Especially when exposed to strong sunlight in the mountains or by the sea, you should protect yourself adequately from the sun’s rays.

The skin protects us against cold, light, heat and infections. As the largest organ of the human body, it consists of two main layers, the epidermis and the dermis, as well as different cell types. Over the last 20 years, there has been a steady increase in the incidence of skin cancer. If skin cancer is detected early, the chances of recovery are very good.

Skin cancer – what do you need to know?

In skin cancer, malignant cells are typically found in the outer layers of the skin. Older patients in particular are affected by skin cancer. Basal cell carcinoma is the most common form, accounting for around 70 % of all skin cancers. This makes basal cell carcinoma the most frequently diagnosed malignant disease worldwide (Rubin et al, N Engl J Med 2005,353:2262-2269). The distribution of the skin surface shows that around 80% of basal cell carcinomas occur in the head and neck region, 15% on the trunk of the body and around 5% on the arms, legs or other body regions. Spinocellular carcinoma is found in around 20% of cases. The face is also often affected by spinocellular carcinoma, as both skin cancers are mainly triggered by UV light. The UV rays cause DNA damage and gene mutations in the skin cells. Basal cell carcinomas and spinocellular carcinomas grow into the tissue at the respective sites and can destroy the tissue and even cause a disfiguring growth. This is particularly true if the growth occurs near important sensory organs such as the eye, nose or ear. Years of growth without therapy can therefore lead to open wounds with a considerably reduced quality of life. Rarely, i.e. in around 5 % of all skin cancers, melanoma is found. However, this tumor, also known as malignant melanoma, can lead to much more serious complications.

How can skin cancer be diagnosed?

Prevention is the most important measure to avoid skin cancer. Early signs of skin cancer should definitely be observed. Such early signs are Skin changes that do not heal after a long period of time, a bumpy surface that shows growth in size and changes in color, size or bleeding tendencies of skin changes. If you notice such a change, it is highly advisable to have an examination carried out by your family doctor or dermatologist. As a rule, it is necessary to take a tissue sample. The removed tissue is examined under a microscope by a specialist. Then you can be told whether you have skin cancer or not.

How common are melanomas?

The frequency of melanoma in Switzerland was investigated by the Federal Office of Public Health (FOPH). In the case of melanoma, which is particularly hazardous to health, the frequency of new cases in Switzerland was found to be 22 per 100,000 inhabitants per year. This means that Switzerland has the highest incidence of new melanoma cases compared to 40 other European countries. Only Australia and New Zealand have a higher incidence of new cases of melanoma. In young adults, melanoma is actually one of the most common types of cancer, as 30% of those affected are under the age of 50. The incidence even seems to be increasing, because according to the Federal Office of Public Health, the incidence has doubled in the last 20 years, especially in women under 50 years of age. Recreational behavior certainly plays an important role as a cause. High exposure to UV rays through sun exposure or sun exposure in winter and summer as well as UV radiation from visiting a solarium are probably important reasons for the increased incidence of melanoma in the last 20 years. According to the FOPH, around 10% of younger Swiss people regularly visit a solarium.

What treatment options are there for skin cancer?

There are a variety of different treatment options for the treatment of skin cancer. This depends on the age, the type of skin cancer and the location of the skin cancer on the body. Typically, skin cancer can be treated well by surgery. In most cases, removal is possible under local anesthesia. A few sutures are usually sufficient to restore the removed area of skin. If there is a larger defect, it is sometimes necessary to remove tissue from the surrounding area and transfer this tissue back into the defect. This is also referred to as a skin flap. Nasal defects place high demands on the facial surgeon. The surgery of such defects is one of the most demanding challenges for a facial surgeon when the nostrils or the tip of the nose are affected by skin cancer and has very high aesthetic demands. In any case, complete removal of the skin cancer is necessary. To do this, the skin cancer tissue is removed with a safety margin and sent to an expert who examines the tissue with a microscope. We use the possibilities of micrographically controlled surgery, in which the edges of the incision are examined for diseased cells in a highly precise clockwise direction. In very advanced cases of skin cancer, radiotherapy and chemotherapy are also possible treatment options.

Am I a risk patient for skin cancer?

There are certain risk factors that increase the likelihood of skin cancer occurring. These include:

• Long-term exposure to the sun
• A light skin type (for example, blonde or red hair with freckles
• Family burden of skin cancer
• Multiple severe sunburns in childhood

It is therefore important to take preventive action. When the sun is at its strongest (between 11 a.m. and 3 p.m.), your skin should not be exposed to much sunlight. High sun protection factors with sun protection factor 15 and more should also be used. If you notice anything new or unusual about your skin, it is highly recommended that you see your doctor. Prevention is the best medicine.