Skin Cancer

About Skin Cancer
Skin Cancer Facts & Stats
Risk Factors for Skin Cancer
Checking for Skin Cancer
Diagnosis & Treatment of Skin Cancer

Skin Cancer Types

Skin cancer is a disease of the body’s skin cells. Skin cancer develops when cells which make up the skin are damaged and grow abnormally. The sun’s ultraviolet (UV) radiation is the main cause of skin cancer. Each time your skin is damaged by UV, changes take place in the structure and function of the skin cells. If UV damage keeps adding up, skin cells become less able to repair, increasing the risk of skin cancer. There are three main types of skin cancer. The most serious is melanoma. Our skin is made up of cells: basal cells, squamous cells and melanocytes. Types of Skin Cancer The different types of skin cancer are named for the skin cell where the cancer develops: basal cell carcinoma, squamous cell carcinoma and melanoma. Carcinoma is another word for cancer. Basal cell and squamous cell carcinomas are often grouped together and called ‘common’ skin cancer or non-melanoma skin cancer. Skin cancer usually appears on parts of the body that have been overexposed to the sun. It can also (less often) appear on skin not normally exposed to the sun.

What does Skin Cancer Look Like?

Skin cancer can present in many different ways which is why it’s important to know your skin and what’s normal for you. Skin cancer can appear as:
  • a new or unusual looking spot including a lump or sore which doesn’t heal or may bleed
  • an existing spot that has changed in colour, size or shape.
If a spot strikes you as being a bit odd, take it seriously – it’s worth getting it checked by a doctor.

Types of Skin Cancer

(Some images below kindly provided by the Skin Health Institute).  

Melanoma

Melanoma can grow quickly. The most aggressive forms can become life-threatening in as little as six weeks and if untreated, it can spread to other parts of the body. Use the ABCDE rule to look for melanoma where:
 Assymetry

– Does the spot look fairly even?

Border

– How irregular is the border of the spot?

Colour

– Is the colour of spot even?

Diameter

– How big is the spot?

Evolution

– Is the spot changing and how quickly?

The earlier melanoma is found, the more successful treatment is likely to be. Melanoma is often related to a pattern of irregular high sun exposure, including episodes of sunburn.

 

Superficial spreading melanoma (the most common type of melanoma)

Asymmetry of Flat Melanoma    Colour Variation of Flat Melanoma   Melanoma Skin Cancer   Melanoma Symptoms   Melanoma Signs and Symptoms    Border Irregularity of Flat Melanoma   It is usually flat with an uneven smudgy outline, may be blotchy and more than one colour – brown, black, blue, red or grey.

 

Nodular melanoma

Nodular melanoma A highly dangerous form of melanoma that looks different from common melanomas – they are raised from the start and have an even colouring (often red or pink and some are brown or black). This type of melanoma grows very quickly and needs to be treated as soon as possible. They are most common in older people in sun exposed areas such as the face, ears, neck and head. Other forms of melanoma include lentigo maligna melanoma, acral lentiginous melanoma and desmoplastic melanoma.

 

Basal cell carcinoma (BCC)

Basal Cell Carcinoma   Basal Cell Carcinoma Treatment   Basal Cell Carcinoma Scalp   Basal Cell Carcinoma Surgery   This is the most common but least dangerous form of skin cancer. It grows slowly, usually on the head, neck and upper torso. It may appear as a lump or dry, scaly area. It can be red, pale or pearly in colour. As it grows, it may ulcerate or appear like a sore that does not heal properly. The earlier BCC is detected, the easier it is to treat.

 

Squamous cell carcinoma (SCC)

Squamous Cell Carcinoma This type of skin cancer is not as dangerous as melanoma but may spread to other parts of the body if not treated. It grows over some months and appears on skin most often exposed to the sun. It can be a thickened, red, scaly spot that may bleed easily, crust or ulcerate.

 

Warning signs of sun damaged skin and skin cancer risk

Sun Exposure and Skin Cancer  Seborrhoeic Keratoses  Solar Keratosis Spots, blemishes, freckles and moles, similar to those pictured above, are signs of sun-damaged skin. They are a warning sign your skin has had UV damage. If you notice them changing, see your doctor.  The main cause of skin cancer is over exposure to UV radiation. You can reduce your risk by using sun protection during sun protection times.

