Skin cancer is a disease caused by abnormal proliferation of skin cells, primarily divided into non-melanoma skin cancers and melanoma. According to statistics from the World Health Organization, skin cancer accounts significantly among new cancer cases worldwide, especially with higher incidence rates in regions with intense sunlight. Early detection and treatment can greatly improve the cure rate, but public awareness of symptoms and preventive measures remains insufficient.
This article systematically analyzes the causes, clinical manifestations, diagnostic methods, and treatment strategies for skin cancer, providing practical prevention advice. Understanding this information can help readers identify risks, seek medical attention early, and establish correct skin health management concepts. The key is to recognize the multi-faceted knowledge covered by "Overview of Skin Cancer," from cellular mechanisms to daily protective measures, to comprehensively understand the characteristics and countermeasures for this disease.
The development of skin cancer is related to various intrinsic and extrinsic factors. Ultraviolet (UV) radiation is the primary environmental trigger, with UVB causing DNA damage in the epidermis, leading to abnormal cell repair mechanisms. Prolonged sun exposure and history of sunburns (especially during childhood) accumulate DNA damage, increasing the risk of malignant transformation. Occupational UV exposure (such as agricultural workers) or residents in high-altitude, low-latitude areas have a 2-3 times higher incidence than the general population.
Genetic factors play a key role in certain types of skin cancer. Individuals with a family history of melanoma have a 5-10 fold increased risk, related to specific gene mutations (such as CDKN2A, BRAF mutations). Immunosuppressed individuals (such as organ transplant recipients) or those infected with human papillomavirus (HPV) are also associated with specific skin cancer subtypes. Additionally, chronic skin injuries (such as long-term exposure to arsenic or tar) and immunosuppression can weaken cellular surveillance mechanisms, promoting the progression of precancerous lesions to malignant tumors.
The symptoms of different types of skin cancer vary significantly. Basal cell carcinoma often presents as a pearl-like nodule on the skin surface, with raised edges and a central depression, commonly with telangiectasia on the surface. Lesions are frequently found on the face, ears, and other sun-exposed areas. Early stages may only cause mild itching, but if untreated, the lesion can invade deeper tissues, causing tissue destruction.
Melanoma exhibits the "ABCDE" features:
Squamous cell carcinoma often manifests as a hard nodule or scaly plaque, commonly on the back of the hands, lips, and other areas, possibly with bleeding or ulceration. Patients may experience local pain or tenderness, and the lesion may have scaly exfoliation around it. When cancer cells metastasize to lymph nodes, there may be local swelling or lymphadenopathy.
The diagnostic process begins with visual inspection and palpation, where the physician carefully observes the lesion's shape, color, and borders. Skin microscopy may be performed, using special light sources to magnify and observe skin structures; patterns of pigmentation or network structures characteristic of melanoma can be identified at this stage. If malignancy is suspected, a biopsy with tissue sampling is necessary for histopathological analysis.
Imaging examinations are used to assess disease progression. Computed tomography (CT) and magnetic resonance imaging (MRI) evaluate tumor depth and lymph node metastasis. Positron emission tomography (PET-CT) is used in advanced cases to detect distant metastases. Blood tests can assess liver and kidney functions to inform subsequent treatment plans.
Emerging diagnostic methods include:
Therapeutic strategies depend on cancer type and stage. Surgical excision is the first choice for early skin cancers, with Mohs surgery allowing layer-by-layer removal and immediate histological analysis to maximize normal tissue preservation. For patients unable to undergo surgery, radiotherapy can effectively control local lesions, especially suitable for elderly patients or those with comorbidities.
Drug treatments include immune checkpoint inhibitors (such as anti-PD-1 monoclonal antibodies), which have shown significant efficacy in advanced melanoma, increasing 2-year survival rates to over 60%. Targeted therapies for BRAF-mutant tumors, such as dabrafenib combined with trametinib, can reduce tumor size by about 60%. Chemotherapy remains a supplementary option in late-stage cases, often combined with targeted drugs.
Photodynamic therapy, combining specific photosensitizers with light exposure, can selectively destroy cancer cells and is suitable for treating extensive actinic keratosis. Gene therapy and cellular therapies are still in clinical trials; CAR-T cell therapy shows potential in laboratory studies for certain subtypes.
The core of skin cancer prevention is reducing UV exposure. Daily sun protection should combine physical barriers (such as broad-spectrum sun-protective clothing and wide-brimmed hats) with chemical sunscreens (SPF30 or higher). Avoid outdoor activities during peak sunlight hours (10 a.m. to 4 p.m.), and reapply sunscreen every two hours to reduce UV damage.
Self-examinations should be performed monthly, using a "head mirror" to inspect hard-to-see areas like the scalp. High-risk groups (such as those with many moles or a family history) should undergo professional skin examinations every six months. Quitting smoking can reduce the risk of squamous cell carcinoma, as tobacco tar directly damages epidermal cell DNA.
Choosing UPF (Ultraviolet Protection Factor) 50+ clothing can block 98% of UV rays. Installing UV-blocking window films at home reduces UVA penetration through windows. Outdoor workers can use portable UV index monitors to track environmental UV intensity in real-time.
Seek immediate medical attention if you notice the following skin abnormalities: a new mole larger than 6 millimeters, uneven coloration, asymmetrical shape, blurred borders, or rapid changes in size or shape. If existing moles enlarge quickly, ulcerate, or bleed, schedule a dermatology examination within three days.
High-risk individuals with unexplained local skin hardening, persistent itching, or tenderness should undergo professional evaluation. People over 60 with unexplained facial ulcers should be examined for basal cell carcinoma, even if asymptomatic. During routine self-examinations, if two or more of the "ABCDE" criteria are met, immediate biopsy is recommended.
Pay attention to abnormal skin lesions, including asymmetrical moles or patches, blurred borders, uneven coloration, diameter exceeding 6 millimeters, or rapid changes over a short period. Use a mirror monthly to check hard-to-see areas like the back and scalp. If abnormalities are found, seek professional diagnosis promptly.
How should I choose daily sunscreens to effectively reduce skin cancer risk?Select sunscreens with SPF 30 or higher and broad-spectrum protection (UVA/UVB), reapplying every two hours, especially during outdoor activities or after swimming. Physical sunscreens containing zinc oxide or titanium dioxide are suitable for sensitive skin, while chemical sunscreens should be checked for allergic reactions. Wearing wide-brimmed hats, long-sleeved clothing, and seeking shade can enhance protection.
If diagnosed with early skin cancer, is surgery always necessary?Early skin cancers (such as actinic keratosis) can be controlled with topical medications or cryotherapy (liquid nitrogen). However, if the lesion is deep or rapidly spreading, surgical removal remains the primary treatment. The doctor will tailor the treatment plan based on tumor size, location, and patient health, with some cases combining radiotherapy or immunotherapy.
Is the risk of recurrence high after treatment for non-melanoma skin cancer?The recurrence rate of non-melanoma skin cancers (such as basal cell carcinoma or squamous cell carcinoma) depends on treatment methods and tumor characteristics. If the initial removal was thorough with clear margins, the recurrence rate is below 5%. However, tumors in deep or highly malignant forms, or in immunocompromised patients, require regular follow-up, typically every 3 to 6 months with skin examinations.
Is it true that skin cancer only affects fair-skinned people? Is this correct?This is not entirely accurate. Although fair-skinned individuals have a higher risk due to weaker melanin protection, dark-skinned populations can also develop skin cancer from prolonged UV exposure or genetic factors, often on less sun-exposed areas like the soles or nails. All groups should perform regular self-examinations and avoid UV lamps or excessive sun exposure.
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