Skin Cancer: Symptoms, Types, Causes and Treatment

Skin cancer is the most common type of cancer worldwide, affecting millions of people each year. Its incidence continues to rise, particularly in fair-skinned populations, due to a combination of environmental, genetic, and lifestyle factors. Understanding the early signs, types, underlying causes, and available treatments for skin cancer is essential for promoting early detection, effective management, and improved outcomes.

Symptoms of Skin Cancer

Recognizing the symptoms of skin cancer can be life-saving. Early detection dramatically improves treatment success and outcomes. While many skin changes are harmless, some can signal malignancy and should not be ignored. Skin cancer symptoms can vary depending on the type and stage, and they may appear as new lesions or changes in existing moles or skin patches. Advanced stages can also bring significant physical discomfort and emotional distress.

Symptom	Description	Stage	Source
New Lesion	Appearance of a new skin bump/patch	Early	1 3
Changing Mole	Change in size, shape, or color	Early	1 3
Non-healing Sore	Sore that does not heal	Early	3 4
Bleeding/Exudate	Bleeding or oozing from lesion	Advanced	2 4
Pain	Localized pain or tenderness	Advanced	2 4
Fatigue	General tiredness	Advanced	2
Anorexia	Loss of appetite	Advanced	2 4
Dyspnea	Shortness of breath (if metastatic)	Advanced	2 4
Psychological Symptoms	Depression, anxiety	All stages	5

Table 1: Key Symptoms of Skin Cancer

Understanding Skin Cancer Symptoms

Early Symptoms

Early symptoms often go unnoticed or are mistaken for benign skin changes. Key warning signs include:

• New growths or spots on the skin that look different from others
• Existing moles or lesions that change in color, size, or texture
• Spots that itch, bleed, crust over, or do not heal

The importance of monitoring the skin for any new or evolving changes cannot be overstated. Physicians often look for classic features but caution that overlapping or atypical presentations are common. A biopsy is usually necessary to confirm a diagnosis 1 3.

Symptoms in Advanced Stages

As skin cancer progresses, symptoms become more severe and systemic. Advanced cases can present with:

• Persistent pain in or around the lesion
• Bleeding, oozing, or ulceration of the tumor
• Fatigue and loss of appetite (anorexia)
• Shortness of breath if cancer spreads to the lungs
• Bleeding or exudate, a hallmark of advanced skin tumors
• Other symptoms like insomnia, delirium, drowsiness, anemia, and even paralysis in rare cases 2 4

Psychological Impact

The diagnosis and treatment of skin cancer can trigger significant psychological reactions, including:

• Depression
• Anxiety
• Hypochondria These psychological symptoms can be more pronounced in women and may significantly affect the quality of life 5.

Types of Skin Cancer

There are several types of skin cancer, each with unique features, risk profiles, and outcomes. The three most common forms are basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. Understanding these types helps guide both prevention and treatment strategies.

Type	Frequency	Aggressiveness	Source
Basal Cell Carcinoma (BCC)	Most common	Low	3 7 9
Squamous Cell Carcinoma (SCC)	Second most common	Moderate to High	3 7 9
Melanoma	Less common	High	3 8 9
Other Rare Types	Merkel cell, Kaposi's, etc.	Variable	9

Table 2: Main Types of Skin Cancer

Major Types of Skin Cancer

Basal Cell Carcinoma (BCC)

• Most prevalent form of skin cancer
• Arises from the basal cells of the epidermis
• Typically found on sun-exposed areas, especially the face
• Grows slowly and rarely metastasizes, but can invade local tissues if untreated
• Presents as pearly or waxy bumps, sometimes with visible blood vessels or ulceration 3 7 9

Squamous Cell Carcinoma (SCC)

• Second most common type
• Originates from squamous cells in the epidermis
• More likely than BCC to invade deeper tissues and metastasize
• Often appears as firm, red nodules, scaly patches, or sores that may bleed or crust
• Higher risk in chronically sun-exposed skin (face, ears, hands) 3 7 9

Melanoma

• Less common but much more dangerous
• Develops from melanocytes (pigment-producing cells)
• Can rapidly spread to other organs if not detected early
• Often starts as a new or changing mole, with asymmetry, irregular borders, color variation, diameter >6mm, and evolving shape (ABCDE rule)
• Most common subtype is superficial spreading melanoma 3 8 9

Other Rare Skin Cancers

• Merkel cell carcinoma: Aggressive neuroendocrine tumor, rare but increasing in incidence
• Kaposi's sarcoma: Associated with immunosuppression (e.g., HIV/AIDS)
• Cutaneous lymphoma: Originates from skin lymphocytes 9

Causes of Skin Cancer

Skin cancer is a multifactorial disease, with ultraviolet (UV) radiation being the primary risk factor. However, genetics, environmental exposures, and other health conditions can also contribute. Understanding these factors is crucial for effective prevention.

