early stages, they can eventually turn pink, red or even purple.
How to Spot These
Stay on the lookout for symmetry and borders, if you notice that the potential melanoma is breaking the 6mm border or it’s a peculiar shape, then you might want to have it checked. Additionally, physicians are now stressing that out of the ABCDEs, E is now regarded as the most important factor to address. If you notice a sudden change or evolution on your skin, contact your doctor to ensure it’s nothing serious.
Identifying Different Types of Melanoma
Spotting melanoma can be difficult if you're unsure of what you're supposed to be looking for. However, if you have noticed a difference in your skin, or specifically a mole, then it's important to visit your local GP for a check-up. The other types of melanoma are listed below. If you have reason to believe that your mole displays an appearance matching any of the below, again, be sure to visit your GP.
Starting with one of the rarer melanomas, these melanomas account, on average, for 5% of cases in the UK. These melanomas are arguably one of the most difficult to spot, as they have little to no colour. If they do, they are usually pink or red with grey or light brown borders. They are notoriously difficult to spot to the untrained eye, and they require careful inspection by a dermatologist to make an accurate diagnosis.
Acral Lentiginous Melanoma
These melanomas do appear more commonly on those with darker skin. However, anyone can develop them. You may find this type of melanoma on the soles of your feet, and your palms. Like amelanotic melanoma, they are notoriously hard to identify and require careful examination and good clinical judgement to make an accurate diagnosis.
Lentigo Maligna Melanoma
Roughly 10% of melanomas are lentigo maligna melanomas. These melanomas take time to develop and are commonly found on elderly people, specifically those who have spent much of their time outdoors in the heat. Common areas where these melanomas appear are the face, neck and arms.
Identifying them can sometimes be difficult, as they take time to develop and they can often be confused with other moles. However, they are usually larger and darker than the common freckle. They will also grow over time and commonly change shape – this is why it's so important to conduct regular mole checks to ensure there are no significant changes to your skin.
If this melanoma is identified early, in most cases, removal rates are very successful. However, if they are left untreated, they can become invasive, growing downwards into the skin. The longer it’s left untreated, the worse the prognosis.
These are faster-growing melanomas that, if left untreated, can grow downwards and form nodules.
They make up approximately 20% of all melanoma cases and are characterised by their very dark colour, usually black or red. Bleeding and oozing are common symptoms.
Due to how fast they develop, it is essential to visit your local GP if you believe you may have a nodular melanoma.
Superficial Spreading Melanoma
Arguably the most common melanoma, the superficial spreading melanoma is responsible for 70% of the recorded melanomas in the UK. People with fairer skin and freckles are more susceptible, in comparison to those with darker skin.
Their growth pattern usually begins by spreading outwards, unlike nodular melanomas that drive downwards. Superficial spreading melanoma don't usually cause issues when they're growing outwards, but if they do begin to grow down, into the skin, they can spread to other areas of your body.
Rules and Guidelines for Spotting Melanomas
For further help in spotting melanomas, you can also apply the Ugly Duckling rule: if you notice a ‘spot’ that doesn’t quite match up with the other freckles and moles on your skin, it’s encouraged to get it checked.
It’s also important to know that the ABCDEs apply mainly to the most common form of melanoma – superficial spreading melanoma. There are actually four types of major melanoma, all of which look slightly different from one another.
The Basal Cell Skin Cancers
Basal Cell Carcinomas (BCCs) are the most common skin cancer within the UK. Despite a reported 200,000 cases a year, BCCs are rarely lethal. They spread at around 1mm every 3 months, and because of this slow growth rate, they aren’t usually identified until after a year.
They can be spotted by persistent bleeding and scabbing of the affected area. This is most noticeable when washing.
Identifying Basal Cell Skin Cancers
There are varying types of basal skin cancer and it’s important to be able to identify potentially cancerous moles, freckles or patches on your skin. Each basal cell cancer is described below:
Characterised as very thin tumours that may resemble eczema, which makes them hard to spot and identify. They’re commonly spotted across the head, neck, back and chest. There are a number of ways to treat them, including chemotherapy creams, liquid nitrogen, photodynamic therapy or surgery.
Morphoeic Basal Cell Cancer & Infiltrative Basal Cell Cancer
The most aggressive type of BCC and they can be tricky to spot, as it may just appear as a sore area on your skin. They are usually found on the beck and head, which can cause problems as if they do grow deeper into the skin, they can reach local, deeper tissues.
If they are not removed, they can lead to the destruction of the ear, and nose nerves, as well as vision loss. Mohs surgery is the most successful treatment for these tumours.
Nodular Basal Cell Cancer
Nodular basal cell cancers can appear translucent and dome-shaped and you might even be able to spot blood vessels within them. In some cases, they have a sore in the centre of the lump. The most successful treatment for nodular BCCs is surgery.
Treatment for Non-melanoma Skin Cancer
The most common form of treatment for non-melanoma skin cancer is surgery. However, this does depend on various factors, age and severity being important considerations.
