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Skin Cancer

Although rare, some pediatric cancer treatments can cause another cancer to develop later in life. For childhood cancer survivors, skin cancer is the most common of these second cancers.

Role of the Skin

The skin protects against heat, sunlight, injury, and infection. Skin also helps control body temperature and stores water, fat, and vitamin D.

Skin has several layers. The outer layer is the epidermis. It is composed of 3 kinds of cells:

  • Squamous: Thin, flat cells that form the top layer of the epidermis.
  • Basal: Round cells under the squamous cells.
  • Melanocytes: Cells located in the deepest part of the epidermis that produce melanin. Melanin gives color (pigment) to the skin and helps protect the skin from ultraviolet (UV) radiation from the sun.
A  graphic showing a cross section of layers of skin, with labels identifying the epidermis, dermis, and subcutaneous layer.

Types of Skin Cancer

Skin cancer is generally divided into 2 main types:

  • Non-melanoma — Occurring in squamous and basal cells.
  • Melanoma — Occurring in melanocytes.

Non-melanoma skin cancers

Non-melanoma skin cancers are the most common form of skin cancer. Basal cell carcinoma is the most common form of non-melanoma skin cancer, both in childhood cancer survivors and in the general population.

Although highly curable, surgical treatments for these skin cancers can cause scarring.

Treatment can be costly especially in patients who have multiple skin cancers.


Melanoma is rarer than non-melanoma skin cancer. It is typically more aggressive and can spread to other parts of the body.

Risk Factors for Skin Cancer

Survivors treated with radiation are at increased risk of developing skin cancer. Other risk factors include:

  • Personal history of melanoma or skin cancer
  • History of dysplastic nevi
  • Family history of melanoma or skin cancer
  • History of severe sunburn at young age
  • Light skin and age 65 and older
  • Atypical moles or greater than 50 moles

Skin cancer is the most common cancer in the U.S., but in the general population it typically happens in older adults. In contrast, skin cancers occur at younger ages in childhood cancer survivors treated with radiation than in the general population.

Reviewed: June 2018