Nonmelanoma Skin Cancer

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Nonmelanoma skin cancer refers to all the types of cancer that occur in the skin that are not melanoma. Several types of skin cancer fall within the broader category of nonmelanoma skin cancer … Read More

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Nonmelanoma Skin Cancer

Nonmelanoma skin cancer refers to all the types of cancer that occur in the skin that are not melanoma. Several types of skin cancer fall within the broader category of nonmelanoma skin cancer, with the most common types being basal cell carcinoma and squamous cell carcinoma. Nonmelanoma skin cancers are skin cancers that develop in the basal, squamous or Merkel cells of the skin. Nonmelanoma skin cancer usually develops on regularly sun-exposed areas of skin; for instance, the ears, the hands, the face, and the shoulders. There are quite a number of nonmelanoma skin cancer, but the leading forms are basal cell carcinoma, squamous cell carcinoma and Merkel cell carcinoma. Types of nonmelanoma skin cancer
  • Basal cell carcinoma
Basal cell carcinoma, also known as basal cell cancer, is the commonest type of nonmelanoma skin cancer. It develops in the basal cells in the deepest part of the epidermis. It usually starts in the areas of skin most exposed to the sun; for instance, the face, the head, the neck, the arms, and the hands. The tumours often appear to be small, raised, shiny or pearly bumps. It, however, can have various kinds of appearance. They develop slowly and rarely do they spread to other parts of the body. Fortunately, virtually all basal cell carcinoma can be treated and cured, but in some cases, they may resurface after treatment. While they rarely spread to other parts of the body, they can extend beneath the skin to the bone if not treated; and this may lead to serious damage of the bone and also puts one at a higher risk to other types of skin cancer.
  • Squamous cell carcinoma
Squamous cell carcinoma, or squamous cell cancer as it is also known, is the second commonest form of skin cancer. It begins in the squamous cells of the upper part of the epidermis. It, also, often starts in areas of the skin exposed to the sun (face, head, neck, arms and hands), but may also start in other parts of the body, like the skin of the genital area. Squamous cell carcinoma lesions often have an appearance of rough or scaly reddish patch on the skin, which tends to grow quickly, but may also have various styles of appearance.
  • Merkel cell carcinoma
Merkel cell carcinoma is a rare kind of nonmelanoma skin cancer. Merkel cells are the cells found in the upper layer of the skin. They are very close to the nerve endings and help the skin sensitive to light touch. Merkel cell carcinoma occurs when these cells grow uncontrollably. Merkel cell carcinoma can be very dangerous because it tends to grow rapidly and may be very tough to treat if it spreads beyond the skin. Merkel cell carcinoma lumps are mostly found on areas of skin frequently exposed to the sun; for instance, the face, the neck and the arms, but can develop on any part of the body. They have a firm, shiny red, pink or blue appearance, and do not hurt. The lumps may be. They have a habit of growing rapidly. Staging of Nonmelanoma Skin Cancer
  • Stage 0: The cancer is still only at the top layer of the skin. This stage is otherwise known as carcinoma in situ.
  • Stage I: The tumour size measures 2 cm in diameter or smaller.
  • Stage II: The tumour size has grown bigger than 2 cm in diameter.
  • Stage III: The growth has spread beyond the skin to the cartilage, muscles, bones, and/or nearby lymph nodes, but not beyond these.
  • Stage IV: The growth has spread to other parts of the body.
A biopsy remains the best means of diagnosing a nonmelanoma skin cancer. The biopsy technique takes out either the entire or part of the lesion and the layers beneath it, permitting an accurate determination of the depth of the lesion.  This biopsy technique is of several forms;
  • Shave Biopsy: The use of a blade to shave off the top layers of the skin.  
  • Punch Biopsy: A cookie-cutter looking tool is used to remove a deep sample of the skin.  
  • Incisional Biopsy: The use of a scalpel to remove some part of the lesion. 
  • Excisional Biopsy: The use of a scalpel to remove the entire lesion.  
Nonmelanoma skin cancer treatment  Nonmelanoma skin cancer treatment can be carried out with the following methods;
  • Chemotherapy: This involves the use of very strong drugs to destroy cancer cells. It may be given through an IV or taken as a take a pill by mouth.
  • Surgery: The removal of the lesion.
  • Radiation therapy: The use of high energy X-rays or other forms of radiation to kill cancer cells. The radiation may be given through a machine, or with the aid of a needle, wire, or tiny sealed seed.
  • Hormone therapy: If hormones are thought to play a part in the cancer formation, the amount of the said hormone being produced are reduced and the ones already produced are rendered inactive. This can be done with drugs, surgery or radiation.
  • Targeted therapy: Drugs or other substances are given to attack the cancer cells without causing harm to the rest of the body.
  • Immunotherapy (biologic therapy): This treatment is used to boost the immune system or to attack cancer cells.
Other treatments option may be;
  • Cryotherapy; the use of liquid nitrogen to rapidly freeze off cancer. 
  • Curettage (that is, scraping).
  • Cautery (that is, burning).


