Skin Cancer: Symptoms, Causes, Treatments, and Natural Approaches

Numerous epidemiological investigations have revealed a rising occurrence of both nonmelanoma skin cancer (NMSC) and melanoma in the last few decades.

Skin cancer may be the most common cancer in the United States, but luckily, it is highly treatable when caught early. Illustrations from Shutterstock/Designed by The Epoch Times

Skin cancer is the most common form of cancer in the United States, with over 5 million cases diagnosed each year and at least 20 percent of Americans developing this type of cancer by age 70.

Numerous epidemiological investigations have revealed a rising occurrence of both nonmelanoma skin cancer (NMSC) and melanoma in the past few decades.

What Are the Types of Skin Cancer?

There are three main types of skin cancer: basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. Although some of these have subtypes, and there are also rare types of skin cancers, these are beyond the scope of this article.

1. Basal Cell Carcinoma (BCC)

Also known as basal cell skin cancer, basal cell carcinoma is the most common type of skin cancer, accounting for 80 percent of all skin cancers in the United States.

As its name suggests, BCC begins in the basal cells in the lower part of the epidermis and continuously divides to replace worn-off squamous cells on the skin’s surface.

BCCs are frequently found in individuals with fair skin, but they can also affect people of color. In individuals with fair skin, BCCs typically manifest as round, flesh-colored growths, pearl-like bumps, or pinkish patches of skin. In individuals with brown or black skin, BCCs often appear as raised brown or glossy black bumps.

There are four major variants of BCCs, including nodular, superficial spreading, sclerosing, and pigmented basal cell carcinomas.

Although BCCs commonly appear on the head (i.e., face, ears, and scalp), neck, shoulders, and arms, they can arise anywhere on the body, including the chest, back, abdomen, and legs, which tend to be frequently exposed to the sun. The development of BCCs is often associated with years of regular sun exposure or indoor tanning.

Prompt diagnosis and treatment of BCCs are crucial, as this type of skin cancer can grow deep and wide. BCCs rarely metastasize or spread. However, in extremely rare cases, they can result in fatality.

Incomplete removal of BCC can lead to its recurrence in the same skin area.

2. Squamous Cell Carcinoma (SCC)

Squamous cell carcinoma ranks as the second most prevalent form of skin cancer, affecting individuals with light and dark skin. It is estimated that 1.8 million cases of SCC are diagnosed in the United States each year.

Squamous cells are flat cells in the outermost layer of the epidermis that continuously shed as new ones are produced.

Typically, SCC presents as a red, solid bump, a scaly patch, or a recurring sore. It can spread to other parts of the body and is generally more fast-growing than BCC. However, if detected early, it can be easily treated.

Frequently, SCCs arise on skin areas exposed to regular sunlight, including the ears, face, neck, arms, chest, and back. They also have the potential to penetrate deeply into the skin, possibly leading to disfigurement.

3. Melanoma

The third most prevalent skin cancer is malignant melanoma. Although accounting for only 1 percent of all skin cancers, malignant melanoma is considered the most dangerous, as it can metastasize to other parts of the body. It causes the most skin cancer deaths.

Melanoma develops when melanocytes, specialized cells that produce melanin, grow uncontrollably. It can sometimes originate from an existing mole on your skin or suddenly appear as a distinctive dark spot that stands out from the surrounding skin.

Four major types of melanoma skin cancer are superficial spreading, nodular, lentigo maligna, and acral lentiginous melanomas.

What Are the Symptoms and Early Signs of Skin Cancer?

Generally speaking, any newly appeared or changing skin spots persisting for two weeks or longer may be skin cancer. Skin cancer frequently has no symptoms in its early stages, but symptoms can emerge anytime.

Common skin cancer symptoms or signs include the following:

• A new skin spot, such as a new mole/bump.
• Changes in the size, shape, or color of an existing spot/mole.
• A mole that starts to bleed.
• A flat, pink, red, or brown patch/bump.
• A wound/sore that doesn’t heal, leading to bleeding or crust formation.
• An itchy, bleeding, or painful spot/scaly lesion.
• A shiny, red- or skin-colored bump on the skin’s surface.
• A rough or scaly red spot.
• A growth with irregular, uneven, or elevated borders.
• A wart-like growth.
• A scar-like growth lacking a well-defined border.
• A growth of an unusual color, such as white, pink, black, blue, or red.

