Skin Cancer Uncovered: Understanding Risks, Innovations, and Prevention
By: Zainab Al-Attwani, Gissou Jafari Torreie, Luca LeClair, Raymond Zeng
Introduction
Our skin is more than just a barrier – it’s a vital organ that shields us from environmental harm, regulates our body temperature, and even helps us stay hydrated. But like any part of our body, it’s not immune to disease. Melanoma, the most serious form of skin cancer, is a stark reminder of this vulnerability. It often starts as a small mole or patch of discoloration, easily overlooked, yet it has the potential to spread quickly and become life-threatening if not caught early (Skin Cancer Foundation, 2024).
This isn’t just a rare condition; melanoma is increasingly common, with over 100,000 new cases diagnosed annually in North America alone (Cancer Society, 2024). According to recent studies, melanoma incidence rates have doubled in the past 30 years, partly due to rising exposure to UV radiation from the sun and artificial sources like tanning beds (American Cancer Society, 2024). While most cases are linked to UV exposure, some are attributed to genetic predisposition, underscoring the importance of regular skin checks for everyone, not just sun lovers (Mayo Clinic, 2024).
What’s more, while melanoma is associated with excessive sun exposure, it’s not limited to the summer months. Research shows that UV damage accumulates over a lifetime, meaning protection is crucial year-round, even during the darker, colder days of winter (World Health Organization, 2024).
The good news? Melanoma is highly preventable and treatable when detected early. Advances in research, including immunotherapy and targeted treatments, are providing hope for improved survival rates and better quality of life for patients (National Cancer Institute, 2024). This blog will explore these innovations while also providing actionable tips to protect yourself and your loved ones.
By understanding melanoma and the risk factors that contribute to its development, we take a significant step toward combating its impact. Join us as we delve into the science, the latest breakthroughs, and simple yet powerful ways to safeguard your skin. Every effort matters when it comes to preventing and fighting melanoma.
Causes and Risk Factors Associated with Skin Cancer
Causes
Skin cancer often results from overexposure of the skin to ultraviolet (UV) radiation from the sun or tanning beds (Mayo Clinic, 2022). Prolonged exposure to UV rays can cause damage to skin cells (Centers for Disease Control and Prevention, 2024). However, this does not explain all cases of skin cancer – some occur in areas of skin that are not normally exposed to UV rays. This suggests that there are other contributions to the disease, such as exposure to other cancer-causing agents or having a weakened immune system (Mayo Clinic, 2022).
Risk Factors
History of Sunburns
A history of sunburns increases one’s risk for skin cancer (Cancer Research UK, 2023). This risk is significantly elevated with multiple sunburn events during childhood (Mayo Clinic, 2022). Individuals who work jobs that increase their exposure to the sun, such as gardeners, farmers, and construction workers, are also at an increased risk for the disease.
Skin Color
Skin color is determined by the amount of melanin (skin pigment) an individual has. Melanin offers natural protection against UV radiation (Cancer Research UK, 2023). Thus, those that have darker skin are less likely to develop skin cancer than those with lighter skin. However, that is not to say that those with darker skin do not develop skin cancer. Additionally, individuals that freckle or sunburn easily are also more likely to be affected (Mayo Clinic, 2022).
Personal or Family History of Skin Cancer
The vast majority of skin cancer cases are not hereditary (The Skin Cancer Foundation, 2024). Individuals with family members that have had the disease prior, may be at an increased risk developing skin cancer (Mayo Clinic, 2022). This may be due to the family’s skin color or them being exposed to the sun a lot. The same applies to those who have had skin cancer themselves (Cancer Research UK, 2023).
Pre-existing Skin Conditions
Individuals with certain skin conditions such as solar keratosis and xeroderma pigmentosum are more likely to develop skin cancer (Cancer Research UK, 2023). Solar keratosis is characterized by rough and red patches of skin on the scalp, hands, or face, caused by exposure to the sun over time (Cancer Research UK, 2023). These symptoms indicate that the skin is already damaged and it may progress into skin cancer if the necessary precautions are not taken (Cancer Research UK, 2023). Xeroderma pigmentosum is a very rare genetic condition in which the skin is unable to repair itself following damage from UV radiation (Cancer Research UK, 2023). Individuals with this condition should avoid sun exposure and other forms of UV whenever possible.
Current Treatment for Skin Cancer
Depending on the type of skin cancer (basal cell carcinoma, squamous cell carcinoma, and melanoma), there are different treatment options that are suggested. Often, and depending on the severity, multiple treatment types can be combined.
Surgery
There are several forms of surgical procedures that can be done to treat basal cell carcinoma and squamous cell carcinoma. One surgical procedure, called simple excision, consists of cutting out the tumour, along with the surrounding tissue (National Cancer Institute [NCI], n.d.). The surgeon will then send the excised tissue to the laboratory where it can be examined by a dermatopathologist to ensure that the entire tumour has been removed (NYU Langone Health, n.d.). Another common surgical procedure is known as Mohs Surgery. Mohs surgery is a precise procedure in which thin layers of skin are removed one at a time, with each layer carefully examined for cancerous cells. The process is repeated until no cancerous tissue remains (Cleveland Clinic, 2022). Mohs surgery is especially useful for treating skin cancers with high risk of recurrence, as well as cancers in areas where you want to keep as much healthy tissue as possible (Mayo Clinic, 2024). Similarly, curettage and electrodesiccation uses a sharp loop edged tool (called a curette) to scrape off the skin tumour. Afterward, an electric needle (electrode) is applied to the site to eliminate any remaining cancer cells (American Cancer Society, n.d.).
