Non-melanoma skin cancer (NMSC) is the most common form of cancer in the UK and worldwide. In the UK, 1 in 5 will be diagnosed with one or multiple NMSC in their lifetime. Whilst considered less serious than melanoma, if left undiagnosed NMSC can cause extensive disfigurement through surgery and in rarer cases become life-threatening - early detection is key.
The term non-melanoma distinguishes these more common types of skin cancer from the less common types of skin cancer known as melanoma, which are often more serious. Non-melanoma skin cancer (NMSC) refers to a group of cancers that slowly develop in the upper layers of the skin (epidermis). NMSC develops when unrepaired damage to the skin cells cause the upper layers of the skin to grow out of control and form cancerous areas, lumps or lesions. These cells are known as basal cells and squamous cells.
Several types of skin cancer fall within the broader category of non-melanoma skin cancer, with the most common types being Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC) which are named after the cells in which the cancer developed. Basal Cell Carcinoma is by far the most common form of NMSC, accounting for around 75-80% of cases and Squamous Cell Carcinoma accounting for the remaining majority.
Non-melanoma skin cancer typically develop on areas of skin most frequently exposed to UV radiation such as the face, scalp, chest and forearms, but they can arise on other areas of the body. As the majority appear on the face surgery to remove the cancer, if detected at later stages can cause disfigurement and in rarer cases can become life-threatening, so early detection is key.
Basal Cell Carcinoma is more commonly diagnosed than all other malignancies combined. They are typically slow growing and rarely spread. In the vast majority of cases BCC can be successfully treated, however large or neglected BCCs can cause extensive local invasion and disfigurement due to surgery. It’s important to get to know your skin and seek professional clinical assessment with any new, unusual or changing skin lesions that have lasted for a few weeks.
Look out for the following signs and symptoms:
A persistent, non–healing sore is a very common sign of an early BCC. Look out for an open sore that bleeds, oozes, or crusts. It can remain open for a few weeks, only to heal, then open up and bleed again.
A pearly, shiny bump or nodule; sometimes clear and often pink, red, or white. The bump can also be tan, black, or brown, especially in dark haired people.
A pink growth with a rolled, slightly elevated border and an indentation in the centre. As the growth enlarges, tiny blood vessels may develop on the surface.
A patch of reddish irritated skin; frequently occurring on the face, chest, shoulders, arms, or legs. Sometimes the patch crusts. It may also itch or hurt. At other times, it persists with no discomfort.
A white, yellow or waxy scar-like area that often has poorly defined borders whilst the skin itself appears taut. This warning sign may indicate the presence of an invasive BCC that could be much larger than it appears on the surface.
In dark or black skin BCCs are generally darker-coloured growths that are less pearly in appearance, these growths can sometimes be confused with a normal mole.
Squamous Cell Carcinoma is the second most common type of non-melanoma skin cancer accounting for around 20 – 25% of cases. The majority occur on sun exposed areas i.e. the face, neck, ears, lips, and forearms. SCCs can appear in different sizes and shapes and grow at variable rates with varied appearance. SCC often cause discomfort and can be tender or painful to touch. They rarely spread, but if left untreated they can rapidly increase in size, spread to other sites and organs and become life-threatening. Early detection, diagnosis and treatment is vital.
Look out for the following signs and symptoms:
Small, hard white or skin coloured lumps is a common early warning sign.
Persistent, thick, rough, scaly patches that are generally slow growing.
A wart-like growth that can bleed if bumped, scratched or scraped.
A persistent open sore or scaly red patch with irregular borders that can crust or bleed.
An elevated growth with a crusted centre or central depression that may rapidly increase in size.
Pain and tenderness is a common warning sign of SCCs
Squamous cell carcinoma in dark or black skin: SCC is the most commonly diagnosed skin cancer among people of colour. In people with dark and black skin tones, squamous cell carcinoma is more likely to develop on skin that isn’t exposed to sun.
Merkel Cell Carcinoma (MCC) is technically considered a non-melanoma skin cancer, however, like melanoma it is an aggressive skin malignancy associated with immunosuppression and UV exposure. MCC is very rare but it develops rapidly over weeks or months. It can spread to other parts of the body such as the lymph nodes, lungs, liver or bones. Despite it’s rarity, MCC is a serious form of skin cancer, but with early detection, many cases can be treated successfully.
MCCs are often found on areas of the skin that get the most direct sun – such as the head, neck, arms and legs – but they can appear anywhere on the body. MCC grow quickly and usually appear as a shiny pink, red or bluish lump. The lumps are often less than 2 cm in diameter (although they can be larger). The skin over them is usually firm (not broken) and they don’t hurt. If you notice any rapidly growing lump or bump on the skin, seek immediate clinical assessment as early diagnosis and treatment is vital.
When you are referred to a skin specialist by your GP, they should be able to confirm the diagnosis by carrying out a physical examination. They may also perform a biopsy, a minor surgical procedure where either part or all of the tumour is removed and studied under a microscope. This is usually carried out under local anaesthetic. A biopsy allows the specialist to determine the type of skin cancer you have and whether there is any chance of it spreading to other parts of your body.
Basal Cell Carcinoma: If you are diagnosed with basal cell carcinoma and the tumour has been removed and tested, further tests aren’t usually required as it’s very unlikely that the cancer will spread.
Squamous Cell Carcinoma: If you are diagnosed with squamous cell carcinoma, further tests may be needed because in rarer cases it can spread to other parts of the body.
Surgery is the main treatment for non-melanoma skin cancer. This involves removing the cancerous tumour and some of the surrounding skin. Other non-surgical treatments for non-melanoma skin cancer include: cryotherapy, anti-cancer creams, photodynamic therapy (PDT), radiotherapy, chemotherapy and/or electrochemotherapy. Overall, treatment is successful for at least 9 out of 10 people with non-melanoma skin cancer.
Install the Skcin app on your mobile device to access all the tools and resources you need to confidently perform full-body skin examinations, set monthly reminders, and track lesions for signs of change using close-up photography.
The Skcin app is a comprehensive, educational, and self-management tool dedicated to the prevention and early detection of skin cancer. The app comprises six key service areas to help you learn more and take charge of your skin health and surveillance.
