Skin cancer (all types)
Skin cancer covers the very common and rarely dangerous basal cell and squamous cell carcinomas, the less common but more serious melanoma, and rarer tumours such as Merkel cell carcinoma and Kaposi sarcoma. Almost all of it is caused by ultraviolet light and most of it is found and cured by simple surgery.
Overview
Skin cancers share a cause, ultraviolet light, and a first line of defence, sun protection and early recognition of a changing spot, but they differ sharply in behaviour. Basal cell carcinoma almost never spreads and is cured by excision, Mohs surgery, topical treatment or radiotherapy. Cutaneous squamous cell carcinoma usually behaves the same way but can spread in immunosuppressed people or when neglected, where PD-1 blockade now works well. Melanoma accounts for most skin cancer deaths; caught early it is cured by excision, and at advanced stages checkpoint immunotherapy and BRAF and MEK inhibitors have transformed survival. Merkel cell carcinoma, Kaposi sarcoma and cutaneous lymphomas are rarer and have their own pages. This page is the entry point for readers who have been told only 'skin cancer'.
State of the art
Anatomy and lymph node drainage
Each skin cancer comes from a different cell layer: melanocytes and basal cells at the base of the epidermis, keratinocytes above them, Merkel cells and blood vessels in the dermis; depth of invasion decides the risk.
- Epidermis (in situ)
- Basal layer (melanocytes, basal cells)Basal cell carcinoma
- Keratinocytes (squamous)Cutaneous squamous cell carcinoma · Actinic keratosis (precancer)
- Dermis (invasive; Breslow depth)
- Merkel cells (dermal-epidermal)Melanoma (including uveal and mucosal melanoma) · Merkel cell carcinoma
- Dermal vessels (Kaposi)Kaposi sarcoma
- Acral and mucosal sitesMelanoma (including uveal and mucosal melanoma)
- sentinel node in the draining basin
- regional basin (axilla, groin, neck)
Same organ: Melanoma, Basal cell carcinoma, Cutaneous squamous cell carcinoma, Merkel cell carcinoma, Kaposi sarcoma
The commonest cancer worldwide: about 1.2 million non-melanoma skin cancers and 325,000 melanomas recorded in 2020 (GLOBOCAN), with non-melanoma cases badly under-counted because many registries do not record them.
- AI in radiologyEstablished
- cfDNA fragmentomicsEstablished
- Colorectal cancer screening (colonoscopy, FIT, stool DNA, blood)Standard of care
- DNA methylation profilingEstablished
- HCC surveillance in cirrhosis (ultrasound + AFP)Standard of care
- High-risk pancreatic surveillance (CAPS / PRECEDE)Established
- A 28-day national pathway for people with a positive multi-cancer blood test
- A breath test to rule out cancer in people with vague symptoms
- A cancer blood test for older people arriving at A&E with unexplained symptoms
- A legislated, publicly reported 28-day standard from urgent referral to diagnosis
- A live national dashboard of stage at diagnosis as the scorecard for early detection
- A single 'cancer check at 60' appointment bundling all screening tests
Background: Alpha-fetoprotein (AFP), Barrett's oesophagus, CA 19-9, Early detection, Faecal immunochemical test (FIT). Also on OnCo: Symptoms and red flags · Early detection roadmap.
Cases by country
No country-level case numbers. This cancer is not mapped to a GLOBOCAN site.
Surgical excision or Mohs surgery; topical or photodynamic therapy for superficial lesions; radiotherapy when surgery is unsuitable; hedgehog inhibitors for advanced basal cell carcinoma and cemiplimab or pembrolizumab for advanced squamous cell carcinoma. See the subtype pages.
Excision with margins by thickness, sentinel node biopsy, adjuvant PD-1 blockade or BRAF/MEK inhibitors for high-risk disease, and checkpoint immunotherapy or targeted therapy for advanced disease. See the melanoma page.
Sun protection, avoiding sunbeds and treating actinic keratoses; regular skin checks for people at high risk, with dermoscopy and AI tools improving lesion triage.
Subtypes & biomarkers
top- Basal cell carcinoma
- Cutaneous squamous cell carcinoma
- Melanoma (including uveal and mucosal melanoma)
- Merkel cell carcinoma
- Kaposi sarcoma
- Cutaneous T-cell lymphoma
- Actinic keratosis (precancer)
- Dermoscopy and biopsy for diagnosis
- Breslow thickness, ulceration and sentinel node status in melanoma
- BRAF V600 mutation in melanoma
- PD-L1 and tumour mutational burden as imperfect immunotherapy markers
- Merkel cell polyomavirus status
How often this target appears
- 2011Ipilimumab and vemurafenib approved for advanced melanoma
The first checkpoint inhibitor and the first BRAF inhibitor, the two routes that transformed melanoma.
- 2012Vismodegib approved for advanced basal cell carcinoma
First hedgehog pathway inhibitor.
