In the United States, skin cancer is one of the fastest spreading forms of cancer, affecting millions annually. For individuals asking, ‘Is Skin Cancer Hereditary?’, yes, it is one of the factors. Skin cancer is a multifactorial disease, and it involves genetic, epigenetic, and environmental factors like ultraviolet (UV) radiation. It is important to note that 5% – 10% (approx.) of all cancers are supposed to be caused by inherited genetic mutations. Here we have discussed the multifactorial basis of skin cancer, highlighting key genetic factors, associated syndromes, and available treatment options.

What Is Skin Cancer?

Skin cancer stems from the uncontrollable growth of skin cells. The three primary types are:

• Basal Cell Carcinoma (BCC): The most common form, typically appearing as a pearly or waxy bump.
• Squamous Cell Carcinoma (SCC): Typically appears as a firm, red nodule or a flat lesion with a dry, scaly surface.
• Melanoma: The most aggressive type, typically arising from an existing mole or as a new dark spot on the skin.

Symptoms

• Changes in the appearance of skin abrasions or existing moles may occur.
• New growths or sores that don’t heal.
• Itching, tenderness, or pain in a specific area.
• Bleeding or oozing from a mole or lesion.

Genetic Factors:

As genetic and epigenetic factors fall among the basis of skin cancer, inherited skin cancer risk can never be disregarded. The following sheds light on the genetic predisposition to skin cancer:

1. Basal Cell Carcinoma (BCC) Hereditary Risk

Individuals with Basal Cell Nevus Syndrome (BCNS), also known as Gorlin Syndrome, have a significantly increased risk of developing BCC. This condition is caused by mutations in the PTCH1 gene, a tumour suppressor gene involved in the hedgehog signalling pathway, which regulates cell growth and differentiation.

2. Melanoma Genetic Causes

Melanoma can be inherited in an autosomal dominant fashion, meaning one copy of the altered gene in each cell is sufficient to increase the risk. Key genes associated with hereditary melanoma include:

CDKN2A: Mutations in this gene are responsible for Familial Atypical Multiple Mole Melanoma (FAMMM) syndrome, accounting for nearly 40% of familial melanoma cases.

CDK4, MITF, BAP1, MC1R, TP53, and TERT: Mutations in these genes also contribute to increased melanoma risk.

3. Squamous Cell Carcinoma (SCC) Genetic Risk

Syndromes such as Xeroderma Pigmentosum (XP), Fanconi Anaemia, and Epidermolysis Bullosa are associated with an increased risk of SCC. XP, for instance, is caused by mutations in genes responsible for DNA repair, leading to heightened sensitivity to UV radiation.

Melanoma Genetic Testing

Genetic testing for melanoma involves analysing a person’s DNA to identify mutations in genes like CDKN2A. This testing is particularly recommended for individuals with a strong family history of melanoma or those diagnosed at a young age. However, the clinical utility of such testing is still under evaluation, and it may not significantly alter clinical care for all individuals.

While melanoma genetic testing may or may not be recommended. Getting tailored medication that optimizes treatment is always preferred. A pharmacogenomics test (PGx test) from RPh LABS can give you insights into your genetic makeup, showing how you may respond to 250+ medications. Book an at-home test now and pay in 4 equal interest-free installments, with FSA or HSA.

What Can Develop into Skin Cancer?

While most skin cancers develop from previously normal skin, certain conditions increase the risk:

• Dysplastic Nevi: Most dysplastic nevi (atypical moles with unusual colour and irregular borders) do not convert into melanoma. However, having multiple atypical moles increases the chances of developing into melanoma.
• Actinic Keratosis: Rough, scaly patches that can progress to SCC.
• Chronic Sun Damage: Long-term UV exposure leading to skin changes.

How Does Skin Cancer Usually Appear?

Skin cancer often manifests as:

• BCC: Basal Cell Carcinomas typically appear as pearly or waxy bumps, often with visible blood vessels.
• SCC: Squamous Cell Carcinomas are characterised by firm red nodules or flat lesions with a scaly, crusted surface.
• Melanoma: Asymmetrical mole with irregular borders, multiple colors, and a diameter larger than 6mm.

What Causes Skin Cancer to Increase?

According to foxchase, various factors can increase the likelihood of developing skin cancer:

• UV Radiation: Prolonged exposure to UV rays from the sun or tanning beds.
• Fair Skin: Individuals with lighter skin tones have less melanin, reducing natural protection against UV radiation.
• Family History: A genetic predisposition increases risk.
• Immune Suppression: Weakened immune systems, such as in organ transplant recipients, heighten susceptibility.
• Age: The risk of skin cancer due to excessive UV exposure increases with age.

Treatment Options

According to MD Anderson, treatment for skin cancer depends on its type and stage:

• Surgical Removal: The tumor is removed along with some surrounding healthy tissue. This tumor is then sent for examination to check whether it’s malignant (cancerous) or not.
• Mohs Surgery: This involves the removal of cancerous tissue layer-by-layer, until the doctor sees tissues with zero tumor cells, thus preserving healthy skin. Mohs involves less scarring.
• Cryotherapy: Often used for treating precancerous conditions. Freezing abnormal cells with liquid nitrogen – doctors may repeat the process as per the condition.
• Radiation Therapy: High-energy rays may also target cancer cells.
• Topical Treatments: Applying medications directly to the skin. May result in crusting or redness, which lasts about 14 to 21 days.
• Immunotherapy: This involves stimulating the immune system to fight cancer cells.

Prevention Strategies

• Sun Protection: Using a sunscreen (broad-spectrum) with SPF 30 or higher.
• Avoid Tanning Beds: Artificial UV sources should be avoided as they may contribute to skin cancer.
• Regular Skin Checks: Monitor skin for any changes or new growths.
• Protective Clothing: Wear hats, sunglasses, and dresses that at least cover your legs and arms.
• Genetic Counselling: Consider counselling if there’s a family history of skin cancer.

Conclusion

The answer to ‘Is skin cancer hereditary?’ is ‘yes’; however, it is only one of the factors behind this cancer. Skin cancer involves several factors, including genetic, epigenetic, artificial UV rays, and accumulation of UV rays. Other factors increasing the chances of skin cancer include sensitive skin, fair skin color, and multiple dysplastic nevi, commonly known as atypical moles (often with different colors and scattered borders). Moreover, if not taken care of the skin, the accumulated UV rays increase the chances of skin cancer as you age. Stay cautious, if you have a strong family history of skin cancer and symptoms occur, talk to your doctor about melanoma genetic testing.

Disclaimer: This blog is only for informational purposes. Always consult your healthcare specialist before taking any medical action.

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