Skin Cancer Detection and Management
This page is dedicated to information around skin cancer. Find out about the different types of skin cancers, how likely they are to develop and why it’s so important to practice active skin protection in our Australian sun.
What Is A Skin Cancer?
Skin cancer is an uncontrolled and unusual growth of abnormal cells in the skin. Skin cancer occurs when normal skin cells are damaged, for example, cumulative exposure to ultraviolet radiation (UV) from sunburn. About 98% skin cancers in Australia are caused by exposure to UV radiation of the sun. About 2% of skin cancers(including melanoma) occur where there has been no sun exposure. Therefore, you must see your skin doctor if you are worried about a new or changing spot/mole even if it is in an area that has never been sunburnt (or never sees the sun).
There are three main types of skin cancer:
- Basal Cell Carcinoma(BCC)
- Squamous Cell Carcinoma(SCC)
Basal Cell Carcinoma (BCC)
- BCC is most common of all skin cancers, making up around 70% of non-melanoma skin cancers.
- BCC commonly appears on the head, neck and upper body.
- It appears as red, pale, pearly flat or raised lesion.
- A BCC may bleed and become inflamed causing ulceration.
- If left untreated, a BCC will continue to slowly spread and cause large sores(ulceration).
- Though BCCs do not usually spread to other parts of the body, it is best to treat early to prevent ulceration and damage to the affected area.
Squamous Cell Carcinoma (SCC)
- SCC is the second most common skin cancer, accounting for about 30% of non-melanoma skin cancers.
- SCCs usually develop on sun exposed areas of the body, such as the head, neck and hands.
- An SCC may look like a sore and may be tender to touch.
- It is not as dangerous as melanoma but can be deadly if left untreated on areas like lips, ears, scalp or temples.
- Melanoma is least common skin cancer but it is the most dangerous.
- It mostly arises as a dark, irregularly pigmented patch or lump on the skin
- Melanoma may also (rarely) present as a pink to red patch or lump.
- Commonly melanoma arises as a brand new spot.
- It could also arise in an existing mole that changes in size, shape or colour.
- Most cases can be successfully treated if caught early, but it can be fatal if treatment is delayed.
- The earlier the melanoma is diagnosed, the better the chance of survival.
Did you know?
- Australia has the highest rate of skin cancer in the world. Approximately two in three Australians being diagnosed with skin cancer before the age of 70
- Over 380,000 Australians are diagnosed with skin cancer every year, and over 1,600 will die from skin cancer each year
- Skin cancer accounts for about 80% of all new cancers diagnosed each year in Australia
- Australia has the highest rate of melanoma in the world
- Melanoma is the cancer most likely to affect people aged 15-39
- Around 30 Australians are diagnosed with melanoma every day
- Approximately one person dies every six hours from Melanoma in Australia
- An estimated 515 Australian women will die from melanoma THIS YEAR
- An estimated 1160 Australian men will die from melanoma THIS YEAR
- Severe sunburn during childhood can DOUBLE your risk of Melanoma
- Tanning beds/Solarium emits dangerous UV rays, increasing the risk of melanoma
- Melanoma can arise in normal looking skin, a mole or freckle
- Skin Cancer can occur anywhere on the body, even where there has been no sun exposure
- There is no cure for melanoma that has spread throughout the body
- Melanoma is one of the most preventable forms of cancer
- Melanoma, if detected/treated early, has a survival rate of nearly 100%
What Causes Skin Cancer?
The main cause the skin cancer is exposure to ultraviolet (UV) radiation from the sun. The Australian climate and fair skin in particular are a poor mix. Other sources of UV radiation, such as solarium tanning beds, also causes skin cancer.
In rare situations, skin cancer appears where you never have been exposed to sun. The available research suggests that while skin cells are often damaged in childhood, it may be sun exposure in adulthood that triggers these damaged cells to turn into cancerous lesions.
Who Is At Risk?
Anyone can develop skin cancer, regardless of their skin type, colour or general wellbeing. This is why it is so important to find a reliable skin cancer doctor with whom you can discuss your risk and plan regular skin surveillance.
One in three Australians can expect to develop some type of skin cancer in their lifetime. Early detection is the best way to improve the outcome for these cancers. Melanoma is by far the most dangerous type of skin cancer. To assess your individual risk of melanoma, see the melanoma risk calculator on the Victorian melanoma service website.
When Should I Worry About A Mole Or Spot?
You should seek urgent medical advice from your skin cancer doctor if you have a mole or spot that;
- change in size, shape or colour
- has been itchy for long time
- is new and appeared recently
- has an irregular shape compared to other ‘normal’ looking moles
Who Should Get Skin Check Ups?
You should see your skin cancer doctor if you have:
- fair skin that burns easily and does not tan
- blue or green eyes and/or fair or red hair
- suffered sunburn as a child
- spent your childhood in Australia
- a large number of freckles and moles
- irregular looking moles
- a family or personal history of melanoma or other skin cancer
- actively tanned or used solarium or sun beds
- worked or spent a lot of leisure time in the sun
- reached the age of 50 or older
- have a weakened immune system
- a worrying spot, mole or skin lesion
Skin Cancer Diagnosis
At your initial skin check, a doctor with specific postgraduate training in skin cancer diagnosis will take a thorough history and then conduct a comprehensive examination of your skin surfaces, assessing suspicious lesions.
