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  • Exploring cancer care
  • Conditions we treat
  • Skin cancer
  • Non-melanoma skin cancer

Introduction

Non-melanoma skin cancer treatment and diagnosis

Non-melanoma skin cancer

There are three main types of skin cancer, squamous cell carcinoma (SCC), basal cell carcinoma (BCC) and melanoma. SCC and BCC are classified as non-melanoma skin cancers or keratinocyte cancers.1

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What is non-melanoma skin cancer

Chapter 01

What is non-melanoma skin cancer

Non-melanoma skin cancers, which you may also hear being called 'keratinocyte cancers' are regarded as being the most common cancer types in Australia.1 BCC’s usually start in the lower layer of the epidermis whilst SCC’s usually start in the upper layer.2 Whether a skin cancer is a BCC or SCC, depends on the type of skin cells affected and their appearance and their treatment can vary:2

  • BCC –treatment approaches usually consider the type, size and location of the BCC amongst other things at the time of diagnosis.3
  • SCC – treatment is usually determined by the size and location of the SCC. Treatment approaches/ results may vary if other body parts are are/have been affected.4

Non-melanoma skin cancers can affect parts of your body exposed to the sun.2 This generally includes body parts such as the face, neck, a bald scalp, arms, back of hands and lower legs.2

Risk factors: Non-melanoma skin cancer

  • Basal cell carcinomas (BCC) can develop as a result of overexposure to the sun's ultraviolet (UV) rays.2 BCCs tend to be most common in people with particular risk factors which may include:3
  • People with a fair complexion, or for example may include a tendency to burn rather than tan, the presence of freckles, light eye colour, light or red hair
  • A history of skin cancer
  • A family history of skin cancer
  • UV light from a sun lam

Squamous cell carcinomas (SCC) are usually caused by overexposure to the sun's ultraviolet (UV rays).2 SCCs can affect people with the following risk factors:4

  • People with a fair complexion, or for example may include a tendency to burn rather than tan, the presence of freckles, light eye colour, light or red hair
  • A history of skin cancer
  • Immunosuppression (i.e. a poor immune system).
  • Solarium use
  • Presence of multiple solar keratoses
  • Some rare genetic disorders

Symptoms

Chapter 02

Symptoms

The signs and symptoms of skin cancer may differ between people and some of the signs or symptoms that can occur in people who have been diagnosed with  BCC include:2,3

  • BCCs can often begin with a slight change in the skin, such as a small bump or a flat red patch.
  • A pearly spot or lump
  • A scaly, dry area that is shiny and pale or bright pink in colour (although some BCCs can be darker)
  • A sore that doesn’t heal
  • A sore that bleeds

Some of the signs or symptoms that can be experienced by people who have been diagnosed with SCC include:4

  • thickened, red, scaly spot that doesn’t heal
  • A crusted sore
  • Small ulcer or thickened scaly skin on the lips
  • A patch of skin that's sore 
  • A firm, red lump
  • A sore or rough patch inside your mouth

If you have noticed any changes to your skin,3,4 and think that you may have a non-melanoma skin cancer, it is recommended to make an appointment with your doctor (GP) or skin specialist for advice and/or a skin examination.

Tests and diagnosis

Chapter 03

Tests and diagnosis

In most cases, your doctor or skin specialist may be able to offer you a diagnosis after a physical examination of your skin. They may also do a biopsy (small sample of skin) if further investigation is needed.3,4 If you do require treatment, your doctor or skin specialist and healthcare team will work with you to determine which treatment is most suitable. This may depend on several factors including the part of your body that is affected, the size of the cancer and potential side effects.2

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      1. Cancer Council Australia. Skin Cancer. January 2020. [cited Apr. 2023].Available: https://www.cancer.org.au/cancer-information/types-of-cancer/skin-cancer
      2. Cancer Council Australia. Non-melanoma skin cancer. January 2022. [cited Apr. 2023].Available: https://www.cancer.org.au/cancer-information/types-of-cancer/non-melanoma-skin-cancer
      3. National Comprehensive Cancer Network. NCCN Guidelines;  Basal Cell Skin Cancer. Version 1.2023 — Last updated March 10, 2023 [cited Apr. 2023]. Available from: https://www.nccn.org
      4. National Comprehensive Cancer Network. NCCN Guidelines;  Squamous Cell Skin Cancer. Version 2020 — Last updated 2020 [cited Apr. 2023]. Available from: https://www.nccn.org

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