Skin cancer is something that we are warned about right from our early childhood. “Put on sunscreen!” “Wear a hat.” “Don’t sit in the sun for too long!” “Stay out of tanning beds.” “Get your moles checked out.” I’m sure you heard your mom or dad’s voice in your head when you read those. Even though skin cancer is easily preventable, it is also one of the most common types of cancer, as people tend to not think about it while they’re outside, or think that they are fine simply because they don’t sun burn. People are naive, and think that skin cancer is something that will not happen to them. The reality of it is, skin cancer can develop in almost anyone, and if you are a carrier of what is known as the “ginger gene”, you do not even need to go outside to potentially develop melanoma.
Worldwide, 1 in 3 cancers are diagnosed to be a form of skin cancer, while 1 in 5 Americans develop skin cancer. It has also been researched that people of our generation (the 90’s babies of Canada) have a 1 in 6 chance of developing skin cancer during their lifetime, while people born in the 1960’s only have a 1 in 20 chance.
What really is skin cancer though?
Everyone knows that skin cancer can be caused by bad burns and sun exposure. Everyone has heard to go and get abnormal moles checked out. While these are common knowledge, the physiology of skin cancer is not as well known. Which is unfortunate, because maybe if it was, people would try to be more proactive and protect themselves better.
Skin cancer is caused by UV radiation, whether that be from the sun or tanning beds. The UV radiation will damage DNA bases, disable the p53 gene, otherwise known as the tumour suppressor gene, and can increase the production of Fas, which is a protein that causes damaged cells to commit suicide. The exposure to UV radiation can than cause the damaged cells to lose homeostasis and divide excessively, or in other words, to become cancerous. There are three different types of skin cancer: basal cell skin carcinoma, squamous cell carcinoma, and melanoma.
The 3 Types of Skin Cancer
The most common type of skin cancer, and the least dangerous, is basal cell carcinoma. It begins in the outer layer of your skin, in the basal cells. When the basal cells become malignant, they continually divide and attack the dermis and hypodermis skin layers. Basal cell carcinoma is caused by exposure to sunlight and UV radiations. This type of cancer is most frequently found on the face, ears, neck, scalp, shoulders, and back – the places that are most likely to be hit with sunlight. While anyone who has had frequent exposure to the sun could potentially develop basal cell carcinoma, it often presents itself in patients above 40, although that is changing, with more and more younger people developing the cancer. Genetics plays a role in the development, particularly if you have fair skin and light hair and eyes, or if you have what is known as the “ginger gene”. Basal cell carcinoma often looks like a non healing sore, which may develop into an open sore, a reddish patch, a shiny bump that is a translucent pink, red, or white, a pink growth with a crusted indentation, or a white, yellow, or waxy scar like area. Currently 99% of people with basal cell carcinoma survive, after treatments such as surgery or radiation.
The next most common type of skin cancer is squamous cell carcinoma. It develops from the keratinocytes in the stratum spinosum layer of the epidermis. Squamous cell carcinoma can be found on any area of the body, including mucous membranes, although it is generally found in areas that have been exposed to the sun – due to it being caused by excessive exposure to UV radiation. Unlike basal cell carcinoma, SCC can pierce through to the under lying tissues, and eventually spread to other tissues and organs if not treated, causing it to be more dangerous than basal cell carcinoma. Similar to basal cell carcinoma, anyone who has had their fair share of exposure to the sun is at risk for SCC, but particularly those with the ginger gene, although dark skinned people can also develop SCC. Squamous cell carcinoma is generally exhibited as a crusty wart, a red scaly patch, and open sore, or an elevated growth with a central depression. This type of cancer can be removed through surgery or radiation, and people with squamous cell carcinoma have a good chance of survival if it is caught early enough.
The third type of skin cancer, malignant melanoma, is the most deadly. It may be caused by excessive UV exposure, from either the sun or tanning beds, and severe blistering sunburns may act as a beginning factor for the cancer development. Once again, anyone can develop melanoma, although it appears to be most commonly found in people with the ginger gene, as well as people with a family history of the disease. It is quite often found on your back, although it can develop on any part of your skin, mouth, or eyes. It generally appears as a brown or black freckle like spot. There are five stages to melanoma: Stage 0, the cancer is found only in your epidermis, Stage 1 is found in the skin’s surface layers and is smaller than 1mm without ulceration or between 1 and 2mm with ulceration, Stage 2 is the same as Stage 1, except it is between 1 and 2mm without ulceration or larger than 2mm with out ulceration, Stage 3 is where the cancer begins to spread to nearby lymph nodes and throughout the skin, and finally Stage 4, the cancer spreads to distant lymph nodes or internal organs. Melanoma may be treated by surgery, chemo, or radiation, depending on the stage and location of the cancer.
MC1R: The Ginger Gene
It has been known for some time that variants of the melanocortin-1-receptor (MC1R) gene that is commonly associated with freckles, fair skin, and red hair causes people to have poorer protection from UV radiation, and are therefore more likely to develop skin cancer. However, a recent study has show that people who have the gene have a much higher likelihood of developing skin cancer than originally thought- they are up to 100 times more likely.
The MC1R gene codes a cyclic AMP stimulating G protein coupled receptor. It is found on melanocytes, which produce melanin, a pigment that produces a person’s skin, hair, and eye colour. There are two forms of melanin: eumelanin, which causes dark hair, dark skin, and lots of protection against UV radiation, and pheomelanin, which leads to lighter hair, freckles, fair skin, and less protection from UV radiation. Therefore, if your body is producing more pheomelanin that eumelanin, such as those who carry the ginger gene, you have less protection from the sun and a higher chance of being sun burnt and developing skin cancer.
Are you a carrier of the MC1R gene? Potentially. 1 in 4 people are carriers of the gene. If you have red hair and freckles, that’s a pretty clear indicator that you have the gene. If you are fair skinned, freckled, but without red hair, you have an 85% chance of being a carrier. Even if you don’t have red hair or freckles, you still have an 18% chance of being a carrier.
If you are a lucky carrier of the gene, your chance of developing melanoma increases dramatically. A study performed in 2012 showed that even if you are not exposed to UV radiation, you have a higher chance of developing melanoma, just because you carry the gene. In fact, people with the gene who do not even have a history of UV exposure still appear to be twice as likely to develop melanoma in their lifetime, compared to those who do not have the gene.
So what do you do if you have the gene?
If you’ve drawn the short end of the stick, and all thanks to your parents and genetics you are a carrier of the MC1R gene, you naturally have a higher chance of developing melanoma. Unfortunately, there is not a lot you can do to prevent that, although you can ensure that you always wear sunscreen, hats, and sunglasses if you are outside, and try to avoid the sun when you can. This will not prevent all ginger gene carriers from developing cancer, but it is a start, and will hopefully make some difference.