Cause	Description	Impact Level	Source
UV Radiation	Sunlight & tanning beds	Major	3 8 11 12 14
Genetics	Family history, skin type	Moderate	10 14
Immunosuppression	Organ transplants, HIV/AIDS	High	14
Chemical Exposure	Arsenic, industrial pollutants	Moderate	14
Viral Infections	HPV (esp. for SCC)	Moderate	14
Aging	Increased risk with age	Moderate	14
Prior Radiation	Previous radiotherapy	Moderate	14

Table 3: Primary Causes and Risk Factors for Skin Cancer

Ultraviolet (UV) Radiation

UV radiation from sunlight is overwhelmingly the leading cause of all major skin cancers 3 8 11 12 14. Both acute (sunburn) and chronic exposure cause DNA damage, mutations, and immunosuppression in skin cells:

• BCC: Linked to intense, intermittent UV exposure, especially during childhood
• SCC: Associated with cumulative, long-term sun exposure
• Melanoma: Tied to both intermittent and chronic UV exposure, particularly sunburns

Artificial sources, such as tanning beds and lamps, also significantly increase risk 12 14.

Genetic and Personal Risk Factors

• Fair skin, light eyes, blond or red hair: Less natural protection against UV, higher susceptibility
• Family history: Inherited genetic mutations can predispose individuals
• Personal history: Previous skin cancer increases future risk
• Polymorphisms and polygenic risk scores: Recent research shows that combining genetic factors can help predict risk and guide screening 10

Immunosuppression

• Organ transplant recipients and HIV/AIDS patients: Have a much higher risk, especially for SCC, due to reduced immune surveillance 14

Chemical and Environmental Exposures

• Arsenic, coal tar, industrial solvents: Occupational or environmental exposure increases risk
• Ozone depletion and higher altitude: More UV reaches the earth's surface

Other Contributing Factors

• Aging: Risk increases with age due to cumulative exposure and skin changes
• Prior radiation treatment: Increases risk at the site of exposure
• Viral infections: Certain strains of HPV, especially in SCC
• Chronic wounds or scars: Sites of chronic injury are more prone to malignant transformation 14

Treatment of Skin Cancer

Treatment of skin cancer depends on the type, stage, location, and patient's overall health. A range of therapies, from surgical excision to advanced targeted treatments, are available. Early diagnosis remains critical for optimal outcomes.

Treatment	Description	Indication	Source
Surgery	Excision, Mohs micrographic surgery	Most cases	1 3 15 18
Radiotherapy	Targeted radiation	Advanced, inoperable	4 15
Topical Therapy	Creams/ointments (e.g., 5-FU, imiquimod)	Superficial cancers	18
Chemotherapy	Systemic or local drugs	Advanced/metastatic	15 16
Immunotherapy	Boosts body's immune response	Advanced melanoma	15 16
Targeted Therapy	Drugs targeting specific mutations	Melanoma	15 16
Nanotechnology	Nanoparticle-based delivery	Experimental	16 17 19
Palliative Care	Symptom management	Advanced disease	2 4

Table 4: Treatment Modalities for Skin Cancer

Standard Treatments

Surgery

• First-line treatment for most skin cancers
• Includes simple excision, curettage, and Mohs micrographic surgery for precise margin control
• High cure rates, especially for BCC and SCC when caught early
• Minimal scarring with modern techniques 1 3 15 18

Radiotherapy

• Used for tumors that cannot be surgically removed or for patients who are not surgical candidates
• Also used for palliative symptom relief in advanced cases 4 15

Topical Treatments

• Useful for superficial BCC and SCC
• Common agents: 5-fluorouracil, imiquimod
• Lower systemic toxicity, but not suitable for deeper tumors 18

Systemic Therapies

Chemotherapy

• Reserved for advanced, metastatic, or recurrent cases
• Can have significant side effects 15 16

Immunotherapy and Targeted Therapy

• Immunotherapy: Checkpoint inhibitors (e.g., pembrolizumab, nivolumab) for advanced melanoma
• Targeted therapy: BRAF and MEK inhibitors for melanomas with specific mutations
• These have improved survival rates for advanced melanoma 15 16

Emerging and Experimental Treatments

Nanotechnology-Based Approaches

• Use nanoparticles for targeted drug delivery, increasing efficacy and reducing side effects
• Potential for combining diagnosis and therapy ("theranostics")
• Still largely experimental, but promising results in clinical trials 16 17 19

Palliative Care

• Focuses on managing symptoms and improving quality of life in unresectable or terminal cases
• Includes pain management, wound care, nutritional support, and psychological support 2 4

Conclusion

Skin cancer poses a significant and growing public health challenge, but early detection, awareness, and advances in treatment are making a positive impact on outcomes.

Key Takeaways:

• Early symptoms can be subtle; monitor your skin for new or changing lesions and seek medical advice promptly.
• Three main types of skin cancer exist: basal cell carcinoma, squamous cell carcinoma, and melanoma—each with different risk profiles and aggressiveness.
• Ultraviolet radiation is the primary cause, but genetics, immunosuppression, chemical exposures, and other factors also contribute.
• Treatment ranges from surgical excision to advanced systemic therapies and emerging nanotechnology-based approaches.
• Psychological support and symptom management are essential, especially for advanced disease.

Staying informed, practicing sun safety, and regular skin checks are vital steps in reducing your risk and ensuring early intervention for the best possible outcome.