Cancer-Specific Symptoms

The specific symptoms and signs for the main types of skin cancer are as follows.

1. BCC

Since BCCs usually appear on sun-exposed areas of the body, you should look for the following signs on your head, neck, shoulders, arms, chest, back, abdomen, and legs:

• A persistent, nonhealing sore. It might appear translucent, shiny, pink, pearly white, or red, and may also feel tender and rough and exhibit raised edges. There may also be bleeding, discharge, and crusting.
• An ulcer on the skin that does not heal within four weeks without an apparent cause for the change.
• A lump/bump/nodule, which can be small, slow-growing, and have a shiny pink, white, or red appearance in white people and black or brown in people of color.
• Red patches on the skin, which might also be accompanied by itchiness, irritation, or pain.
• A small pink growth with a slightly elevated, curled perimeter and a center indentation that may crust over time, possibly developing small surface blood vessels.
• A scar-like area with a flat, white, yellow, or waxy glossy appearance, frequently lacking well-defined borders. This might be a sign of invasive BCC.

2. SCC

SCC can arise on any part of the body but primarily occurs in sun-exposed areas. These cancers can also develop within scars, skin sores, or injured skin, often with surrounding skin showing signs of sun damage like wrinkles, pigment changes, and loss of elasticity.

The signs of SCCs are as follows:

• A persistent, thick, and scaly red patch with irregular edges that may crust or bleed.
• A raised growth with a bleeding or itching central indentation, potentially showing rapid growth.
• A persistent open sore that bleeds or crusts and lasts for several weeks.
• A wart-like growth that crusts and may occasionally bleed.

3. Melanoma

Melanoma often appears on areas of the skin associated with intense, sporadic sun exposure, but it can also emerge in areas not exposed to sunlight.

Initial indications of melanoma frequently include alterations in an existing mole or the emergence of new, pigmented, or atypical skin growth.

Since melanoma is fatal, with nearly 8,000 Americans expected to die from it in 2023, knowledge of the ABCDE warning signs and the “ugly duckling” warning signs of melanoma is imperative.

ABCDE warning signs include:

• Asymmetry: Most melanomas are asymmetrical. In this case, the spot/mole has an irregular shape with two parts looking very different.
• Border: The spot’s border appears irregular, jagged, or scalloped.
• Color: The spot may exhibit multiple colors, such as varying shades of tan, brown, or black, or patches of white, red, or blue.
• Diameter: Melanomas are typically larger than 6 millimeters when diagnosed. However, the smaller and earlier detected, the better.
• Evolving: The mole/spot changes in size, shape, or color. It may also start to bleed, itch, or crust.

Watch for the ABCDE signs in moles on your body. Illustrations from Shutterstock/Designed by The Epoch Times

The ugly duckling approach is rooted in the idea that most typical moles on your body have similar appearances, whereas melanomas distinguish themselves as uncharacteristic “ugly ducklings” outliers.

What Causes Skin Cancer?

Sunlight, especially the sun’s harmful ultraviolet (UV) rays, is the main reason people get skin cancers, according to experts in the field.

UV rays can cause skin cancer in two ways: They can damage your DNA, leading to cancer, and weaken your immunity, making it harder for your immune system to fight cancer cells. It’s important to note that the risk isn’t solely determined by the amount of sun you’ve been exposed to or your skin type; the duration and intensity of your exposure, particularly during childhood and adolescence, are also significant factors.

The primary cause of BCC is exposure to UVB rays. Using tanning beds and certain medical treatments involving UV light can elevate the risk of BCC.

Notably, due to the risk of developing skin cancer, Australia, Brazil, and Iran have banned indoor tanning, with over 20 countries banning it for minors. Nearly half of the 50 states in the United States prohibit individuals under 18 from using indoor tanning devices.

While the main reason for SCC is also exposure to UV light, prolonged exposure to cancer-causing substances, like the tar in cigarettes, can also contribute to the SCC’s formation. Other potential SCC causes include long-standing burn scars, persistent ulcers or sores, and specific types of human papillomavirus (HPV), particularly in the genital area.

Unlike BCC and SCC, the risk of melanoma is more linked to sunburns during your teenage years, especially between the ages of 15 and 20. Ultraviolet radiation, strongly linked to DNA mutations, plays a key role in causing melanoma.