Skin Cancer Facts & Statistics

  • Two in three Australians will be diagnosed with skin cancer by the age of 70.1
  • About 2,000 Australians die from skin cancer each year.2
  • Australia has one of the highest rates of skin cancer in the world.3
  • Medicare records show there were over a million treatments for squamous and basal cell carcinoma skin cancers in 2018 – that’s more than 100 skin cancer treatments every hour.
  • Basal and squamous cell carcinoma skin cancers accounted for one quarter of all cancer-related hospitalisations in 2014–15.4 The cost to the health system of these skin cancers alone is estimated to be more than $700 million annually. The costs to the Federal Government and the community from basal and squamous cell carcinomas are predicted to continue to increase in the future.5
  • In 2018, 3,097 Victorians were diagnosed with melanoma and 291 lost their lives to it.6
  • It is estimated that approximately 200 melanomas and 34,000 other skin cancer types per year are caused by occupational exposures in Australia.7

Cancer Council Australia’s Skin Cancer Committee
For more information visit Cancer Council’s Skin Cancer Statistics & Issues.

 

Position statements

 

Cancer Council Australia’s Skin Cancer Committee has developed a number of position statements addressing common myths and misunderstandings and providing clear information and advice aimed at helping Australians reduce their skin cancer risk. Many of the statements have been developed with input from other expert health organisations, particularly the Australasian College of Dermatologists.

These include:

  • Eye protection
  • Fake tans
  • Risks and benefits of sun exposure
  • Screening and early detection of skin cancer
  • Private solariums
  • Sunscreen
  • Sun protection and infants (0–12 months)
  • Sun protection in the workplace
  • Tinted windows

References

1. Staples MP, Elwood M, Burton RC, Williams JL, Marks R, Giles GG. Non-melanoma skin cancer in Australia: the 2002 national survey and trends since 1985. Med J Aust. 2006;184(1):6–10.
2. Australian Bureau of Statistics. Causes of Death, Australia, 2017.  Vol. 3303.0. Australian Bureau of Statistics: Canberra, Australia, 2018.
3. Ferlay J, Soerjomatram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin D, Forman D, Bray F. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11. IARC, World Health Organisation, 2013.
4. Australian Institute of Health and Welfare.  Cancer in Australia 2017. Cancer Series no.101. Cat.no. CAN 100. AIHW: Canberra, Australia, 2017.
5. Fransen M, Karahalios A, Sharma N, English DR, Giles GG, Sinclair RD. Non-melanoma skin cancer in Australia. Med J Aust. 2012;197(10):565–8.
6. Victorian Cancer Registry. Cancer in Victoria: Statistics & Trends 2018 Cancer Council Victoria: Melbourne, Victoria, 2019. Available from: www.cancervic.org.au/downloads/cec/cancer-in-vic/Cancer-in-Victoria-2018.pdf.
7. Fritschi L, Driscoll T. Cancer due to occupation in Australia. Aust N Z Public Health. 2006;30(3):213–9

Skin Cancer Causes and Risk Factors

Who is at risk of skin cancer? Tori Mar, Dermatologist People at higher risk of skin cancer are those who have:

A personal or family history of skin cancer

5–10% of melanomas are influenced by genetics. Be aware of your family’s skin cancer history to help inform your own risk.
People who’ve had skin cancer have a higher risk of developing more skin cancers. It’s important to prevent further damage to your skin by using sun protection during sun protection times. Your doctor will recommend a surveillance program for you, but you will need to check your skin regularly for any changes. UV damage is the cause of most skin cancers. Using regular sun protection and developing a surveillance plan with your doctor can help reduce your risk.

A large number of moles

The more moles you have on your skin, the higher the risk of the most dangerous type of skin cancer – melanoma. Moles are overgrowths of melanocytes (a type of skin cell). We are not normally born with moles, but most of us will develop some on our skin by 15 years of age. The number of moles we develop is determined by genetic (inherited) factors and exposure to ultraviolet (UV) radiation. Australians tend to have more moles than people living in other countries, possibly because of childhood sun exposure.

What do moles look like?

Moles are usually medium to dark brown but can also be pale or black. The majority of moles are flat and have an even shape and colouring. Some moles are raised and these are usually soft to touch and lighter in colour.
Dysplastic naevi
‘Dysplastic naevi’ is a medical term which means ‘unusual moles’. These moles look different to ordinary moles and can evolve to melanomas. If you have multiple dysplastic moles you are at greater risk of melanoma. Your doctor may recommend regular checks with a dermatologist (skin specialist). See your doctor if you think you have moles with the following ‘dysplastic’ features:
  • larger than most moles
  • smudgy and irregular edges
  • uneven in colour
  • may have some pinkness.

