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Skin cancer (non-melanoma) at a glance

Non-melanoma skin cancer is the most common cancer in the UK.

Official figures report that over 72,400 cases were diagnosed in the UK in 2004. But this figure is an underestimate as not every case is registered at the doctors.

Non-melanoma skin cancers develop after the DNA (the genetic material in our cells) is damaged.

Ultraviolet (UV) radiation from sunlight or artificial sources such as sunbeds, ionising radiation (e.g. X-rays) and certain chemicals can cause this damage. This may happen years before cancer develops.

The most common forms of non-melanoma skin cancer are called basal cell carcinoma and squamous cell carcinoma, reflecting the different types of skin cell from which the disease can develop.

If you are looking for information about melanoma, a much more serious form of skin cancer that develops from abnormal moles, please go to the malignant melanoma pages of this section.

Treatment for non-melanoma skin cancer is usually very successful.

Non-melanoma skin cancers are usually slow growing, and it can take many years before the cancer is detectable. It is possible, although rare, for non-melanoma skin cancer to spread to other parts of the body.

Click on the links below to find out more about non-melanoma skin cancer cancer.

• Risks and causes
• Signs and symptoms
• Prevention
• Detection
• Treatment

If you are a patient looking for information on non-melanoma skin cancer, please visit our patient information website, CancerHelp UK.

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Risks and causes

The following things affect a person's chances of developing non-melanoma skin cancer.

UV radiation is the major risk factor for skin cancer. The main source of UV is the sun, so people who work outdoors are at greater risk. But UV from sun beds can also increase your risk of skin cancer.

Non-melanoma skin cancer mainly occurs in people over 50. However, it can also appear in younger people.

Skin that is fair and freckled has less protective pigment than darker skin and carries a higher risk of non-melanoma skin cancer.

People with this condition are born without protective pigment in the skin. This increases the risk of developing skin cancer.

More men than women develop non-melanoma skin cancer.

People who have had non-melanoma skin cancer in the past have a significantly increased risk of developing another skin cancer.

Some drugs given for organ or bone marrow transplants suppress the immune system. This increases the risk, in later years, of developing a type of non-melanoma skin cancer called squamous cell carcinoma.

People who have received radiotherapy as a treatment for cancer, or who have been exposed to radiation because of their job, have a slightly increased risk of developing non-melanoma skin cancer.

People who have suffered from severe burns or ulcers have skin that is more vulnerable to ultraviolet light. These people may be at greater risk of developing a non-melanoma skin cancer.

Sunspots are a sign of skin damage. They are flesh coloured, rough spots that can look like a wound which is not healing. Sunspots usually develop in areas of the body exposed to the sun. They can cover large areas such as the forehead. People with sunspots are at increased risk of non- melanoma skin cancer.

There are rare skin disorders that run in families. They can greatly increase the risk of skin cancer and include:

Xeroderma pigmentosum

This very rare inherited condition also greatly increases the risk of melanoma.

Naevoid basal cell carcinoma syndrome

This rare inherited syndrome is also known as Gorlin’s syndrome.

Bowen’s disease

Bowen’s disease is a very early type of non-melanoma skin cancer, which usually appears as reddened patches on the skin. Untreated, it can develop into squamous cell carcinoma, an uncommon type of non- melanoma skin cancer.

You can find out more about what 'cancer risk' means in the 'Understanding 'risk'' section of this website.

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Signs and symptons

Signs of non-melanoma skin cancer are visible on the skin, usually in areas that are exposed to the sun. It is useful to know what is normal, and to be aware of any changes. Symptoms can include:

• a spot or sore that does not heal in four weeks
• a spot or sore that continues to itch, hurt, crust, scab, erode or bleed for more than four weeks
• persistent skin ulcers that cannot be explained.

Any of these changes may be symptoms of non-cancerous skin growths. However, people who notice them should always report them to their doctor. If cancer is detected at an early stage, it is much easier to treat successfully.

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Screening

The best way to prevent non-melanoma skin cancer is to avoid over-exposure to the sun and other sources of ultraviolet (UV) radiation.

To find out more about the dangers of sun damage, and the five key actions you can take to protect yourself, please visit our SunSmart website.

Detection

Initially, the GP will ask about medical history and current symptoms, and carry out an examination of the skin. The GP or, after referral, a specialist, may want to carry out a biopsy

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Treatment

Treatment usually needs only to remove the cancer that is visible, as most non-melanoma skin cancers are unlikely to spread to other parts of the body. In some cases one type of treatment is all that is needed.

Surgery is successful for most types of non-melanoma skin cancer. There are a variety of different procedures, which doctors will select depending on the type and extent of the cancer.

Doctors use radiotherapy as a treatment for non-melanoma skin cancers that cover a large area. or are in areas of the body that are difficult to operate on. It is also an alternative for people who may find surgery difficult to cope with, such as elderly people or those in poor health.

For some superficial cancers, a chemotherapy drug can be used in the form of a cream. Rarely, where cancer has spread to other parts of the body, doctors may use chemotherapy drugs injected into a vein to treat it.

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