Advik Singh
Skin cancer is one of the most common and concerning cancers worldwide, driven by increased sun exposure and tanning habits. Though the term “skin cancer” seems simple, it encompasses two main types: melanoma and non-melanoma, each with distinct risks, symptoms, and treatments. Early detection is key to enhancing outcomes, so understanding these differences is crucial.
In this article, we'll highlight how to spot and distinguish melanoma from non-melanoma skin cancers and explore modern treatments for advanced melanoma.
Melanoma is a type of skin cancer that starts in the melanocytes, the cells responsible for producing melanin—the pigment that gives skin its colour.
Although melanoma is not as familiar as other types of skin cancer, it is the most aggressive and dangerous form. If not caught early, melanoma can spread to different parts of the body, making it harder to treat.
Melanoma often develops in areas of the skin that have been exposed to the sun, but it can also appear in areas not typically exposed to sunlight.
It typically presents as a new mole or a change in an existing mole. This change may include alterations in size, shape, colour, or texture.
Melanomas can develop anywhere on the body, but they are most commonly found on the back, legs, arms, and face.
Non-melanoma skin cancers, on the other hand, refer to a group of skin cancers that are not melanoma. The most common forms of non-melanoma skin cancers are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).
These cancers are typically less aggressive than melanoma and are generally easier to treat. They usually grow at a slow pace and seldom spread to other areas of the body, making them less deadly than melanoma.
Basal cell carcinoma starts from the basal cells, which are located in the lower part of the epidermis (the outermost layer of skin).
It usually appears as a small, shiny bump or nodule, often with a pearly or translucent appearance.
BCC most commonly occurs on sun-exposed areas of the skin, such as the face, neck, and hands, and is more common in fair-skinned individuals.
Squamous cell carcinoma develops from the squamous cells in the upper layers of the skin. It generally appears as a red, scaly patch or an open sore that doesn’t heal.
SCC can also occur on sun-exposed areas of the skin but may also develop in scars, burns, or areas of chronic inflammation.
Here are the key differences between melanoma and non-melanoma skin cancer:
Melanoma: Often appears as unusual or asymmetrical moles with irregular borders and multiple colours (brown, black, red, blue, or white). The surface may be uneven or raised, and bleeding or oozing can occur.
Non-melanoma: Basal cell carcinoma usually looks like smooth, shiny, or pearly bumps and may develop into sores that bleed easily and don’t heal. Squamous cell carcinoma appears as scaly, red patches or open sores that may be tender.
Melanoma: Grows rapidly, often within weeks or months, with changes in size, diameter, or height.
Non-melanoma: Grows slowly, with basal cell carcinoma being the slowest-growing, and can take months or years to show noticeable changes.
Melanoma: Can appear anywhere on the skin, including areas not typically exposed to the sun.
Non-melanoma: More likely to develop in sun-exposed areas, such as the face, neck, ears, and arms. Basal cell carcinoma is most common on the face, while squamous cell carcinoma is typically found on the ears, lips, neck, and hands.
Melanoma: Strongly linked to intermittent, intense sun exposure (e.g., sunburns), a family history of melanoma, numerous moles, and fair skin.
Non-melanoma: Associated with chronic, long-term sun exposure. Basal cell carcinoma is more common in those with a history of frequent tanning, while squamous cell carcinoma is more prevalent in individuals with suppressed immune systems.
Regular skin checks are essential for identifying both melanoma and non-melanoma skin cancers early. Here are some steps you can take:
1. Examine your skin regularly: Look for new developments or changes in existing moles, freckles, or other skin lesions.
2. Use the ABCDE rule for moles:
A stands for Asymmetry – one half of the mole doesn’t match the other.
B stands for Border – the edges of the mole are irregular, scalloped, or poorly defined.
C stands for Color – the mole has multiple colours or shades.
D stands for Diameter – the mole is larger than 6mm (roughly the size of a pencil eraser).
E stands for Evolving – the mole changes in size, shape, or colour over time.
3. Watch for unusual sores: Look for scaly, red patches or open sores that don’t heal, which could indicate a non-melanoma skin cancer.
4. Consult a healthcare provider: If you notice any changes or unusual growths, it is crucial to seek professional advice from a dermatologist.
Treatment for melanoma and non-melanoma skin cancers varies depending on the type and stage of cancer.
For melanoma, early-stage tumours are primarily treated with surgery, while advanced cases may require immunotherapy like Keytruda Injection (Pembrolizumab), which boosts the immune system to target melanoma cells. Chemo and radiation therapy are also options for advanced melanoma.
Non-melanoma skin cancers, such as basal and squamous cell carcinomas, are typically treated with surgery, cryotherapy, or topical treatments for localised cases. Mohs surgery is effective for precise tumour removal, especially in delicate areas. Radiation therapy is an alternative option when surgery is not feasible.
Early detection is key in differentiating melanoma from non-melanoma skin cancers. While melanoma is more aggressive, non-melanomas grow slowly and are less likely to spread. Regular self-exams and professional checkups are essential for catching changes early.
Advancements in treatments, like immunotherapy, have improved outcomes for advanced melanoma. If you notice any unusual changes in your skin, seek medical advice promptly—regular skin checks can save lives.
