Facts & Stats Risks Detection Types Prevention Treatment
What is Skin Cancer?
Skin cancers are the most commonly diagnosed cancers in Australia. Ultraviolet (UV) radiation from the sun accounts for the development of most skin cancers.
Skin cancers are divided into melanoma (the most deadly form of skin cancer) and non-melanoma skin cancers. SCCs (squamous cell carcinomas) and BCCs (basal cell carcinomas) are the most common non-melanoma skin cancers.
Facts & Stats about Skin Cancer
- At least 2 in 3 Australians will be diagnosed with skin cancer before the age of 70. The risk is higher in men (2 in 3) than in women (3 in 5).
- Over 400,000 Australians are treated for skin cancer each year - over 1,000 people each day.
- 95% of skin cancers can be successfully treated if found early.
- Over 2300 Australians die from skin cancer each year (Latest available figures from 2016: melanoma and non-melanoma).
- Each year, many more people die from skin cancer than from road accidents in Australia.
- Sun exposure has been identified as the cause of around 99% of non-melanoma skin cancers and 95% of melanoma in Australia.
- Increased sun protection against sun exposure will prevent skin cancer at whatever age it is applied.
- Australians are more likely to be diagnosed with non-melanoma skin cancer than all other forms of cancer combined. (NB: no updated stat in Cancer in Australia 2010)
Are you at a higher risk?
If you identify with any of the following you are at a higher risk of skin cancer:
- You previously had skin cancer.
- You have a family history of skin cancer.
- You have a skin type that burns easily or is sensitive to UV light.
- You have a history of severe sunburn, particularly as a child.
- You actively tan, including the usage of solariums.
- You work outside.
- You are immune-suppressed e.g. a solid organ transplant recipient.
Skin cancer and UV
Skin cancer results from skin cell damage, most often caused by exposure to ultraviolet (UV) light from the sun, or artificial sources like tanning beds.
Whenever we are exposed to UV light the structure and function of our skin cells are affected. Over time this can lead to permanent cell damage, and this damage will continue to develop with each exposure.
Other factors can impact on the risk of skin cancer, but sun exposure is the main cause. Less than 5% of melanomas are attributable to an inherited gene.
Every type of skin is damaged by UV exposure, including those skin types that have a lower risk of sunburn.
Your Skin, Vitamin D & the sun
Symptoms of skin cancer
Early warning signs of skin cancer can vary, however some important symptoms to keep an eye out for are listed below. If in doubt have any lesion of concern checked by your GP or dermatologist.
Melanomas may be diagnosed using the ABCDE method:
A - Asymmetry
B - Border irregularity
C - Colour variation
D - Diameter (usually over 6mm)
E - Evolution (change and growing larger)
How to check your skin
Other skin cancers can be pink, red or skin coloured. They are commonly found on sun exposed sites like the face, neck and arms. Important signs include:
- Change in size, shape or elevation
- Sores or ulcers that do not heal within 2-3 months
If any of these occur it is very important to consult your GP or dermatologist as soon as possible.
Types of skin cancer
The three main types of skin cancer are Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC) and Melanoma.
Basal Cell Carcinoma (BCC)
BCCs are the most common form of skin cancer and the least dangerous. BCCs develop slowly over months or even years. BCCs can present as a pearly-surfaced, pink-raised lump or as a pink-red scaly area, and may ulcerate. BCCs most often occur on sun-exposed areas like the head and neck although they can be found anywhere on the body. Although BCCs very rarely spread to other parts of the body, early detection is important as it may allow the lesion to be treated non-surgically or with minimally invasive surgery.
BCCs are predominantly related to cumulative sun exposure, together with some genetic factors. If left untreated they can damage surrounding tissues and organs.
Squamous Cell Carcinoma (SCC)
SCCs can be scaly or crusted lumps, pale pink to red in colour, and may be tender to touch. SCCs are found on sun exposed areas and can take weeks to several months to grow. They are less common than BCCs and tend to grow faster. This form of skin cancer more commonly occurs in older people. SCCs may spread to other parts of the body if not treated appropriately. Treatment is usually with surgical excision.
Melanoma is the least common of the main three types of skin cancer, but is the most dangerous and causes the most deaths . If a melanoma is not diagnosed early it can spread around the body. Melanoma can be found anywhere on the body and even in non-exposed skin areas. They can appear as a new or changing mole and changes can be in terms of colour, size, shape or thickness.
A rapidly growing form of melanoma is the Nodular Melanoma. Nodular Melanomas can ulcerate and bleed, or can present as a raised dome-shaped lump coloured red, pink or black.
Melanomas detected early can often be cured. Risk factors for melanoma include genetic factors, the number of moles a person has, multiple sunburns in the past and solarium use. It may be a mix of colours.
Read more about Melanoma.
