Skin cancer is an abnormal growth of skin cells on skin exposed to the sun. But this doesn’t mean skin cancer can’t occur on areas of the skin that are not exposed to the sun.
When something causes change in how your skin cells grow, such as exposure to ultraviolet light, skin cancer happens. Symptoms of skin cancer include new bumps or patches on the skin, or a change in the size, shape or color of skin growths. This may affect the sun-exposed skin, scalp, face, lips, ears, neck, chest, arms and hands but also the areas that rarely see the light such as palms, beneath the fingernails, and the genital area.
Normally, as skin cells grow old and die, new cells form to replace them. But if something causes a change to this process, such as exposure to ultraviolet (UV) light, cells may grow more quickly. These new cells may be non-cancerous or cancerous. If not caught early, skin cancer can spread to nearby tissue or other areas of the body. Fortunately, if skin cancer is identified and treated in early stages, most are cured.
Skin cancer is a type of cancer that originates in the skin cells. It occurs when there is an abnormal growth of skin cells, often triggered by damage to the DNA within these cells. This damage is most commonly caused by ultraviolet (UV) radiation from the sun or tanning beds. There are three primary types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and melanoma.
Basal cell carcinoma: is the most common form of skin cancer. It begins in the basal cells, which are found in the lower part of the epidermis, the outermost layer of the skin. This type of cancer typically appears on sun-exposed areas of the body, such as the face and neck. It often manifests as a pearly or waxy bump, a flat, flesh-colored or brown scar-like lesion, or a sore that bleeds and scabs over.
Squamous cell carcinoma: is the second most common type of skin cancer. It originates in the squamous cells, which make up most of the skin's upper layers. This cancer usually develops on sun-exposed areas like the face, ears, and hands. It can appear as a firm, red nodule or a flat lesion with a scaly, crusted surface. While it is generally more aggressive than basal cell carcinoma, it is still highly treatable when detected early.
Melanoma: is the most dangerous form of skin cancer, though it is less common than the other two types. It develops in the melanocytes, the cells responsible for producing melanin, the pigment that gives skin its color. Melanoma can occur anywhere on the body, even in areas not typically exposed to the sun. It often appears as a large brownish spot with darker speckles, a mole that changes in color, size, or feel, or a small lesion with an irregular border and multiple colors. Early detection is crucial, as melanoma can spread to other parts of the body and become life-threatening.
The cost of Skin Cancer treatment may vary based on the patient's specific surgical needs, surgeons' fees, and way of treatment and hospital fees.
You should visit a dermatologist in case you are experiencing any of these signs: a new spot on the skin –changes in the size, shape, or color of an existing spot – a spot that is itchy or painful – non-healing sore that bleeds or develops a crust – a red colored shiny bump on the top of the skin – a red rough or scaly spot that you can feel.
At first, you may notice a rash or irregular patch on the surface of your skin. As your cancer grows, the size or shape of the visible skin mass may change, as well as grow deeper and bleed easily.
Skin cancer can also develop in less common forms, such as Merkel cell carcinoma and lymphoma of the skin. Merkel cell carcinoma is a rare but aggressive cancer that forms in the Merkel cells, which are found at the base of the epidermis. Lymphoma of the skin involves the lymphocytes, a type of white blood cell, and can present as patches, plaques, or nodules on the skin.
Skin cancer is a broad term that encompasses several different types of cancers originating in the skin. The three most common types are basal cell carcinoma, squamous cell carcinoma, and melanoma, each with distinct characteristics and levels of severity.
Basal cell carcinoma (BCC) is the most common type of skin cancer, originating in the basal cells, which are found in the deepest layer of the epidermis. These cells are responsible for producing new skin cells as old ones die off. BCC typically develops on areas of the skin that are frequently exposed to the sun, such as the face, neck, and arms.
The primary cause of BCC is prolonged exposure to ultraviolet (UV) radiation from the sun or tanning beds. This exposure leads to DNA damage in the skin cells, which can result in uncontrolled cell growth. People with fair skin, light hair, and light eyes are at a higher risk, as are those with a history of frequent sunburns or extensive time spent outdoors without adequate sun protection.
BCC often appears as a change in the skin, such as a growth or a sore that does not heal. It can take several forms, including a pearly or waxy bump, a flat, flesh-colored or brown scar-like lesion, or a sore that bleeds and scabs over. On darker skin, BCC may appear as a brown or glossy black bump. These lesions can vary in size and may have visible blood vessels on their surface.
While BCC grows slowly and rarely spreads to other parts of the body (metastasizes), it can cause significant local damage if left untreated. The cancer can invade surrounding tissues, including bones and nerves, leading to disfigurement and functional impairment. Therefore, early detection and treatment are crucial.
