How Skin Cancer Develop due to Sun
Chronic exposure to sunlight can cause malignant and non malignant effects (sunburn and vitamin D synthesis) and affects patients’ health state. The major known effect of chronic skin exposure to sunlight is nonmelanoma skin cancer. There are two types of nonmelanoma skin cancer and they are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).
Steps of skin cancer development:
There are three major steps for cancer induction and they are initiation of cancer, promotion of cancer, and progression of cancer. Chronic exposure of human skin to sun results in initiation (of cancer).
First step:
In the first step (the step of initiation by exposure to UV-B) structural (mutagenic) changes in DNA can cause an irreversible change in the target cell (keratinocyte) that begins the tumorigenic process. The exposure of skin to a tumor initiator such as UV-B, although necessary, but not sufficient step (alone) in the causation of cancer, since initiated skin cells not exposed to tumor promoters do not generally develop cancer.
Second step:
The second stage in development of skin cancer is promotion, which is a multi-step process whereby chronic exposure to sunlight evokes genetic changes that culminate and cause the development of premalignant growths known as actinic keratoses, over many years and a minority of which progress to form skin cancer.
Third step:
The third and final step in the malignant process (for skin cancer) is malignant conversion and progression of benign precursors into malignant lesions. In the step of malignant conversion and progression there is requirement of additional genetic alterations in already transformed cells. Skin carcinogenesis is thought to be caused by the accumulation of mutations in the tumor-suppressor gene p53 as a result of UV-induced DNA damage. The p53 mutations are present in sun-exposed normal human skin, in actinic keratoses, and in nonmelanoma skin cancers including basal cell carcinoma and squamous cell carcinoma.
N.B.: Based on extensive studies it is clear that UV-B is a complete carcinogen, which means that it can act as both a tumor initiator and a tumor promoter which have negative impact on skin health state.
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