What is skin cancer?
Skin cancer occurs when skin cells are damaged, for example, by overexposure to ultraviolet (UV) radiation from the sun.
There are three main types of skin cancer:
- basal cell carcinoma
- squamous cell carcinoma
- melanoma – the most dangerous form of skin cancer
Both basal cell carcinoma and squamous cell carcinoma are known as non-melanoma skin cancer.
Approximately, two in three Australians will be diagnosed with skin cancer by the time they are 70. Non-melanoma skin cancer is more common in men, with almost double the incidence compared to women.
Excluding non-melanoma skin cancer, melanoma is the third most common cancer in Australians. In 2015, 13,694 Australians were diagnosed with melanoma.
Every year, in Australia:
- Skin cancers account for around 80% of all newly diagnosed cancers
- The majority of skin cancers are caused by exposure to the sun
- GPs have over 1 million patient consultations per year for skin cancer
- The incidence of skin cancer is one of the highest in the world, two to three times the rates in Canada, the US and the UK.
- In 2016, 1960 people died from skin cancer in Australia, 1281 from melanoma and 679 from non-melanoma skin cancers.
Skin cancer symptoms
The sooner a skin cancer is identified and treated, the better your chance of avoiding surgery or, in the case of a serious melanoma or other skin cancer, potential disfigurement or even death.
It is also a good idea to talk to your doctor about your level of risk and for advice on early detection.
Become familiar with the look of your skin, so you pick up any changes that might suggest a skin cancer. Look for:
- Any crusty, non-healing sores
- Small lumps that are red, pale or pearly in colour
- New spots, freckles or any moles changing in colour, thickness or shape over a period of weeks to months.
Causes of skin cancer
Australia has one of the highest rates of skin cancer in the world. Anyone can be at risk of developing skin cancer, though the risk increases as you get older.
The majority of skin cancers in Australia are caused by exposure to UV radiation in sunlight.
· Sunburn
Exposure to UV radiation causes 95% of melanomas, the most deadly form of skin cancer.
In Australia, 1 in 8 adults and 1 in 5 teenagers are sunburnt on an average summer weekend. Many people get sunburnt when they are taking part in water sports and activities at the beach or a pool, as well gardening or having a barbeque.
Sunburn is also common on cooler or overcast days, as many people mistakenly believe UV radiation is not as strong. This is untrue – you can still be sunburnt when the temperature is cool.
Sun exposure that doesn’t result in burning can still cause damage to skin cells and increase your risk of developing skin cancer. Evidence suggests that regular exposure to UV radiation year after year can also lead to skin cancer.
· Tanning
A tan is not a sign of good health or wellbeing, despite many Australians referring to a “healthy tan”. Almost half of Australian adults still hold the misguided belief that a tan looks healthy.
Tanning is a sign that you have been exposed to enough UV radiation (from the sun or solarium) to damage your skin. This will eventually cause loss of elasticity (wrinkles), sagging, yellowish discolouration and even brown patches to appear on your skin. Worst of all, it increases your risk of skin cancer.
A tan will offer only limited protection from sunburn, usually equivalent to SPF3, depending on your skin type. It does not protect from DNA damage, which can lead to skin cancer.
Some people who use fake tans mistakenly believe it will provide them with protection against UV radiation. As a result, they may not take sun protection measures, putting them at greater risk of skin cancer.
· Solariums
Solariums emit UVA and UVB radiation, both known causes of cancer. Cancer Council does not recommend solarium use for cosmetic tanning under any circumstances.
Diagnosis for skin cancer
It is important to check your skin regularly and check with your doctor if you notice any changes.
In the majority of cases, your GP will examine you, paying attention to any spots that may look suspicious.
How important is whole body Skin Check?
The best way to prevent death from skin cancers is early diagnosis (before skin cancer spread) and treatment. Many of skin cancers including melanoma are not always visible to the naked eye. They appear just like a normal mole. Doctors use a special device called dermoscope, which magnifies the mole/skin lesion about 10 times. An expert can identify a skin cancer by looking at the various features of the lesion. Sometimes the lesions or moles need to be monitored periodically (3 monthly or 6 monthly) to see if there is any change (growth). Mole Scan Machine (Dermdoc) is special equipment for computer assisted skin scanning. The pictures of the moles can be stored and used for periodic monitoring. The magnification of the mole is 30-40 times the size of the mole.
Who needs regular Skin Check?
- Those who have family history of skin cancers
- Age >40
- Those who have lot of sun exposure, sunburn, sun tan etc.
- Those who have many moles or freckles (irrespective of age)
- Those who has any skin cancers removed
- Caucasians of Northern European ancestry
You can check your risk of skin cancer by checking following site.
What is whole body skin check?
It is a head to toe thorough whole body check, first with the naked eye and then with a computerised magnifying device (Dermdoc) or dermoscope to analyse the details of each skin lesion. Doctor will take pictures of the skin lesions and mark the location on the body images for further monitoring or removal.
What happens after skin check?
If any skin lesion found to be suspicious, the doctor decides either to monitor or to biopsy (sending a small part of lesion for microscopic examination). Depending on the type and aggressiveness of skin cancers, treatment plan is made.
Treatment for skin cancer
Skin cancer Surgery
Skin cancers are almost always removed. In more advanced skin cancers, some of the surrounding tissue may also be removed to make sure that all of the cancerous cells have been taken out. Some aggressive skin cancers like melanoma may need wider excisions. Skin cancers on the face needs completed excision with slow Moh’s surgery. Many of those excisions need to be closed with skin flaps or skin grafts. Plastic Surgeons, Generals Surgeons or GPs who has advanced training in Skin Cancer Surgery do those types of surgeries.
Chemotherapy
Some type of skin cancers can be treated with topical Chemotherapy creams. This may need 4-5 weeks of treatment.
Photo Dynamic Therapy (PDT)
Some non melanoma skin cancers can be treated by UV rays after applying photosensitive creams on the lesions
Radiotherapy
Some Skin cancers can be treated by fractionated radiotherapy
Preventing skin cancer
Protect your skin
For best protection, when the UV level is 3 or above, we recommend a combination of sun protection measures:
- Slip on some sun-protective clothing – that covers as much skin as possible
- Slop on broad spectrum, water resistant SPF30+ sunscreen. Put it on 20 minutes before you go outdoors and every two hours afterwards. Sunscreen should never be used to extend the time you spend in the sun.
- Slap on a hat – that protects your face, head, neck and ears
- Seek shade
- Slide on some sunglasses – make sure they meet Australian standards.
Be extra cautious in the middle of the day when UV levels are most intense.