A compromised immune system or are on immunosuppression medication

Some medical conditions impacting your immune system and associated medications can increase your skin cancer risk. Your doctor can advise you on the best steps to protect your skin from UV damage and appropriate skin check and surveillance activities for your condition.
A fair skin type and skin colour
Some people are at higher risk of skin cancer because they have a skin type that is more sensitive to UV damage. People with light-coloured eyes and red or fair hair also have an increased risk of melanoma, compared to people with darker hair and eyes. Skin Type Chart

A history of bad sunburns

While sun exposure in the first 10 years of life determines a person’s lifetime potential for skin cancer, sun exposure in later life determines the extent to which this potential is realised. You can reduce your risk of skin cancer at any age by improving your sun protection use, whether you are 6, 16 or 60.

Spent lots of time outdoors unprotected or work outdoors

Within Australia, it is estimated that 95% of melanomas are caused by overexposure to UV radiation. Outdoor workers in Australia receive up to 10 times more sun exposure than indoor workers, placing them at an increased risk of skin damage and skin cancer.

Suntanned, use or have used solariums and/or sunlamps

Solariums can emit ultraviolet (UV) radiation up to six times as strong as the midday summer sun. This is equivalent to a UV level of 36, whereas the UV levels in Victoria rarely exceed 12. Exposure to UV radiation from the sun or a solarium increases your risk of skin cancer and ages your skin. Tanning without burning can still cause skin damage, premature ageing and will increase your risk of skin cancer. Research shows that using solariums before the age of 35 increases the risk of melanoma by 59%. Commercial solariums were banned in Victoria on 1 January 2015.
Skin cancer can usually be successfully treated if found early. But without treatment, skin cancer can be deadly. Calculate your melanoma risk

What to do if you are ‘at risk’

If you meet any of the above criteria, see your doctor to develop a surveillance plan and check your skin regularly for any changes. Some people (such as transplant recipient patients, people with compromised immune systems and genetic skin cancer risk) are at high risk of skin cancer and may require additional sun protection and early detection strategies specific to their health needs. Please consult your doctor for specific health advice.

Check for Signs of Skin Cancer

The sooner skin cancer is found, the easier it is to treat.

The best way to ensure skin cancer is found early is to get to know your skin and what’s normal for you. Any changes including new spots, or changes in shape, colour or size of an existing spot should be checked by your GP.


How to Detect Skin Cancer Early?


Most skin cancers are found by people checking their own skin or are noticed by a loved one. There is no evidence to support screening programs for skin cancer at a population level, however, people at high risk of skin cancer should discuss a surveillance strategy with their GP.

Get to know your skin and, if you notice anything unusual, visit your doctor as soon as possible. Read more about the signs of skin cancer.D

Skin Cancer – Diagnosis, Treatment, & Reducing the Risks

Who to see

General practitioner (GP)

Cancer Council Victoria recommends seeing your GP as your first port of call for a suspicious spot. Your GP can help ensure your personal medical history is taken into account if treatment or a referral is required. If there is any cause for concern your GP will refer you to a dermatologist or surgeon for further investigation.

Dermatologist

A dermatologist is a doctor who specialises in treating and diagnosing all conditions relating to the skin, hair and nails. After becoming a doctor, they undertake several years of additional training. You need a referral from your GP to see a dermatologist.

What does a dermatologist do?

Diagnosis

Skin cancer is diagnosed by physical examination and biopsy.

A biopsy is a quick and simple procedure where part or all of the spot is removed and sent to a laboratory. It may be done by your doctor or you might be referred to a dermatologist or surgeon. Results may take about a week to come through.

In some cases, your biopsy may remove all of your skin cancer and you may not require further treatment.

How skin cancer is treated

In choosing the best treatment option, your doctor will consider your age and general health, the type and size of cancer, where it is on your body and what you want. The treatment choice will also depend on whether the skin cancer has spread elsewhere in your body. Types of further treatment include:

  • surgery
  • freezing
  • scraping
  • radiotherapy
  • removing lymph nodes
  • immunotherapy
  • targeted therapy
  • chemotherapy

Skin cancer clinics are mostly run by GPs with special skills and interests in Skin Cancer. It is important you find out about the services offered and the expertise of the doctors in Skin cancer clinics to assess if they suit your particular needs.