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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.

It is important that childhood cancer survivors have regular skin exams and take steps to prevent skin cancer.

If skin cancer is diagnosed early, it is usually very treatable.

A  graphic showing a cross section of layers of skin, with labels identifying the epidermis, dermis, and subcutaneous layer.

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.

Cancer Treatments that May Cause Skin Cancer

People who have received:

  • Radiation — typically in the area that received radiation. For example, if the skin around your knee received radiation that area of skin has an increased risk of developing a skin cancer.
  • Hematopoietic cell transplant (also known as bone marrow transplant or stem cell transplant)

Risk Factors for Skin Cancer

  • Personal or family history of melanoma or skin cancer
  • History of dysplastic nevi
  • Severe sunburn at a young age
  • Light skin
  • Chronic sun exposure
  • Atypical moles or greater than 50 moles

Skin Cancer Types

There are 3 major forms of skin cancer:

  • Basal cell carcinoma
  • Squamous cell carcinoma
  • Melanoma

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.

What Survivors Can Do about Skin Cancer

Know Your Risks and Monitor Your Health

  • Know your risk of developing skin cancer. Ask your doctor if you received treatments that increase your risk.
  • Share a copy of your Survivorship Care Plan with health care providers. It includes details about your cancer treatment and health problems that may occur because of your treatment.

Recommended Screenings for Skin Cancer

  • Check your skin monthly for changes.
  • Have a thorough skin exam by a health care provider at least once a year.

How to Prevent Skin Cancer

Protecting skin from the sun is the best way to prevent skin cancer. It is especially important for childhood cancer survivors.

For more information, visit the Children’s Oncology Group’s Skin Health After Cancer Treatment Health Link.

Reviewed: May 2020