Overexposure to UV light can damage skin cell DNA, leading to an overabundance of mutated cells that may evolve into a tumor. Illustrations from Shutterstock/Designed by The Epoch Times

What Are the Stages of Skin Cancer?

Staging depends upon the type of skin cancer and is arguably most relevant for melanoma.

BCC

Staging is typically unnecessary for most BCCs since their spreading tendency is extremely rare. Staging becomes relevant primarily when the cancer has reached a significant size.

Most oncologists commonly use the following staging system:

• Stage 0 (BCC in situ): The cancer is confined to the epidermis or the upper skin layer and has not extended into deeper layers or lymph nodes.
• Stage 1: The cancer is smaller than 2 centimeters and has not metastasized to nearby lymph nodes or organs. However, it may exhibit a single factor that increases the risk of recurrence or spreading, such as infiltration into small skin nerves.
• Stage 2: The cancer exceeds 2 centimeters and displays two or more characteristics that increase the likelihood of recurrence or metastasis, although it’s still localized.
• Stage 3: The cancer has progressed to the regional lymph nodes or facial bones but has not affected distant organs.
• Stage 4: The cancer has metastasized to multiple lymph nodes, bones, or other organs. Its size can vary.

SCC

Squamous cell carcinoma has the following five stages:

• Stage 0: This stage doesn’t constitute invasive cancer. It involves abnormal cells confined solely to the uppermost skin layer.
• Stage 1: The cancer has penetrated deeply into the skin but has not extended to adjacent lymph nodes or healthy tissues.
• Stage 2: The cancer has deeply invaded the skin and exhibits one or more high-risk characteristics (e.g., infiltration of lower skin layers) but has not spread to nearby lymph nodes or healthy tissues.
• Stage 3: This stage signifies the extension of cancer beyond the skin, involving areas beneath, such as lymph nodes or other structures like muscle, bone, or cartilage.
• Stage 4: The cancer has metastasized to one or more distant organs or regions of the skin.

Melanoma

Melanoma also has five stages:

• Stage 0: Melanoma is confined to the epidermis and highly unlikely to have spread, and it has not reached any lymph nodes.
• Stage 1: The primary melanoma is thin and limited to the skin. It has not spread to lymph nodes.
• Stage 2: Melanoma is thicker, extending into the dermis. It has not spread to lymph nodes but has a higher potential for spreading.
• Stage 3: Melanoma has locally spread to nearby lymph nodes or skin sites along the lymphatic system.
• Stage 4: Melanoma has metastasized via the bloodstream to distant areas of the body, including skin or soft tissue, remote lymph nodes, or distant organs. Subclassification at this stage is based on the location of distant metastasis.

Who Is at Risk of Skin Cancer?

Skin cancer can affect anyone, but certain characteristics can increase your risk for the main three types, including the following:

• Lighter natural skin color, typically skin types 1 and 2 on the Fitzpatrick classification scale.
• Skin that burns, freckles, or reddens easily or becomes painful in the sun.
• History of sunburns or blistering sunburns during childhood.
• Blue or green eyes.
• Blond or red hair.
• Certain types and lots of moles.
• Family history of skin cancer.
• Personal history of skin cancer.
• Older age. As you get older, sun exposure and damage to your skin accumulate, increasing your chances of developing cancer. Being over 50 is a risk factor.
• Long-term exposure to sunlight (i.e., UV radiation). This is considered the most important modifiable risk.
• Arsenic exposure.
• A weak immune system.
• Being male.
• History of tanning bed use.
• Having xeroderma pigmentosum, a rare genetic disorder involving hypersensitivity to UV light.
• Taking immunosuppressant drugs.

Specific types of cancer have additional risk factors.

BCC

• Exposure to other types of radiation (e.g., treatment) or specific chemicals
• Having had burns, scars, or infections (e.g., human papillomavirus)
• Having actinic keratosis
• Gorlin syndrome
• Smoking in women
• Bazex-Dupré-Christol syndrome
• Rombo syndrome

SCC

• Being HIV-positive
• Having had burns, scars, or infections (e.g., human papillomavirus)
• Having actinic keratosis

Melanoma

• Having many atypical moles. The more moles on the body, the higher the risk of developing melanoma
• Personal history of breast or thyroid cancer

How Is Skin Cancer Diagnosed?