Squamous cell carcinoma (SCC) is a common type of skin cancer that originates in the squamous cells, which are flat cells located near the surface of the skin. These cells are part of the epidermis, the outermost layer of the skin. SCC can also develop in other parts of the body where squamous cells are found, such as the lungs, mucous membranes, and digestive tract.
The primary cause of SCC is prolonged exposure to ultraviolet (UV) radiation from the sun or tanning beds. This exposure leads to DNA damage in the squamous cells, causing them to grow uncontrollably. People with fair skin, light hair, and light eyes are at a higher risk, as are those with a history of frequent sunburns or extensive time spent outdoors without adequate sun protection.
SCC typically appears on sun-exposed areas of the body, such as the face, ears, neck, hands, and arms. It often presents as a rough, scaly red patch, an open sore, a raised growth with a central depression, or a wart-like growth. These lesions can be painful and may bleed or crust over. Unlike basal cell carcinoma, SCC has a higher potential to spread (metastasize) to other parts of the body, making early detection and treatment crucial.
Diagnosis of SCC involves a physical examination and a biopsy. During the biopsy, a small sample of the suspicious lesion is removed and examined under a microscope to confirm the presence of cancer cells. Once diagnosed, several treatment options are available, depending on the size, location, and aggressiveness of the tumor.
Melanoma is a serious and potentially deadly form of skin cancer that originates in the melanocytes, the cells responsible for producing melanin, the pigment that gives skin its color. Although melanoma is less common than other types of skin cancer, such as basal cell carcinoma and squamous cell carcinoma, it is far more dangerous due to its ability to spread to other parts of the body if not detected and treated early.
Melanoma can develop anywhere on the skin, but it most frequently appears on areas that have been exposed to the sun, such as the back, legs, arms, and face. However, it can also occur in less obvious places, like the soles of the feet, palms of the hands, and under the nails. In rare cases, melanoma can form in the eyes, mouth, genitals, and even internal organs.
The primary cause of melanoma is exposure to ultraviolet (UV) radiation from the sun or tanning beds, which can damage the DNA in skin cells and lead to uncontrolled cell growth. Risk factors for melanoma include having fair skin, a history of sunburns, excessive UV exposure, a family history of melanoma, and the presence of many moles or unusual moles on the skin.
Melanoma often begins as a change in an existing mole or as a new, unusual-looking growth on the skin. The ABCDE rule is a helpful guide for identifying potential melanomas: Asymmetry (one half of the mole doesn't match the other), Border (irregular, scalloped, or poorly defined edges), Color (varied shades of brown, black, or other colors), Diameter (larger than 6mm, about the size of a pencil eraser), and Evolving (changes in size, shape, or color over time).
Early detection of melanoma is crucial for successful treatment. If caught early, melanoma can often be treated effectively with surgical removal. However, if the cancer has spread to other parts of the body, treatment becomes more complex and may involve a combination of surgery, radiation therapy, chemotherapy, immunotherapy, and targeted therapy.
Skin cancer is categorized into different stages based on the size of the tumor, its depth of penetration, and whether it has spread to other parts of the body. The staging system helps doctors determine the severity of the cancer and plan the appropriate treatment.
Stage 0 (Carcinoma in Situ): At this stage, the cancerous cells are confined to the outermost layer of the skin (the epidermis) and have not invaded deeper tissues. This stage is also known as carcinoma in situ. The abnormal cells have the potential to become cancerous but have not yet spread.
Stage I: In this stage, the tumor is small, typically 2 centimeters (cm) or less in diameter, and has not spread to nearby lymph nodes or other parts of the body. The cancer is still localized and has not penetrated deeply into the skin.
Stage II: The tumor is larger than 2 cm but smaller than 4 cm in diameter. It may have one or more high-risk features, such as being thicker than 2 millimeters (mm), invading the lower layers of the skin, or being located on high-risk areas like the ears or lips. However, it has not yet spread to nearby lymph nodes or distant sites.
Stage III: At this stage, the tumor is larger than 4 cm or has grown into nearby tissues, such as the bone or cartilage. It may also have spread to nearby lymph nodes but not too distant parts of the body. This stage indicates a more advanced local spread of the cancer.
Stage IV: This is the most advanced stage of skin cancer. The tumor can be of any size and may have spread to nearby lymph nodes. Additionally, the cancer has metastasized to distant parts of the body, such as the lungs, liver, or other organs. Stage IV skin cancer is more challenging to treat and often requires a combination of therapies.