Skin cancer Prevention
We all know the saying 'prevention is the best medicine'. Well, in the prevention of skin cancer this is absolutely true! There are a number of key tips that you can use to prevent skin cancer.
- Check your own skin every 3 months or enlist the help of a friend or family member and make it a regular occurrence.
- Report any spots that are changing to your local GP or dermatologist.
- Yearly skin checks by a dermatologist are also recommended, particularly for people over 40.
- Remember skin cancers, especially melanomas, can occur on non sun-exposed sites such as the groin and feet, so remember to check all areas of the body.
- Use a broad spectrum sunscreen that provides protection from both UVA and UVB rays when the UV index hits 3 or above. In Melbourne, the UV index usually hits 3, on or about September 1 until May 1 (it is recommended you check your regions dates).
- Wear a hat, protective clothing and sunglasses when the UV index reaches 3 or above.
- Avoid sunburns and using solariums. It is now against the law to operate a commercial solarium anywhere in Australia.
- Learn about the UV index. A free app is available from the SunSmart website, which tells you the daily UV index all over Australia.
- Remember it’s the UV radiation that burns you, not the temperature! Even a cold, cloudy day can have a high UV index.
Treatment of skin cancer
There are a number of different treatment methods available for each form of skin cancer. The treatment method used will be dependent on the type and severity of the skin cancer. Some common examples of available treatments are listed below.
Cryotherapy involves freezing a skin lesion with liquid nitrogen.
It is generally reserved for benign lesions like solar keratoses but may be used for superficial basal cell carcinomas in some situations.
Curettage / Electrodessication
Curettage is a surgical technique where the skin lesion is scraped off the skin.
It is used for superficial skin cancers and avoids the need for sutures.
The curettage site usually heals with a white scar.
Surgical excision is the most common treatment for skin cancers.
This is generally performed under local anaesthetic.
The surgical wound is usually closed with skin sutures and leaves a straight scar.
Larger wounds may be closed using a skin graft or flap.
Mohs' surgery is a highly specialised form of skin cancer surgery.
In Mohs' surgery, the surgeon uses a microscope immediately following surgery to examine the excised skin and ensure the tumour is completely removed.
It has the highest cure rate of all surgical treatments and aims to conserve as much normal skin as possible.
Mohs' surgery is the treatment of choice for more complicated tumours, particularly on the face.
Radiotherapy uses X-rays to destroy cancer cells and is an effective treatment for some skin cancers.
It is usually reserved for cancers that are not amenable to surgery, particularly in older age groups.
Radiotherapy has the advantage of avoiding a surgical wound and can have an excellent cosmetic outcome in the short to medium term.
Imiquimod is a cream that stimulates the immune system to destroy cancer cells.
It is usually applied by the patient themselves for a 6-week period and causes a brisk red reaction.
Imiquimod may achieve a superior cosmetic outcome to surgical excision but is reserved for specific types of superficial skin cancers.
It must not be used for invasive SCCs or melanoma.
Photodynamic Therapy (PDT)
PDT is a non-surgical treatment for some skin cancers.
It involves application of a light sensitive chemical to the skin followed by illumination with a specialised light source.
PDT results in selective destruction of cancer cells and avoids damage to surrounding skin. A inflammatory reaction follows with redness, swelling and peeling, which typically heals with an excellent cosmetic result.
Like other non-surgical treatments, PDT must not be used for invasive SCCs or melanoma.
Can I reverse sun damage?
It’s the question everyone asks after experiencing sunburn. How can I reverse the damage? According to A/Prof Baker, sun damage is essentially not reversible.
Not only is sun damage irreversible, it is also cumulative. So, every time you or your child is sunburnt, you are increasing your risk of skin cancers and melanoma.
Every burn adds to the risk of skin cancers and adds to the signs of ageing, such as wrinkles, brown spots and scaly sun spots"
Skin Health Institute
Research has found that one or more blistering sunburns in childhood or adolescence more than doubles a person’s chances of developing melanoma later in life. So sun protection has to start from birth.
A/Prof Baker said rather than worrying about how to reverse damage after a burn, we should be putting more energy into avoiding getting burnt in the first place.
“The good news is that with sun protection and sunscreens, you can prevent further damage,” A/Prof Baker said.
Using an SPF 50+ sunscreen correctly, wearing a hat, covering up with high UPF clothing (UPF 50+ clothing blocks more than 98% of the sun's UVA and UVB rays), putting on some sunglasses, staying hydrated, and trying to avoid sun exposure altogether when the UV Index is above 3 will help your skin stay protected and will prevent any further sun damage.
Sun damage image sourced from: http://dailymail.co.uk/female/article-2557746/The-unflattering-headshots-Model-turned-photographer-shoots-subjects-UV-light-reveal-shocking-sun-damage.html