Radiation
Radiation is a treatment option that uses high energy particles to target and destroy cancerous cells. It is commonly used in cases where surgery is challenging, such as for large tumors or cancers located in difficult-to-treat areas. It is also an option for individuals who cannot undergo surgery or prefer not to (Cancer Research UK, 2023). The 2 main types of radiation are External Radiation Therapy (ERT) and Brachytherapy. ERT fires beams of electrons onto the tumour from outside the body. This is done to treat superficial tumours, and has very little penetration into surrounding tissue. ERT will typically be administered 5 days a week over several weeks, or through fewer sessions with higher radiation dose (Canadian Cancer Society, 2024). Brachytherapy is another way to treat skin tumors, especially those on the head and neck. In this method, a hollow applicator is placed either on the tumor (superficial Brachytherapy) or directly into the tumor (interstitial brachytherapy). A radioactive source is then put into the applicator, and it will target the tumor directly while minimizing exposure to surrounding healthy tissue (American Cancer Society, n.d.). Brachytherapy usually requires fewer sessions than ERT.
Chemotherapy
Chemotherapy is a cancer treatment that employs drugs to halt the growth of cancer cells by either destroying them or preventing their division (Mayo Clinic, 2024). In skin cancer, chemotherapy can be administered in a few different ways. The usual method, which you see with other cancer types as well, is to deliver the chemotherapy drug through needle injection. This will allow the chemotherapy to have an effect on cancer cells that have spread to other parts of the body. Another method involves the use of creams that contain the chemotherapy drug. The cream is applied directly to the skin to treat superficial cancers (Cancer Research UK, 2020).
Advances in Skin Cancer Treatments
Skin cancer, particularly melanoma, is one of the most aggressive forms of cancer but has seen significant breakthroughs in treatment over the years. Advances in targeted therapies, immunotherapies, and personalized approaches offer hope for improved outcomes. Below, we’ll discuss three innovative approaches: immunotherapy, CAR-T cell therapy, and the combination of BRAF and MEK inhibitors.
Immunotherapy
Immunotherapy is a treatment that uses the body’s immune system to fight diseases, such as cancer. Treatments such as checkpoint inhibitors, which are like brakes in the car and stop the immune cells from attacking healthy cells, which are defective by cancer cells. PD-1 is a protein on immune cells which binds to another protein called PD-L1 on cancer cells, and stops the immune cell from attacking. By blocking this connection using medications called anti-PD-1, PD-1 inhibitors re-activate the immune cells to fight cancer (Ralli et al., 2020). More research for this medication is required as the overactivation of these immune cells may cause them to attack healthy cells causing inflammation, but it holds a promising future.
CAR-T based approaches
T-cells are immune cells essential for your body’s defense mechanisms. In CAR-T cell therapy, these cells are collected in a lab and genetically modified to have specific receptors, known as chimeric antigen receptors (CAR), which act like GPS, helping the T-cells locate and target cancer cells. The modified cells are then infused back into the patient’s body, where they are designed to attack and kill cancer cells. A key advantage of this treatment is its personalization for each patient, which significantly lowers the risk of rejection. However, more research is needed to improve its effectiveness against solid tumors, such as melanoma, and to manage side effects like fever and low blood pressure caused by the excessive release of inflammatory proteins called cytokines, a condition known as cytokine release syndrome (CRS). Additionally, policymakers must work to make this treatment more accessible, as its personalized nature makes it very expensive (Pan et al., 2022).
Combination of BRAF and MEK Inhibitors
An unwanted change in the BRAF gene causes uncontrolled cell growth, which is a possible cause for melanoma. This change sends increased signals to another protein called MEK (Mitogen-Activated Protein Kinase Kinase) which causes cells to grow and divide even when they shouldn’t. Scientists have developed BRAF and MEK inhibitors, which target the proteins causing this change in the DNA, and allowing the increased cell division, and fortunately, these treatments have shown remarkable success in improving survival rates for patients with advanced melanoma that has spread (metastatic melanoma). They are also used after surgery (adjuvant therapy) to help prevent the cancer from returning (Tétu et al., 2020). Researchers are now exploring their use before surgery (neoadjuvant therapy) to shrink tumors, make surgery easier, and reduce the chances of recurrence.
Emerging treatments like immunotherapy, CAR-T cell therapy, and BRAF-MEK inhibitors are transforming how skin cancer is treated. These innovations offer hope for patients with advanced forms of the disease. However, challenges remain, including managing side effects, improving accessibility, and enhancing effectiveness against solid tumors like melanoma. Continued research and policy efforts are essential to ensure these therapies reach their full potential.
References
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