The staging of skin cancer is crucial for determining the prognosis and treatment plan. Early-stage skin cancers (stages 0 and I) are generally treated with surgical removal and have a high cure rate. For more advanced stages (stages II, III, and IV), treatment may involve a combination of surgery, radiation therapy, chemotherapy, immunotherapy, and targeted therapy.
Equipped hospitals, advanced specialized centers with experienced doctors and specialists are available in all medical treatment areas in Iran. Also, good hotels and entertainment centers have made Iran an appropriate choice for patients who are suffering from Skin Cancer.
The cost of diagnosing skin cancer in Iran can vary significantly based on several factors, including the type of healthcare facility, the specific diagnostic tests required, and whether the patient is using public or private healthcare services. If a suspicious lesion is identified during the consultation, a biopsy is typically performed to obtain a tissue sample for further examination. This cost includes the procedure itself and the pathology laboratory fees for analyzing the tissue sample. In addition to the biopsy, other diagnostic tests may be required to determine the extent of the cancer. These tests can include imaging studies such as ultrasound, CT scans, or MRI, which can add significantly to the overall cost.
The total cost of diagnosing skin cancer can therefore vary widely, for a simple consultation and biopsy in a public hospital, to more comprehensive diagnostic procedures in private clinics. To mitigate these costs, the Iranian healthcare system provides various support mechanisms.
Skin cancer is primarily caused by overexposure to ultraviolet (UV) radiation from the sun, tanning beds, or sunlamps. UV radiation damages the DNA in skin cells, leading to mutations that can cause the cells to grow uncontrollably and form malignant tumors. There are three main types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and melanoma. Basal cell carcinoma, the most common type, often appears as a pearly or waxy bump on sun-exposed areas like the face and neck. Squamous cell carcinoma typically manifests as a firm, red nodule or a flat lesion with a scaly, crusted surface. Melanoma, the most dangerous form, can develop anywhere on the body and often starts as a mole that changes in color, size, or feel. The risk of developing skin cancer is influenced by several factors.
Prolonged and intense exposure to UV radiation is the most significant risk factor. People with fair skin, light-colored eyes, and blond or red hair are more susceptible because they have less melanin, the pigment that provides some protection against UV radiation. A history of sunburns, especially blistering sunburns in childhood, can significantly increase the risk¹. Additionally, living in sunny or high-altitude climates, where UV radiation is more intense, also raises the risk.
Genetics play a role as well. Individuals with a family history of skin cancer are at a higher risk. Certain genetic disorders, such as xeroderma pigmentosum, which impairs the skin's ability to repair UV-induced damage, can also increase susceptibility. Moreover, having a large number of moles or atypical moles can be a risk factor for melanoma.
Preventive measures are crucial in reducing the risk of skin cancer. Limiting sun exposure, especially during peak hours (10 a.m. to 4 p.m.), wearing protective clothing, and using broad-spectrum sunscreen with an SPF of 30 or higher can help protect the skin.
Regular skin examinations, both self-exams and professional check-ups, are essential for early detection and treatment. Early detection significantly improves the chances of successful treatment and can prevent the cancer from spreading to other parts of the body.
Skin cancer is influenced by a variety of risk factors, many of which are related to ultraviolet (UV) radiation exposure.
The most significant risk factor is prolonged and unprotected exposure to UV rays from the sun or artificial sources like tanning beds. UV radiation damages the DNA in skin cells, leading to mutations that can cause cancer. People with fair skin, light-colored eyes, and blond or red hair are particularly susceptible because they have less melanin, the pigment that provides some protection against UV radiation. Those who burn easily, freckle, or have a history of sunburns, especially blistering sunburns in childhood, are at a higher risk.
Genetics also play a crucial role in skin cancer risk. A family history of skin cancer increases the likelihood of developing the disease. Certain genetic disorders, such as xeroderma pigmentosum, which impairs the skin's ability to repair UV-induced damage, significantly elevate the risk. Additionally, individuals with a large number of moles or atypical moles are more prone to melanoma, the most dangerous form of skin cancer.
Age is another important factor. The risk of skin cancer increases with age, as the cumulative exposure to UV radiation over the years adds up. However, skin cancer can also affect younger individuals, particularly those who spend a lot of time outdoors without adequate sun protection. People living in sunny or high-altitude climates, where UV radiation is more intense, are at greater risk as well.
Certain lifestyle choices and medical conditions can also contribute to skin cancer risk. For instance, individuals who use tanning beds are at a significantly higher risk of developing skin cancer. Organ transplant recipients, who often take immunosuppressive drugs to prevent organ rejection, are more susceptible to skin cancer due to their weakened immune systems. Additionally, exposure to certain chemicals, such as arsenic, can increase the risk of skin cancer.
