18 May May is skin cancer awareness month
Skin cancer is the most common cancer worldwide. It is typically divided into melanoma and non-melanoma skin cancer. Non-melanoma skin cancer encompasses basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) and is by far the most common cancer in South Africa. Although melanoma is less common it is more dangerous as it is much more likely to spread (metastasise). The rates of skin cancer are increasing globally, and South Africa is no exception.
The common risk factor for all skin cancers is UV light exposure, whether this comes from natural sunlight or artificial sources like tanning beds. Both accumulated sunlight exposure and bursts of intense sunlight exposure are considered risk factors.
The South African population is at a particularly high risk of skin cancer due to the country’s geographical position and level of ultraviolet radiation (UVR). South Africans are also known to love the outdoors and as a result may have increased sun exposure due to outdoor occupational and recreational activities.
Other risk factors for developing skin cancer include:
- Skin that burns quickly or is prone to freckling.
- A lighter natural skin tone.
- Blond or red hair, with blue or green eyes.
- A large number or specific types of moles.
- A personal or family history of skin cancer.
- A weakened immune system (those with HIV, for example).
- Older age.
What is the appearance of skin cancer?
BCCs can take on different forms, as many types exist. Sometimes it can look like a small pearly lump with visible blood vessels on the surface, or like a red, scaly patch. BCCs may even develop into ulcers.
SCCs tend to start off as scaly, red patches that may also become ulcers or bleed. It often looks quite inflamed or develop a crusty appearance. It can also present as a non-healing scab covered wound.
A melanoma usually looks like a dark mole that starts to change its appearance or that looks unusual compared to its neighbours. It is important to know that melanoma can development in existing moles but also in areas where no previous moles existed. Melanomas can be recognised by the ABCDE rule:
Diameter greater than 6 millimetres
In rare instances, a melanoma can look pink, red or pale. It is important to note that black South Africans are disproportionately affected by melanomas at ‘acral’ sites – often the sole of the foot.
Dermatologists are trained to manage skin cancers, being the only specialists with years of training in the recognition and treatment of these cancers. Dermatologists are able to detect skin cancers at an early stage using sophisticated techniques such as dermoscopy and mole mapping. A partial or complete biopsy may be taken if a skin growth is suspicious.
Skin cancers may reach a considerably large size or spread to other sites of the body if they are not detected early enough. Fortunately, this can be prevented by frequently examining your skin for changes at home, combined with a Total Body Skin Examination (TBSE) performed by your dermatologist at regular intervals.
- Wright, Caradee Y et al. Solar ultraviolet radiation exposure and human health in South Africa: Finding a balance. South African Medical Journal, [S.l.], v. 102, n. 8, p. 665-666, jun. 2012. ISSN 2078-5135.
- Wet, J.D., Steyn, M., Jordaan, H.F., Smith, R., Claasens, S., & Visser, W.I. (2020). An Analysis of Biopsies for Suspected Skin Cancer at a Tertiary Care Dermatology Clinic in the Western Cape Province of South Africa. Journal of skin cancer, 2020, 1-7.
- WHO website – section on skin cancer: accessed at https://www.who.int/uv/faq/skincancer/en/index1.html
- SA National Cancer Registry 2016 Cancer Statistics Report accessed at https://www.nicd.ac.za/centres/national-cancer-registry/
- British Association of Dermatologists patient information leaflets on BCC, SCC and melanoma.