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Skin Cancer and you

Skin Cancer and you

In Australia, every year:

    • Skin cancers account for 80% of all newly diagnosed cancers.
    • Two in three Australians will be diagnosed with skin cancer by the time they are 70.
    • Melanoma is the most common cancer in people aged 15-44 years.
    • Excluding non-melanoma skin cancer, melanoma is the fourth most common cancer in both women and men.
    • One in seventeen Australians will be diagnosed with melanoma before the age of 85.
    • It is estimated that 12,544 people will be diagnosed with melanoma in 2014.
    • Expected number of new melanomas in 2020 is 17,570 cases. (Melanoma Patients Aust).
    • The number of new cases has increased from 8,692 in 2000 to over 12,500 cases in 2014, equating to a 44 per cent increase, or an average 3 per cent increase annually.
    • The five-year relative survival rate for melanoma is 90% for Australian men and 95% for Australian women.

Skin cancer is the most prevalent of all cancers. 90% of skin cancers are due to over exposure to UV light either from the sun or solariums. Some skin cancers are not related to UV exposure and these include hereditary skin conditions and chemical exposure. In the treatment of any skin cancer, early detection and treatment is vital for the best outcome.

There are three main types of skin cancer:
– click on type below for more info

Melanoma

What is Melanoma?

Melanoma, the most serious type of skin cancer, develops in the cells that produce melanin — the pigment that gives your skin its colour. The exact cause of all melanomas isn’t clear, but exposure to ultraviolet (UV) radiation from sunlight or solariums increases your risk of developing melanoma. Other risk factors include having a large number of moles, previous minor skin cancers, increasing age or a suppressed immune system.

peninsula-skin-cancer molemapping

Changing melanoma – Click to enlarge image

What are the symptoms of melanoma?

Melanomas most commonly occur as a new mole rather than a normal mole that turns into a melanoma. These new moles will continue to grow and show changes. Melanomas can develop anywhere on your body, but they most often develop in areas that have had exposure to the sun, such as your back, legs, arms and face. Women most commonly get melanomas on their legs and feet whilst melanomas on men are usually on the back. Melanomas can also occur in areas that are not exposed to the sun, such as the scalp, soles of your feet, genital area and inside the mouth. These hidden melanomas are more common in people with darker skin.

What do normal moles look like?

Normal moles are generally symmetrical, a uniform brown / black colour, and have a regular border separating the mole from your surrounding skin. They’re oval or round and usually smaller than 6mm in diameter. Most people have between 10 and 40 moles and they will all look similar. Most moles will have developed by the age of 40, although moles may change in appearance over time — some may even disappear with age.

What do melanomas look like?

Melanomas are varied in their appearance. They are not always a mole, sometimes they are a flat patch of pink / red skin or a pimple-like nodule. They are usually different to all the other moles on your skin. Most melanomas are asymmetrical, in colour and/or pattern; however some melanomas can be perfectly symmetrical. Melanomas are always changing, growing in size, changing colour, becoming flat to raised or starting to ulcerate or bleed. Many of these features are only seen when magnified by a dermatoscope, so it essential to have a professional skin check by a doctor experienced in dermatoscopy. It is also important to get to know the moles on your skin so you can detect if there is a new mole or if an existing mole is changing.

peninsula-skin-cancer molemapping

What melanomas look like – Click to enlarge image

Melanomas have many distinctive microscopic/dermatoscopic features that are recognised by experienced dermatoscopists. These features enable them to detect melanoma and non-melanoma skin cancers at a very early stage, vital to a good prognostic outcome. It is essential that your doctor performing your skin check is using a dermatoscope whilst looking at your skin.

What are the risk factors of melanoma?

    •    A large number of moles on the skin
•    History of a previous melanoma detected
•    Family history of melanoma
•    Previous minor skin cancers ( BCC’s and SCC’s) detected
•    Multiple peeling or blistering sunburns
•    Solarium use or actively tanning
•    Working outdoors
•    Increasing age

peninsula-skin-cancer molemapping

No such thing as a safe tan – Click to enlarge image

How is melanoma screened and diagnosed?

