Medicines for Non-melanoma skin cancer

What it is

Non-melanoma skin cancer refers to the most common types of skin cancer, which develop in the upper layers of the skin — mainly basal cell carcinoma (the most common, sometimes called a "rodent ulcer") and squamous cell carcinoma. Unlike melanoma, these cancers grow more slowly and are much less likely to spread to other parts of the body, and they are usually very treatable, particularly when caught early. The main cause is long-term exposure to ultraviolet (UV) light from the sun or sunbeds, so they most often appear on areas exposed to the sun, such as the face, ears, neck, scalp, hands, and lower legs. The risk is higher in people with fair skin, older age, a lot of sun exposure or sunburn over the years, previous skin cancer, or a weakened immune system. Non-melanoma skin cancer can appear in different ways, including: a lump or nodule that may be shiny, pearly, red, or skin-coloured; a flat, scaly, red or crusty patch; a sore or ulcer that does not heal, or heals and comes back; a growth that bleeds, crusts, or itches; or a waxy, scar-like area. Because these can look like other, harmless skin problems, and because they change slowly, they can be easy to overlook — so any new, changing, unusual, or non-healing skin lesion should be checked. There may also be pre-cancerous changes (such as actinic keratoses — rough, scaly patches from sun damage) that can be treated to reduce risk. Non-melanoma skin cancer is usually treated successfully, most often with surgery to remove it, and other treatments are available; protecting the skin from UV is the key way to reduce the risk.

How it is treated

Non-melanoma skin cancer is assessed and treated by GPs and specialists (such as dermatologists), and because it is usually slow-growing and unlikely to spread, it is very often treated successfully, especially when caught early. A suspicious lesion is examined and usually confirmed with a biopsy or removed, and examined under a microscope. Treatment options include: surgery to remove the cancer (the most common treatment, which usually cures it), sometimes with specialised techniques for certain sites; and other treatments depending on the type, size, and location, such as freezing (cryotherapy), creams applied to the skin, curettage (scraping and cauterising), photodynamic therapy, and radiotherapy — these may be used for certain lesions or where surgery is less suitable. Pre-cancerous changes such as actinic keratoses may also be treated. Follow-up and skin checks are arranged where appropriate, as people who have had one skin cancer are at higher risk of further ones. The emphasis is on prevention and early detection: protecting the skin from UV — seeking shade (especially in the middle of the day), covering up with clothing and a hat, using a high-factor broad-spectrum sunscreen, and avoiding sunbeds — reduces the risk; and being aware of your skin and getting any new, changing, unusual, or non-healing lesion checked allows early diagnosis. Because non-melanoma skin cancers can look like harmless skin problems, a sore or patch that does not heal, or a new or changing lump or patch, should be seen by a GP. The reassuring messages are that non-melanoma skin cancer is common but usually not dangerous and highly treatable (often cured with simple surgery), and that sun protection and prompt checking of unusual or non-healing skin changes are the most valuable steps.