Skin cancer manifests through various signs and symptoms, which can differ based on the type of skin cancer. The three main types are basal cell carcinoma, squamous cell carcinoma, and melanoma.
Basal cell carcinoma is the most common type and typically appears on sun-exposed areas such as the face, neck, and arms. It often presents as a pearly or waxy bump, a flat, flesh-colored or brown scar-like lesion, or a sore that bleeds, scabs, and heals but then returns. These lesions may also appear as a shiny, translucent bump that can be pink, red, white, or even blue or black.
Squamous cell carcinoma usually occurs on sun-exposed areas like the face, ears, neck, lips, and hands. It may present as a firm, red nodule or a flat lesion with a scaly, crusted surface. This type of skin cancer can also appear as a sore that doesn't heal or a rough, scaly patch that may bleed or become crusty.
Melanoma is the most dangerous form of skin cancer and can develop anywhere on the body, including areas not typically exposed to the sun. It often starts as a mole that changes in color, size, or feel, or that bleeds. Melanomas can appear as a large brownish spot with darker speckles, a mole that changes in appearance, or a small lesion with an irregular border and portions that appear red, pink, white, blue, or blue-black. They can also present as a painful lesion that itches or burns.
Other general signs of skin cancer include new growths or sores that do not heal within a few weeks. Any change in the size, shape, or color of a mole or other skin lesion should be evaluated by a healthcare professional. Additionally, skin cancer can manifest as a spot that oozes, bleeds, gets scaly or crusty, or a lesion that spontaneously bleeds without being picked at.
Diagnosing skin cancer involves a series of steps, beginning with a thorough clinical examination by a healthcare provider, typically a dermatologist. The process starts with a visual inspection of the skin, looking for unusual moles, growths, or lesions using the ABCDE criteria: Asymmetry, Border irregularities, Color variations, Diameter greater than 6 mm, and Evolving features. A dermatoscope, a special magnifying lens with a light source, may be employed for a closer examination of suspicious lesions. The provider also takes a detailed medical history and inquiries about symptoms such as itching, bleeding, or changes in the lesion's appearance.
If a suspicious lesion is identified, a biopsy is performed to obtain a tissue sample for microscopic examination. The type of biopsy—shave, punch, excisional, or incisional—depends on the lesion's characteristics. A shave biopsy involves removing the top layers of skin, while a punch biopsy removes a deeper, circular section of skin. An excisional biopsy involves removing the entire lesion along with some surrounding tissue, and an incisional biopsy removes only a portion of the lesion. The tissue sample is then analyzed by a pathologist to determine the presence and type of cancer cells, such as basal cell carcinoma, squamous cell carcinoma, or melanoma.
Staging of skin cancer is crucial for determining the most effective treatment options. Doctors use Roman numerals I through IV to indicate a cancer's stage, with Stage I being small and localized, and Stage IV indicating advanced cancer that has spread to other parts of the body. Early detection and accurate staging significantly improve the chances of successful treatment and can prevent the cancer from spreading.
Treatment options for skin cancer vary depending on the type, stage, and location of the cancer, as well as the patient's overall health and preferences. The most common treatments include surgical excision, Mohs surgery, cryotherapy, radiation therapy, topical treatments, photodynamic therapy, and immunotherapy.
Surgical excision involves removing the cancerous tissue along with a margin of healthy skin to ensure all cancer cells are eliminated. This method is effective for most types of skin cancer and is often used for basal cell carcinoma and squamous cell carcinoma. Mohs surgery is a specialized technique used for larger, recurring, or difficult-to-treat skin cancers, particularly those on the face. It involves removing the cancer layer by layer and examining each layer under a microscope until no abnormal cells remain. This method preserves as much healthy tissue as possible.
Cryotherapy uses liquid nitrogen to freeze and destroy cancer cells. This treatment is typically used for small, early-stage skin cancers and precancerous lesions like actinic keratoses. Radiation therapy employs high-energy rays to kill cancer cells and shrink tumors. It is often used for cancers that are difficult to treat surgically or for patients who cannot undergo surgery.
Topical treatments involve applying medications directly to the skin to treat superficial skin cancers. These treatments include creams or gels containing anti-cancer agents like imiquimod or 5-fluorouracil. Photodynamic therapy combines a photosensitizing agent with light exposure to destroy cancer cells. This method is effective for treating superficial skin cancers and precancerous lesions.
Immunotherapy works by boosting the body's immune system to help fight cancer. Drugs like pembrolizumab and nivolumab are used to treat advanced melanoma by targeting specific proteins that help cancer cells evade the immune system. Targeted therapy involves drugs that specifically target genetic mutations within cancer cells. For example, BRAF inhibitors are used to treat melanoma with specific genetic mutations.
