Skin Cancers

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 (BCC)
Squamous Cell Carcinoma (SCC)
Melanoma – the most dangerous form of skin cancer

Both Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC) 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.

Understanding Melanoma (Cancer Council)

Skin Cancers (Cancer Council)

Check for Signs (Cancer Council)

Australia and New Zealand have the highest incidence of skin cancer in the world
Skin cancers account for around 80% of all newly diagnosed cancers
More than 90% of skin cancers are caused by exposure to the sun
Melanoma is the most common life threatening cancer in the 15 to 44 year age group
Melanoma is the third most common life threatening cancer in both men and women overall

There are different types of skin cancers. More common varieties are

Basal Cell Cancers (BCC)

They are generally locally spreading cancers. But some BCCs like micronodular and sclerosing types are aggressive forms of BCCs, which has the potential to spread.

Squamous Cell Cancers (SCC)

They are more aggressive varieties, which can spread to the Lymph Glands and other parts of body.

Melanoma

They are more aggressive than above two types. They can rapidly spread via blood stream throughout the body. People will die if it spread to vital organs like liver, kidney, lungs etc.

There are other rare verities of skin cancers like Spindle cell cancers, Merckel Cell Cancers etc., which can be life threatening as well.

How important is whole body Skin Check?

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.

http://scanyourskin.org/skin-cancer-risk-checklist/

What is whole body skin check?

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).

What are the treatments for skin cancer?

Treatments depend upon the type of skin cancer and extend of spread.

Excision and closure

Skin cancers will be removed with adequate margin. The defect is closed either by direct closure or flaps or skin grafts.

Cryotherapy

Some superficial skin cancers can be treated by freezing with liquid nitrogen (cryotherapy)