For a proper examination you will be asked to undress to your underwear (be assured, your privacy is protected at all times). We use a hand held dermatoscope (basically a strong microscope for viewing the skin) to check your skin for unusual lesions, spots or blemishes.
Suspicious lesions are noted and recorded via18 megapixel high resolution digital SLR photography and digital dermatoscope (skin surface microscope) photography/mole scanning.These are stored in our state of the art Canfield Mirror Mole Mapping software for future reference and comparison.
We also record digital images of your back and face as baseline photographs for future comparison. We do this regardless of whether you have suspicious lesions as these areas are more prone to skin cancer.
If there is any need for follow up visits, biopsy or skin surgery we will advise you as soon as possible. In some cases, suspicious lesions require a skin biopsy first and surgical removal under local anaesthetics. This may be done at our clinic or in some cases a referral is to a relevant specialist centre.
Depending on your risk of developing future skin cancers we may also recommend Total Body Photography(TBP) and mole mapping, either total body or a specific body region.
Research shows about 80% of melanomas appear as new spots on the skin, and about 20% will arise from an existing mole. A combination of TBP and digital mole mapping allows us to keep an eye on suspicious moles. By keeping track of their size, shape and colour we can quickly identify when things are not right and take quick action if required. With a record of your existing blemishes/spots from your last visit we can also easily spot new ones and keep an eye on them too.
Total Body Photography
Total Body Photography (TBP) is a series of 18 megapixel high resolution digital SLR photographs taken of your skin, in our special studio. The studio has been fitted with state of the art Canfield IntelliStudio Dermagraphix body mapping software, providing you with a complete medical record of your skin surface.
These images are used as reference points and allow changes in your skin to be monitored over time, meaning dangerous skin cancers, such as melanoma, have a higher chance of being detected early. Your doctor can use these photos as a baseline at future skin checks, but more importantly, you can look for changes on your own skin in between visits to our clinic. These photographs are saved to a USB and a record is also kept in your computerised medical file at the clinic.
Those who have the greatest risk and therefore may benefit from TBP are those with:
- a family history of melanoma
- a previous melanoma
- a history of non-melanoma skin cancers
- fair skin (especially those with red hair) and previous sun damage
- a large number of moles, more than 50-100
- more than 5 unusual/atypical moles (irregular in shape, asymmetrical in colour and larger than ordinary)
- many freckles
- anyone anxious about their moles
Digital Dermatoscopic Mole Mapping
We use a dermatoscope (a skin surface microscope) attached to a high-resolution digital SLR camera to take detailed microscopic digital images of any suspicious moles. This is called mole mapping. Suspicious moles can then be followed up several months later to see if they have changed. We only map unusual looking or atypical moles which have potential to become melanomas in the near future. We store these high-resolution images in our specialised Canfield Mirror software for future comparison.
Total body photography (TBP) is not used by our clinic for diagnosis of moles on the first visit. An initial skin check is required prior to the TBP appointment. The purpose of the photographs is to retain them for comparison with future skin checks.
If we do identify a suspicious area we will undertake further investigation and if necessary, treatment and referral. We refer our patients to other specialist centres i.e., Victoria Melanoma Service at the Alfred for complex and advanced melanomas, which we cannot manage at our skin clinic.
We also refer our patients to Melbourne’s best specialist centres for secondary and tertiary care when they are diagnosed with more complex and rare skin conditions.
Tips For Skin Cancer Prevention
Check Your Own Skin Regularly
Even skin that has never been exposed to the sun has the potential to develop skin cancer. Regular check ups mean early detection, and early detection is the key to beating skin cancers. Most skin cancers are detected by people themselves or by close family members.
Unlike many other cancers, skin cancer is often visible, making it easier to detect in the early stages. We recommend you undertake your own full body skin check regularly, because skin cancers can occur on parts of the body not exposed the sun.
If you are worried about any mole, spot or freckle, please see your skin cancer doctor for an advice.
Protect Your Skin From Sun Damage
Protect your skin from ultraviolet (UV) radiation as 98% of skin cancers are caused by the sun. We recommend using UV index to know when to protect your skin from sunburn. The UV index shows the intensity of the UV radiation emitted by the sun. It’s part of most weather reports these days.
The daily SunSmart UV Alert identifies the sun protection times for more than 200 locations across Australia. You can check the SunSmart UV alert on the weather page of most daily Newspapers, via a free app for smartphones or on the SunSmart website.
When the UV index is 3 or above, we recommend you:
- Slip on sun-protective clothing
- Slop on SPF30+ broad spectrum sunscreen
- Slap on a hat
- Seek shade
- Slide on some sunglasses
Please contact us on (03) 8080 0555 to find out more or make an appointment.