The chief symptoms of nonmelanoma skin cancer is the appearance of a lump or a discoloured patch on the skin, which persists and slowly progresses after a few weeks, to over months or sometimes years.

  • Any change to the skin; especially a change in size or colour of a mole or other dark pigmented growth or spot.
  • Scaliness, oozing, bleeding or change to the appearance of a bump or nodule.
  • The spread of a pigmentation beyond its border.
  • Change in sensation.
  • Itchiness, tenderness and pain.
  • Sores that refuse to heal.

• sore that doesn't heal or comes back after healing.
• pale white or yellow flat areas that look like scars.
• raise and scaly red patches.
• small, smooth and shiny lumps that are pearly white, pink or red.
• a pink growth with raised edges and indents in the centre.
• a growth that has small blood vessels on the surface.


The main cause of a nonmelanoma skin cancer is overexposure to the sun and its ultraviolet (UV) rays, or artificial ultraviolet rays. This can be due to;

  • Having had severe sunburns and blistering, especially during childhood.
  • Having spent too much time in the sun over the years.
  • The use of tanning beds or sunlamps, which are artificial sources of ultraviolet rays.

Other causes of nonmelanoma skin cancer may be

  • Increase in numbers of unusual moles.
  • Fair skin complexion, freckles, light eye colour, light or red hair colour
  • History of skin cancer.
  • A family history of skin cancer.
  • Pale skin which burns easily. 
  • Immune system suppressing medication.
  • A co-existing medical disorder that suppresses the immune system
  • Smoking tobacco.
  • Lingering non-healing wounds or previous burns.

UVC is filtered out by the earth's atmosphere. UVA and UVB damage skin over time, making it more likely for skin cancers to develop. UVB is thought to be the main cause of non-melanoma skin cancer. Artificial sources of UV light, such as sunlamps and tanning beds, also increase your risk of developing skin cancer.


How can I prevent nonmelanoma skin cancer?

Non-melanoma skin cancer may not be completely preventable, but its risk can be reduced by;

  • Avoiding overexposure to ultraviolet light.
  • Using high-factor sunscreen. 
  • Proper and sensible dressing in the sun, such as wearing sunglasses (with 100% UVA/UVB protection), wearing clothing to shield the face and cover the body, wearing wide brimmed hat to protect the face, ears and neck
  • Limiting the amount of time spent in the sun during the hottest period of the day.
  • Avoiding sunbeds and sunlamps.
  • Frequently checking your skin for signs and symptoms of skin cancer.
  • Quitting smoking.

Melanoma vs. nonmelanoma skin cancer

Nonmelanoma skin cancer develops in the basal, squamous or Merkel cells of the skin, while melanoma skin cancer develops in the skin’s melanocytes.

What are the risk factors of nonmelanoma skin cancer?

  • Extreme exposure to ultraviolet radiation.
  • Fair complexion.
  • Occupational exposure to coal tar, pitch, creosote or arsenic compounds but to mention a few.
  • Family history.
  • Sunbed exposure.

Prognosis of Nonmelanoma Skin Cancer

Nonmelanoma skin cancer (very) rarely metastasizes, as a result the prognosis is generally very good. However, certain characteristics increases the risk of recurrence or metastasis.

These include 

  • Large tumour size (more than 2cm) or tumour depth.
  • Poorly defined tumour border.
  • Tumour development on the head or neck. 
  • A suppressed immune system.
  • Tumour invasion near a nerve. 
  • Tumour growth at a site of previous radiation therapy. 
  • Aggressive tumour pattern of growth. 

The 5 years survival rate of a nonmelanoma skin cancer witnesses another growth of nonmelanoma skin cancer in 30% to 50% of patients. Also, individuals who have had nonmelanoma skin cancer are at an increased risk of developing melanoma skin cancer.