Many patients book themselves in for a skin check after they have discovered an unusual mole on their body. However, many melanomas are detected that the patient was unaware of. These are detected in full body skin checks and mole mappings. During skin checks and mole mapping, a full body skin examination is done, from the top of the scalp to soles of the feet, using dermatoscopy to look at every mole or lesion. If a suspicious spot is found, it may be biopsied or reviewed for change depending on the level of suspicion. Pathology must be performed to confirm any skin cancers.
Mole mapping is the most effective way to screen for melanoma. Mole mapping involves Total Body Photography and digital imaging of individual moles. The total body photography enables the detection of new moles on the skin, whilst the digital comparison images show suspicious changes within a mole which leads to detection of melanoma.

peninsula-skin-cancer molemapping

Molemapping – Click to enlarge image

How is melanoma treated?

Once a melanoma has been confirmed by pathology, a treatment plan is discussed. All melanomas need to have a clearance margin around the site of the melanoma and the size of the excision margin varies according to the depth of the melanoma. Most melanomas need 5 – 10 mm of normal skin excised around the site of the melanoma. This is to prevent localised spread of that melanoma. For most melanoma patients this will be the only treatment they need except for regular follow up skin checks or mole mapping for the next two years and then annual checks for life. Melanoma patients are at a high risk of developing a completely new melanoma on their skin during the first two years after detection. A few patients will have a thicker / deeper melanoma that will require a larger excision margin and follow up testing. This will be discussed with the patient at the time of their procedure.

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Our highly experienced and qualified surgeons– Click to enlarge image

Can you prevent melanoma?

As most melanomas are due to UV exposure, we can certainly prevent excess sun damage by protecting our skin from the sun. These involve:
•    Wearing protective clothing such as long sleeve shirts, trousers, rash vests with long board shorts when outside during peak UV times 11am to 3pm.
•    Wear a hat with a broad brim to cover the face, ears and neck.
•    Put on a 50+SPF sunscreen to any exposed skin whenever the UV index is over 3.
•    Slide on some sunglasses to protect your eyes
•    Seek shade when available
•    Avoid tanning and solariums
Some melanomas are not due to UV exposure, therefore prevention is not possible. Surveillance is the next best thing. Checking your own skin routinely for new or changing moles and regular skin checks with a professional will help with the early detection of melanoma and improve the survival rate.

Basal Cell Carcinoma

Basal cell carcinoma (BCC) is the most common form of skin cancer and is very prevalent in Australia and New Zealand. These skin cancers are due to excess UV exposure and hence appear on skin regularly exposed to the sun such as the face, arms and back. The most common nodular type of BCC appears as a slowly-growing shiny white, pink or discoloured bump, most often on the face or neck. The superficial type of BCC presents as one or more irregular red scaly patches growing on the trunk or limbs. BCC may invade into deeper tissues but does not spread to other parts of the body. Multiple BCCs are common.

Treatment of BCC

When a lesion is suspicious for BCC, a small punch biopsy is performed to confirm the diagnosis and to see what type of BCC it is. Some BCC’s will always need to be excised, but there are some types of BCC’s that may be treated non-invasively with creams and light treatment, e.g.  Aldara and PDT.
Regular skin checks are required after the detection of a minor skin cancer as there is a high risk of another skin cancer appearing on similar sun damaged skin.

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Basal Cell Carcinoma – Click to enlarge image

Squamous Cell Carcinoma

Squamous cell carcinoma (SCC) is a common form of skin cancer typically found on sun exposed skin such as the ear, face, lips, hands or lower legs. Invasive SCC usually grows within a solar keratosis (scaly spots due to sun damage) and presents as a tender scaly or ulcerated lump. In the pre-invasive phase, SCC in situ (often called Bowen’s disease); characteristically presents with one or more dry or crusted red or brown patches. Invasive SCC needs to be attended to promptly as there is a risk of secondary spread.

Treatment of SCC

When a lesion is suspicious for SCC, a small punch biopsy is performed to confirm the diagnosis and to see what type of SCC it is. Some SCC’s will always need to be excised, but there are some types of SCC’s e.g. Bowen’s that may be treated non-invasively with creams or light treatment.
Regular skin checks are required after the detection of a minor skin cancer as there is a high risk of another skin cancer appearing on similar sun damaged skin. If you are concerned about a lesion then please do not hesitate to act. Contact The Peninsula Skin Cancer Centre nearest to you or your doctor immediately.

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Squamous Cell Carcinoma – Click to enlarge image