Metastasis is the process where cancer cells spread from the primary tumor to other parts of the body through the bloodstream or lymphatic system. Skin cancer is one of the most prevalent forms of cancer, and it also has the potential to metastasize.

Several factors can affect skin cancer metastasis, ranging from genetic to environmental.

1. Skin Cancer Type

There are three main types of skin cancer: melanoma, squamous cell carcinoma (SCC), and basal cell carcinoma (BCC). Among the three, melanoma is the most lethal type, and it has a higher tendency to metastasize.

Melanoma can spread to the lungs, liver, brain, and bone.

2. Tumor Thickness

Tumor thickness is one of the most important determinants of the risk of skin cancer metastasis. The deeper the tumor infiltrates into the skin layers, the higher the likelihood of metastasis.

This is because the tumor cells can easily enter the lymphatic vessels or capillaries and travel to other parts of the body. Therefore, early detection and treatment of skin cancer can significantly reduce the risk of metastasis.

3. Mitotic Rate

The mitotic rate reflects the speed at which the cancer cells divide and grow. Skin cancer cells with a high mitotic rate have a more aggressive behavior and are more likely to metastasize.

The presence of abnormal cells undergoing mitosis is another indicator of metastatic potential, so it is essential to monitor the tumor for these changes.

4. Age

The age of the patient plays a role in skin cancer metastasis. Metastatic melanoma is more common in older patients, although it can affect people of any age.

This may be due to cumulative exposure to environmental factors, immune system function, or genetic changes that accumulate over time.

5. Immune System

The immune system plays a vital role in controlling cancer cells and preventing their metastasis. Patients with compromised immune systems, either due to medication, illness, or autoimmune conditions, have a higher risk of skin cancer metastasis.

6. Sex

Globally, skin cancer is more common in men than women, although the incidence of melanoma is higher in women aged 15-39 years. Data has shown that melanoma is more likely to metastasize in men than women, although the reasons for this are unclear.

7. Genetics

Several genetic mutations are associated with an increased risk of skin cancer and its metastasis. For example, mutations in the tumor suppressor gene p53 are commonly found in SCCs and BCCs.

The BRAF gene mutation is often detected in melanoma, and it contributes to the development of the disease and its spread. Patients with a family history of skin cancer have a higher risk of metastasis, and genetic testing can help identify individuals with a higher risk.

8. Ultraviolet (UV) Exposure

UV exposure is a well-known risk factor for skin cancer development and its metastasis. Chronic exposure to UV radiation can damage cellular DNA, leading to mutations that can cause cancer.

UV exposure can also inhibit the immune system’s ability to recognize and destroy cancer cells, leading to a higher risk of metastasis.

9. Smoking

Smoking is linked to several types of cancer, including skin cancer. Smokers are more likely to develop squamous cell carcinoma, which has a higher metastatic potential than other skin cancer types.

Smoking also impairs the immune system’s ability to defend against cancer cells and increases oxidative stress, promoting tumor growth and metastasis.

10. Diet

Dietary factors also play a role in skin cancer development and its metastasis. A diet high in red and processed meats and low in fruits and vegetables has been linked to a higher risk of skin cancer.

In contrast, a diet rich in antioxidants, such as vitamins C and E and beta-carotene, has been shown to reduce the risk of skin cancer and its metastasis.