Patient education: Non-melanoma skin cancer (The Basics)

What is skin cancer? — Skin cancer happens when normal cells in the skin change into abnormal cells. There are 2 main types of skin cancer: melanoma and non-melanoma.

Non-melanoma skin cancer can occur anywhere on the skin. But it is often found on the head, face, neck, back of the hands, arms, and legs. This is because those body parts are most exposed to the sun's rays.

Skin cancer is often caused by sun exposure and sunburn. It usually affects people with light skin that burns easily. The damaging effects of the sun build up over time. The more you are exposed to the sun (or tanning beds) in your life, the higher your risk of skin cancer.

The 2 most common types of non-melanoma skin cancer are called "basal cell carcinoma" and "squamous cell carcinoma." Most forms of non-melanoma skin cancer can be easily treated because they grow slowly. But if not treated, some non-melanoma skin cancers can become large or spread inside the body.

What are the symptoms of non-melanoma skin cancer? — Skin cancer looks like an abnormal area of skin (picture 1) and can be:

●Pink

●Red and swollen

●Peeling

●Bleeding or look like an open sore

●Thick or crusty

Other skin changes due to sun damage can also occur. Some people, especially those with light skin, can get scaly, rough, or bumpy spots called "actinic keratoses." Actinic keratoses are often found on the face, ears, arms, or scalp (picture 2). They can sometimes turn into skin cancer. Doctors often treat actinic keratoses to decrease the chance that this will happen.

Skin changes can also be caused by conditions that are not cancer. But you should show your doctor or nurse any skin changes that you think might be abnormal.

Is there a test for skin cancer? — Yes. Your doctor or nurse will do an exam and check the skin all over your body. If they think that you might have skin cancer, you will have a follow-up test called a biopsy. During a biopsy, a doctor takes a small sample of the abnormal area or removes the whole abnormal area. Then, another doctor looks at the skin sample under a microscope to check for cancer.

If your doctor suspects that your skin cancer has spread inside your body, you will have other follow-up tests. These can include imaging tests. These create pictures of the inside of the body and can show abnormal growths.

The right treatment for you will depend a lot on the type of skin cancer you have, and its size and location. It will also depend on your age and other health problems.

How is non-melanoma skin cancer treated? — Most people with non-melanoma skin cancer have 1 or more of the following treatments:

●Surgery – Skin cancer is usually treated with surgery to remove or destroy the cancer. Doctors can do different types of surgery to treat skin cancer.

●Radiation therapy – Radiation kills cancer cells. It can be used when surgery is not possible. It can also be used after surgery if the cancer cannot be removed completely.

●Skin creams – Your doctor might prescribe a strong cream for you to put on your skin cancer. The medicines in these creams can kill cancer cells.

●Photodynamic therapy – Photodynamic therapy kills cancer cells. For this therapy, a doctor uses a special cream and a special light to treat the skin cancer.

In some situations, other treatments might be used. For certain types of non-melanoma skin cancer that cannot be treated with the above options, doctors might recommend 1 of the following:

●Immunotherapy – Immunotherapy is the term doctors use to describe medicines that work with the person's immune system to stop cancer growth.

●Targeted therapy – Targeted therapy is the term doctors use to describe a group of medicines that work only on cancers with certain characteristics. These medicines usually work by blocking a specific protein or molecule.

What happens after treatment? — After treatment, you will need to be checked every so often to see if the skin cancer comes back or if new skin cancer appears. Your doctor will do an exam and check your skin all over. Most doctors also recommend that you keep checking your skin to look for any new changes. Show your doctor or nurse any skin changes that you find.

What happens if the cancer comes back or if new skin cancer appears? — If the cancer comes back, or if you develop new skin cancer, you might need to have surgery or radiation therapy, or use a prescription skin cream.

Can skin cancer be prevented? — You can help prevent skin cancer by protecting your skin from the sun's rays. To reduce the chance of getting skin cancer, you can:

●Stay out of the sun in the middle of the day (from 10 AM to 4 PM).

●Wear sunscreen, and reapply it often.

●Wear a wide-brimmed hat, long-sleeved shirt, or long pants.

●Avoid tanning beds.

What else should I do? — Follow all of your doctors' instructions about visits and tests. It's also important to talk to your doctor about any side effects or problems you have during treatment.

Always let your doctors and nurses know how you feel about a treatment. Any time you are offered a treatment, ask:

●What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?

●What are the downsides to this treatment?

●Are there other options besides this treatment?

●What happens if I do not have this treatment?

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