There are several tests used to detect and diagnose skin cancer, including:

• Skin exam: This is the first step in detecting skin cancer. A medical professional carefully examines the skin, looking for unusual growths while assessing their size, color, shape, and texture.
• Skin biopsy: For a skin biopsy, a doctor takes a sample of skin cells for detailed examination under a microscope, typically performed by a specialized pathologist.
• Tests of the biopsy sample’s DNA: These are used if the diagnosis is in doubt and, in the case of melanoma, to guide treatment.
• Immunohistochemistry (IHC): This test employs antibodies to detect antigens or markers in the tissue sample, revealing the presence of cancer cells.
• Magnetic resonance imaging (MRI) scan: MRI can be employed to detect cancer cells or tumors that have metastasized. It’s used more for staging than detection.
• Computed tomography (CT) scan: This imaging procedure can detect cancer cells or tumors throughout the body if prior tests suggest the cancer has advanced. It is typically used during the staging process.

Biopsy

There are several biopsy methods, including:

• Shave: This biopsy employs a sterile blade to remove an abnormal-looking growth.
• Punch: A punch biopsy uses a specific instrument to cut out circular sections of skin or tissue.
• Incisional: Part of the growth is removed using a scalpel.
• Excisional: The entire abnormal skin area or growth is surgically removed.
• “Optical": Advanced “virtual” biopsies use needle-free methods, employing 3D-imaging techniques such as reflectance confocal microscopy to obtain images of concerning lesions. This approach is painless and noninvasive.

What Are the Complications of Skin Cancer?

Different types of skin cancer have different complications.

BCC

• Recurrence
• Compression of nearby tissues, including eroding of bone, if allowed to grow very large
• Cancer metastasis (very rare)
• Increased susceptibility to other types of skin cancer
• Death, though rarely

SCC

• Spreads to other sites
• Invasion of nearby tissues
• Discomfort
• Impaired function
• Cosmetic concerns
• Death

Melanoma

• Metastasis (common)
• Secondary infection due to skin barrier disruption
• Scarring from the lesion or treatments
• Lymphedema, often after lymph node removal or due to cancer
• Local recurrence, especially in advanced cases
• Depression and anxiety related to cosmetic concerns
• Death

What Are the Treatments for Skin Cancer?

Skin cancer is highly treatable. The specific treatment plan is determined by the following:

• Type of skin cancer
• The extent of cancer growth or spread
• Location of the cancer
• Cancer stage (if applicable)

1. Excisional Surgery

This is the primary approach to treating skin cancer. For most individuals, surgery alone suffices, without further treatment. The surgeon removes the entire tumor and a safety margin of surrounding tissue using a scalpel. This tissue is sent to an off-site lab for analysis. If cancer cells are found beyond the margins, further surgery may be needed later until cancer-free margins are achieved.

This procedure is typically used for small, early-stage BCCs and SCCs that have not spread. It provides cure rates of over 95 percent in most body areas.

If melanoma is identified, staging will determine if further treatment is needed in addition to lymph node biopsy or removal.

A form of excisional surgery, Mohs micrographic surgery is performed in stages during a single visit. The surgeon removes the tumor and a small margin of surrounding tissue, color-coding and mapping it for reference. After examining the tissue under a microscope in an on-site lab, the surgeon returns to remove more tissue if cancer cells are detected. This process repeats until no cancer remains.

Mohs surgery is the gold standard for BCC removal, offering the highest cure rate of up to 99 percent for first-time treated tumors while minimizing damage to healthy tissue.

It is also highly effective for removing SCCs, preserving healthy tissue, and achieving cure rates of up to 97 percent for initial treatments. It’s commonly recommended for SCCs in critical/delicate areas such as the face, fingers, toes, and genitals. Mohs surgery is also preferred for immunosuppressed patients, recurrent SCC, SCC with aggressive features, and SCC deeper than or equal to 2 millimeters.

2. Radiation Therapy

This low-energy X-ray beam procedure is mainly employed for challenging BCC or SCC cases where surgery is not a viable option, particularly in older patients or individuals in fragile health for whom surgery is not recommended. It is less accurate and achieves cure rates of 90 percent.