Treating non-melanoma skin cancer is usually very successful, with 9 out of 10 people making a recovery. Treatment depends on a number of factors, and in most cases, you will have a specialist team overlooking your treatment. Dermatologists, plastic surgeons, chemo and radiotherapists and specialist nurses may be part of this team.
In some cases, non-surgical treatments such as cryotherapy, creams, radiotherapy, electrochemotherapy and photodynamic therapy may be used. Again, this is up to the discretion of your doctor, who will consider your general health, the type of cancer you have and what stage it's at.
While your doctor and your team will advise you on the best course of treatment, it is you who will have the final say. You might also find it helpful to prepare some questions for your doctor and their team. Common questions revolve around the advantages of certain treatments over others, recovery times, and what each treatment involves.
The Types of Surgery that are Available
There are a few surgical options that you may want to consider for your treatment. We have outlined the most common and effective surgical treatments below:
Surgical excision is a treatment which involves identifying the cancer and then cutting it out.
Surgeons adopting this technique will also remove some healthy tissue surrounding the cancerous area to ensure all the cancer is removed.
In some cases, this technique may be combined with a skin graft in order to cover and help conceal the affected area. The skin is usually taken from an area of your body where the scar won't be visible, such as the upper thigh, abdomen or neck.
This technique is highly effective. Most surgical excisions are enough to cure non-melanoma skin cancer.
Curettage and Electrocautery
This technique shares some similarities with surgical excision but is primarily used to treat cancers that are smaller. The technique itself sees the surgeon use a circular blade to remove the top layer of the cancer, before cauterising the skin. This is to ensure that any cancer cells that were not removed by the blade are removed by cauterisation.
Due to the nature of the procedure, you may need repeated procedures (usually two or three) to ensure the cancer has been removed entirely.
This procedure involves using cold treatment to freeze and ultimately remove the cancer. Once cryotherapy has been applied to the affected area, it will scab over. The scab will fall off after about a month, along with the cancer inside it.
It can also be used to remove non-melanoma cancers, but only in the earlier stages.
Creams and Topical Treatments for Treating Skin Cancer
These are known as 'anti-cancer creams' and can be used to help treat certain types of melanoma cancers. However, they are only used and effective when the cancer has breached the top layer of the skin.
The two types of cancer cream that are used are:
These include 5-fluorouracil, which can also be used to treat breast cancer, as well as bowel, stomach and pancreatic cancer. Creams with 5-fluorouracil are typically applied to the skin up to two times a day for up to a month (your doctor should give you a time frame).
5-fluorouracil will target and kill tumour cells, but only on the surface of the skin. It will not be able to reach cells that are deep within the skin, or cells that have spread to other organs. This is the reason it is used for superficial skin cancers.
PDT involves using a powerful light source to eliminate cancer cells. A cream is applied beforehand, which makes your skin sensitive to the light. The treatment itself may cause a slight burning sensation, but this is to be expected. Once the treatment is over, you may be left with some scarring, however it is usually not as noticeable in contrast to surgery.
This technique involves removing the cancer as well as a thin layer of skin from underneath its location. The skin is then analysed through a microscope to ensure all the cancer has been removed. If cancer cells are discovered, then more skin will be removed to ensure that there are no lingering cells left.
This technique focuses on minimising the amount of normal tissue needed to be removed around the cancer. This means that there is less visible scarring in contrast to other surgical options. This is why this technique is often used on the face.
The procedure itself removes all the malignant tumour, so there is no need for any return trips to treat the issue. Additionally, surgery can also be completed in just one day.
Mohs surgery has a 99% success rate for primary (untreated) cancers and that figure only lowers marginally when treating secondary or recurrent (previously treated) cancers. This is arguably the most successful method for removing skin cancer.
Stay Cautious During the Summer
There are many simple and effective ways to prevent skin cancer. Sun-cream is the most obvious safety tip, although many still neglect to use adequate protection. Even on the days that aren't particularly sunny, it's advised that you wear sun protection as you may still be at risk of burning if the UV rays are strong enough – this includes the winter months! Additionally, make sure the sun protection you're using protects against both UVA and UVB radiation.
Staying protected in summer is essential, constant exposure to the sun without adequate protection drastically increases your chances of developing a form of skin cancer. We cannot stress enough the importance of wearing sun protection.
Know Your Body - Be on the Lookout for Any Changes
We all think we know our bodies very well, but it's easy to miss a mole or a difference to our skin, especially if it's slow to develop. While it is very important to keep on top of any changes to your skin in the summer, it's equally important to monitor your skin throughout the rest of the year. As stated previously, some skin cancers can take time to develop, so if you do notice anything abnormal, it's important to go for a check-up, just to be on the safe side.
Alongside check-ups and consultations, they offer skin lesion and mole removal at The McIndoe Centre. So, if you are looking for a check-up, get in touch today. Their team are always on-hand to help patients, and they are happy to answer any questions or concerns you may have.