SUBSEQUENT NEOPLASMS: SKIN CANCER

This page is part of the PanCare PLAIN summaries about late effects and recommendations for long-term follow-up care for survivors of childhood, adolescent, and young adult cancer. Click here, for more information on the PLAIN summaries.

This brochure is a sequel to the brochure Subsequent neoplasms: general. Please read that brochure first before you continue.

This PLAIN summary is based on the PanCareFollowUp guideline about “Subsequent neoplasms” [1], which is based on the consensus of different national guidelines.

PLAIN version 2.1: 27/05/2024

Subsequent cancer: skin cancer

Our skin is very complex and has many functions. For example, the skin protects us from bad bacteria, viruses and toxins. It also allows us to feel sensations such as touch or heat and cold.

The skin contains different types of skin cells, such as basal cells, melanocytes and squamous cells. Sometimes, the cells that make up the skin can become malignant. This means that they do not work properly anymore and multiply uncontrollably, causing a tumour to grow. When this happens, this is called skin cancer.

Different types of skin cancer include:

  • Basal cell carcinoma, where the basal cells become malignant.
  • Squamous cell carcinoma, where the squamous cells become malignant.
  • Melanoma, where the melanocytes become malignant. Melanoma is the most aggressive, but also least common type of skin cancer.

Due to treatment of the first cancer, survivors sometimes have a higher risk of skin cancer. There are a number of things anyone can do to lower the risk of skin cancer, such as avoiding (too much) sun exposure, especially in the middle of the day.

Am I at higher risk of skin cancer?

Anyone, including people who have never had cancer treatment, may develop skin cancer. However, there are some cancer treatments that may increase the risk of having skin cancer as a subsequent cancer later in life.

The following treatments can increase the risk of skin cancer:

You can find out if you have received any of these treatments by looking at your treatment summary. If you do not have a treatment summary or if you have any questions, do contact your treating hospital.

If you develop skin cancer, it does not always mean that this is caused by treatment for your first cancer. Skin cancer may have other causes, such as (too much) sun exposure. Skin cancer is most common in people with a light skin type and older age. If cancer at an unusually young age is common in your family, this may also increase your risk of having skin cancer.

What are the symptoms and signs of skin cancer?

There are symptoms and signs that can tell you if you might have skin cancer. You might not have these symptoms and signs at the moment, but it is important to be aware of them in case they may develop in the future.

These symptoms and signs may suggest that you have basal cell carcinoma:

  • Raised, transparent or pearly bump(s) on the skin
  • Scaly patch(es) on the skin
  • Red, itchy patch(es) on the skin
  • Patches with brown or black spots in them
  • A sore that does not heal, or heals but comes back

Symptoms and signs of squamous cell carcinoma are:

  • A firm, pink lump with a scaly crust
  • A lump that bleeds easily
  • Pain or tenderness where the lump is located

Symptoms and signs of melanoma are:

  • A spot that looks like a mole
  • A new or newly changed spot that does not go away

To help distinguish melanoma from a regular mole, you can use the ABCDE rule:

A Asymmetry Melanomas are often asymmetric in shape, whereas moles are symmetric.
B Border The border of melanomas is often uneven, or ragged.
C Colour A mole usually has one colour, whereas melanomas are often a mix of 2 or more colours.
D Diameter Melanomas are often larger (> 6 mm) than moles (< 6 mm).

These symptoms and signs are often caused by something else. However, early diagnosis and treatment of skin cancer is very important. If you experience any of these symptoms or signs, please contact your general practitioner or follow-up care specialist soon.

I am at higher risk of skin cancer. What tests should I have and when?

If you are at higher risk of skin cancer, it is highly recommended to inspect your skin every 6 months for new spots or changing moles. If you suspect skin cancer, or when you are in doubt, show the bump, patch or mole to your general practitioner or follow-up care specialist.

It is also advised to:

  • Discuss your family history of skin cancer with your follow-up care specialist at least every 2 years.
  • Have a skin exam done at least every 2 years.

What happens if I (might) have skin cancer?

If you have a bump, patch or mole that may be skin cancer, your general practitioner or follow-up care specialist will refer you to a:

  • Dermatologist (physician specialised in the skin)

The dermatologist may discuss different treatment options with you. When diagnosed early, most skin cancers can be removed easily.

What else can I do?

Knowing that you may be at increased risk of subsequent cancer can be difficult. Talking to friends and family can be helpful as well as specialist counselling and/or contact with support groups, such as patient organisations. For more information on taking care of your mental health, please read: Mental health problems.

To lower your risk of skin cancer, adopting or maintaining a healthy lifestyle is extremely important. In particular, it is important to avoid (too much) sun exposure, especially in the middle of the day. When you go outside, it is recommended to use sunscreen with a high SPF and wear protective clothing. Taking care of your mental health may be beneficial; even small changes to your lifestyle can have a positive impact on both your physical and mental health. For more information on taking up a healthier lifestyle, please read: Health promotion.

It is important that you are aware of the possibility of developing skin cancer and that you know the symptoms and signs. If you have any further questions or if the information in this brochure concerns you, please contact your general practitioner or follow-up care specialist.

Where can I find more information?

You may find more information about skin cancer online. However, it is important to be aware that this information is not always up to date or accurate.

On this website, you can also find more information related to this topic:

Please note

This PLAIN summary is based on the PanCareFollowUp guideline about “Subsequent neoplasms” [1], which is based on the consensus of different national guidelines.

While the PanCare PLAIN information group strives to provide accurate and complete information that is up-to-date as of the date of publication, you can check with your general practitioner or follow-up care specialist if this summary reflects the most up-to-date information available and whether it is relevant for you.

Please do not rely solely on this information. It is best to also seek the advice of a qualified medical practitioner if you have questions regarding a specific medical condition, disease, diagnosis or symptom.

No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information. PanCare has produced the English version and PanCare is not responsible for the translated versions of this summary.

The PanCare materials are free to use for anyone aiming to inform about late effects and long-term survivorship care. However, no financial advantage may be achieved. All communication should reference PanCare and link to the PanCare website.

[1] van Kalsbeek, R. et al. (2021) European PANCAREFOLLOWUP recommendations for surveillance of late effects of childhood, adolescent, and Young Adult Cancer, European journal of cancer. Available at: https://www.ejcancer.com/article/S0959-8049(21)00368-3/fulltext.