We are, unfortunately, seeing more and more skin cancer cases. There are a number of reasons for this, but our aging population and increased sun exposure, especially of the binge type, are both implicated.

Most skin cancers are recognised early, treated simply on a day-case basis and cure is usually assured. More complicated cases may require inpatient treatment and involvement of a multi-disciplinary team.

Some sunshine is good for us as we depend on a degree of sun exposure to build up our Vitamin D stocks for the long northern winters, but sensible sun-protection includes the following steps:

• Recognition of your skin type – fair, freckled, blue-eyed people are especially vulnerable
• Avoid the midday sun when on holiday and don’t ‘binge’ tan
• Wear hats and long-sleeved shirts for protection
• Use sun protection creams or sun blocks (SPF 15 or greater) on sensitive areas
• Avoid sun beds

I will briefly describe the most common skin cancers:

Basal Cell Cancer (BCC) or ‘rodent ulcer’ is the commonest skin cancer and usually occurs in sun-exposed areas such as the face, head, arms and torso. They present as small pinkish/red non-healing nodules or ulcers. They are not usually itchy but will not go away. They grow slowly and generally do not spread beyond the local area. If caught early simple skin excision, often on a ‘see and treat’ basis under local anaesthetic, is curative. More complicated cases may require radiotherapy.

http://www.bapras.org.uk/public/patient-information/surgery-guides/skin-cancer/basal-cell-carcinoma

Squamous Cell Cancer (SCC) is the next most common skin cancer and again it’s usually sun-exposure related.              
It tends to occur in older people and presents as a steadily growing nodule or non-healing ulcer. Any ulcer which will not heal or bleeds easily should be checked by your doctor. These are more serious skin cancers as they can spread to local lymph glands and beyond. Early recognition and prompt surgical treatment, which often includes skin grafting, is, however, curative in the vast majority of cases.

http://www.bapras.org.uk/public/patient-information/surgery-guides/skin-cancer/squamous-cell-carcinoma

Malignant Melanoma (MM) is the most serious form of skin cancer as it readily spreads to other parts of the body.         It is also not as obviously sun-related so they can occur anywhere, including non-skin parts of the body. The most common presentation is the ‘changing mole’ – a pigmented skin lesion that is doing one or more of the following:

• Getting noticeably bigger
• Irregular outline
• Bleeds easily
• Different colours within pre-existing mole

The good news is that if melanomas are removed at an early stage the condition is usually easy to cure. The surgical excision generally involves a slightly wider area than the previous two skin cancers mentioned, and the use of a flap or skin graft to close the area is common. In selected cases examination of the local lymph nodes will also be discussed with you.

Please find a BAPRAS guide to skin cancer as a PDF. rcs_bapras_guide_skin_cancer

http://www.bapras.org.uk/public/patient-information/surgery-guides/skin-cancer/malignant-melanoma
http://www.bapras.org.uk/public/patient-information/surgery-guides/skin-cancer/lymph-node-surgery