There are several types of radiation therapy for SCCs:

• Superficial radiation therapy: Radiation beams target just below the skin to treat the tumor.
• External beam radiation therapy: High-energy radiation beams are aimed at the tumor to eliminate cancer cells.
• Brachytherapy (internal radiation): Radioactive implants are inserted inside or near the cancer.

3. Immunotherapy

Immunotherapy harnesses the patient’s own immune system to combat cancer such as melanoma. Natural or lab-produced substances enhance, guide, or restore the body’s innate defenses against cancer. There are different types of immunotherapy:

• Immune checkpoint inhibitor therapy: By blocking these natural checkpoint proteins, immune checkpoint inhibitors enable the body’s T cells to eliminate cancer cells more effectively.
• Interleukin-2 (IL-2): IL-2 enhances the growth and function of various immune cells, particularly lymphocytes, which can target and eliminate cancer cells.
• Tumor necrosis factor (TNF) therapy: TNF is a protein produced by white blood cells in response to infections or antigens and can kill tumor cells.

Another form of immunotherapy, vaccine therapy, uses substances to activate the immune system to locate and destroy the tumor. It can be used for late-stage melanoma and is currently being studied in clinical trials.

4. Photodynamic Therapy (PDT)

The dermatologist uses a topical agent or injection to sensitize the lesion to light, followed by treatment with blue light, pulsed-dye laser, or controlled sunlight. This process triggers a reaction that eradicates skin cancer. Afterward, patients must avoid sunlight for at least 48 hours to prevent UV exposure from activating the medication and potentially causing severe sunburns.

This procedure is used for some superficial BCCs and SCCs but not invasive SCCs.

5. Cryosurgery

Liquid nitrogen is applied with a cotton-tipped applicator or spray device to freeze and eliminate the tumor. This may cause the lesion and surrounding skin to blister, crust, and eventually fall off, leaving only healthy skin.

This method is effective for smaller, superficial BCCs and SCCs and is suitable for patients with bleeding disorders or anesthesia sensitivities. It achieves a cure rate of 85 to 90 percent but is less commonly used for invasive BCC.

6. Curettage and Electrodesiccation (Electrosurgery)

Dermatologists scrape or shave off the skin cancer with a curette, then use heat or chemicals to eliminate any remaining cancer cells and seal the wound, often repeating it in the same session until all cancer cells are gone.

This procedure is suitable for most small BCC lesions, with cure rates nearing 95 percent in such cases and small, superficial, or minimally invasive SCCs.

7. Targeted Therapy

This treatment can be used in advanced melanoma. It employs drugs or substances to pinpoint and combat specific cancer cells. There are different types of targeted therapy, including:

• Signal transduction inhibitor therapy: Signal transduction inhibitors disrupt the communication between molecules within a cell, potentially leading to the death of cancer cells.
• Oncolytic virus therapy: This method uses a virus that selectively infects and destroys melanoma cancer cells while sparing normal ones. Talimogene laherparepvec, a modified herpesvirus, is a form of oncolytic virus therapy. It is administered via direct injection into skin and lymph node tumors.
• Angiogenesis inhibitors: These hinder the formation of new blood vessels, which tumors rely on for growth.

8. Other

• Chemotherapy: These drugs kill or inhibit the growth of metastatic squamous cell or melanoma cells. It may be given orally or through injection. In some cases, it’s directly administered into specific areas like the cerebrospinal fluid, organs, or body cavities, targeting cancer cells in those regions (regional chemotherapy).
• Medicinal creams: For superficial BCCs, these creams or gels are directly applied to the affected skin areas to treat superficial skin cancers with minimal scarring risk. Such topical medications include imiquimod, which stimulates the immune system to target cancer cells, and topical chemotherapy agent 5-fluorouracil (5FU), which eliminates cancer cells.
• Oral medication: Two oral medications for treating adults with advanced BCCs approved by the U.S. Food and Drug Administration (FDA) are vismodegib and sonidegib. These drugs block a genetic signal within the cancer cells.

How Does Mindset Affect Skin Cancer?

While research suggests that maintaining a positive attitude may not directly impact cancer survival rates or disease progression, other research indicates that optimism and a positive mindset can lead to an enhanced quality of life for individuals with cancer. Many cancer patients feel that staying optimistic and positive improves their overall life perspective. Some also believe that their optimistic and positive mindset can positively influence their disease management, treatment outcomes, and chances of survival.