- 2014PD-1 blockade approved in melanoma
Pembrolizumab and nivolumab approved for advanced melanoma, later moving to adjuvant and neoadjuvant use.
Open problems and what is being done
Non-melanoma skin cancer is missing from most cancer registries, so its true burden is unknown.
Melanoma incidence continues to rise in fair-skinned populations.
Trials
topTrials recruiting now
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Expert centres
topExpert centres
- Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer CenterBaltimore, USNewsweek oncology #10NCI comprehensivevia Pembrolizumab
- via Nivolumab, Ipilimumab
- via Nivolumab, Ipilimumab
- via Nivolumab, Ipilimumab
- via Nivolumab
- Alliance for Clinical Trials in OncologyChicago, IL, USvia Pembrolizumab
- German Hodgkin Study GroupCologne, DEvia Nivolumab
- GOG FoundationPhiladelphia, PA, USvia Pembrolizumab
- Institut Jules BordetBrussels, BEvia Pembrolizumab
- Kyoto University HospitalKyoto, JPvia Nivolumab
- via Nivolumab
- via Pembrolizumab
- via Lifileucel
- National Cancer Center Hospital EastKashiwa, Chiba, JPvia Nivolumab
- SWOG Cancer Research NetworkPortland, OR, USvia Nivolumab
Questions to ask
topQuestions to ask your oncologist about Skin cancer
Newly diagnosed
- What is my exact diagnosis, stage, and grade, and which tests established them?Why: Everything else follows from an accurate stage and subtype.
- Which biomarkers have been tested on my tumour (for example Dermoscopy and biopsy for diagnosis, Breslow thickness, ulceration and sentinel node status in melanoma, BRAF V600 mutation in melanoma, PD-L1 and tumour mutational burden as imperfect immunotherapy markers, Merkel cell polyomavirus status), and what were the results?Why: These results decide eligibility for targeted therapy, immunotherapy, and trials.
- Which subtype is my cancer, and does that change the recommended treatment?Why: Recognised subtypes for this cancer include Basal cell carcinoma, Cutaneous squamous cell carcinoma, Melanoma.
- Is germline (inherited) genetic testing recommended for me or my family?Why: Inherited variants can change treatment and matter for relatives.
Basal cell and squamous cell carcinoma
- For my situation (basal cell and squamous cell carcinoma), which of the standard options do you recommend and why?Why: Guideline options include: Surgical excision or Mohs surgery; topical or photodynamic therapy for superficial lesions; radiotherapy when surgery is unsuitable; hedgehog inhibitors for advanced basal cell carcinoma and cemiplimab or pembrolizumab for advanced squamous cell carcinoma. See the subtype pages.
- Am I a candidate for Cemiplimab, Vismodegib, and what side effects should I expect?Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
Melanoma
- For my situation (melanoma), which of the standard options do you recommend and why?Why: Guideline options include: Excision with margins by thickness, sentinel node biopsy, adjuvant PD-1 blockade or BRAF/MEK inhibitors for high-risk disease, and checkpoint immunotherapy or targeted therapy for advanced disease. See the melanoma page.
- Am I a candidate for Pembrolizumab, Nivolumab, Dabrafenib, and what side effects should I expect?Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
Prevention
- For my situation (prevention), which of the standard options do you recommend and why?Why: Guideline options include: Sun protection, avoiding sunbeds and treating actinic keratoses; regular skin checks for people at high risk, with dermoscopy and AI tools improving lesion triage.
Any stage
- Are there clinical trials I could join, for example of Fianlimab, Lifileucel?Why: Trials are how the next standard of care is set; asking early keeps options open.
- Would a second opinion at a high-volume centre change anything, and can you help arrange it?Why: Rare or high-stakes decisions benefit from a centre that treats many similar patients.
- What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?Why: Supportive care improves quality of life and helps patients complete treatment.
- I read that “Non-melanoma skin cancer is missing from most cancer registries, so its true burden is unknown”. How does that affect my plan?Why: Open problems are where trials and second opinions matter most.
- I read that “Melanoma incidence continues to rise in fair-skinned populations”. How does that affect my plan?Why: Open problems are where trials and second opinions matter most.
Print this page for your appointment (your browser's print command). These prompts are for discussion; your clinical team knows your case.
Direct links plus the targets, companies, and technologies of this cancer's products.
technologies
4targets
6drugs
9companies
6Latest papers
topQuery for this cancer: (TITLE:"Skin cancer" OR ABSTRACT:"Skin cancer" OR TITLE:"all types" OR ABSTRACT:"all types" OR TITLE:"Skin Cancer" OR ABSTRACT:"Skin Cancer" OR TITLE:"Skin cancers" OR ABSTRACT:"Skin cancers" OR TITLE:"Cutaneous malignancies" OR ABSTRACT:"Cutaneous malignancies") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Skin cancer (all types), not a curated reading list.
Similar pages
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