What Are the Natural Approaches to Skin Cancer?

There are some potential natural remedies for skin cancer. However, they should be used only to complement conventional treatments and with your doctor’s approval.

1. Intermittent Fasting

In one study, two 48-hour intermittent fasting cycles were as effective as two rounds of chemotherapy in slowing melanoma growth and spread in mice. Combining fasting with chemotherapy produced better results than either treatment alone and reduced the melanoma’s spread to other organs.

2. Curcumin

As some melanoma cells resist standard chemotherapy, curcumin, a polyphenol found in turmeric responsible for its yellow color, offers new possibilities for cancer treatment.

Curcumin has shown potential in fighting melanoma cancer cells in laboratory cell cultures. It can hinder the growth and spread of melanoma cells and trigger their apoptosis. Curcumin is also known for its anti-inflammatory and antioxidant properties.

3. Green Tea

Green tea is renowned for its anti-cancer and anti-inflammatory properties. Catechins, a group of potent antioxidants found in green tea, including epicatechin (EC), epigallocatechin (EGC), epicatechin gallate (ECG), and epigallocatechin gallate (EGCG), are particularly noteworthy. Among these, EGCG stands out for its exceptional anti-inflammatory and anti-cancer potential in animal studies.

Another study found that the topical application of the caffeine in tea led to a 72 percent reduction in nonmelanoma skin tumors and a 44 percent decrease in nonmalignant tumors. Additionally, the topical EGCG in tea resulted in a 66 percent reduction in nonmelanoma skin cancers and a 55 percent decrease in nonmalignant tumors.

Extensive animal and cell culture research indicates that green tea catechins influence various biological pathways and can induce apoptotic cell death and cell-cycle arrest in tumor cells without affecting normal cells. Further human clinical studies are needed.

4. Frankincense Essential Oil

Frankincense essential oil is derived from the Boswellia tree, native to India and regions in the Middle East and Africa.

In one study, frankincense essential oil displayed the ability to fight against melanoma cells in a lab setting by causing them to die through specific biological pathways, while normal skin cells remained unharmed. In addition, when tested in mice with human melanoma tumors, frankincense essential oil reduced the size of their tumors.

The findings indicate that this product could serve as a potential novel treatment for melanoma cancer, selectively targeting and eliminating melanoma cells while sparing normal cells.

5. Ginger

Ginger, a spice and medicinal plant with a long history in Indian and Chinese cultures, contains over 400 compounds.

Known for its anti-inflammatory, antibacterial, anti-angiogenic (blocking blood vessel growth), and anti-cancer characteristics, ginger extract has shown significant anti-tumor effects on amelanotic melanoma in laboratory cell cultures. Several studies have indicated its anti-skin tumor-promoting effects.

6. Cream Containing Eggplant Extract

A UK study showed that a cream containing a 0.005 percent concentration of solasodine glycosides, a compound derived from eggplant, can be a safe and effective treatment for keratosis and early-stage BCCs and SCCs.

How Can I Prevent Skin Cancer?

Skin cancer cannot be prevented entirely, as some of the risk factors for skin cancer are uncontrollable, such as age and genetics. However, you can do the following to minimize your risk of developing skin cancer.

• Avoid prolonged exposure to sunlight and other sources of UV radiation: Wear protective clothing, as well as sunscreen when necessary. Avoid using indoor tanning equipment. Each blistering sunburn dramatically increases the lifetime risk of melanoma.
• Avoid arsenic and harmful chemical exposure.
• Avoid skin injury and thermal burns.
• Drink green tea: Thanks to its polyphenols, green tea can help prevent nonmelanoma skin cancer by enhancing DNA repair.
• Drink coffee: In a study involving nearly half a million people for almost 15 years, it was observed that men who consumed more coffee had a lower risk of developing melanoma. The researchers believe that caffeine in coffee may be the critical factor contributing to this reduced risk. However, this link wasn’t found in women. Conflicting studies have since been done.
• Self-exam your skin regularly: Pay attention to new moles/spots and changes to existing skin growths. The earlier you detect a problem, the better the treatment outcomes. Visit a board-certified dermatologist if you see any suspicious skin growths.