March 12, 2019

The skinny on skin cancer

By dryeongs

Photo by Matheus Vinicius on Unsplash

Skin cancer is the most common cause of cancer in Australia. In fact, we diagnose and treat so many skin cancers that the non-melanoma skin cancers are not even included in the Australian Cancer Database, so we aren’t even exactly sure of the true prevalence.

Even though Summer is over, skin cancer can develop at any time. Read on for the “skinny” on skin cancer.

What is skin cancer?

As I’ve already alluded to, there are two different types of skin cancer- melanoma and non-melanoma skin cancers. Non-melanoma skin cancers were previously known as benign skin cancers, but this was a bit of a misnomer, as not all non-melanoma skin cancers are completely benign. While it is true that the vast majority do not cause death, certain subtypes of these cancers, in certain locations, can definitely cause harm or health complications. According to the Cancer Council, in 2015 there were 642 deaths from non-melanoma skin cancers. These skin cancers include most commonly squamous cell carcinomas (SCCs) and basal cell carcinomas (BCCs).

Basal cell carcinoma. Image from

Squamous cell carcinoma. Image from

Melanoma. Image from

The other, more scary skin cancer is melanoma. Melanoma is a true cancer in the sense that it can grow rapidly and spread, causing metastatic deposits in other parts of the body. Melanoma is the cancer that can kill, and the one that we try to pick up as early as possible, before it has spread.

What are risk factors for skin cancer?

The most important risk for skin cancer is UV (ultraviolet) radiation exposure. Not just “sun exposure” but UV exposure. The difference is important because you can still have UV light exposure even on a cloudy day, without the sun shining.

Studies seem to suggest that high, intermittent exposure to UV radiation increases the risk of malignant melanoma. This means excessive tanning or cases of sunburn, especially at a youthful age. Cumulative, lifelong exposure to UV radiation increases the risk of non-melanoma skin cancers.

Skin type and family history also have a role to play. Skin cancer, like all other cancers, has an element of heredity, whether that is due to inherited skin type or through other mechanisms (such as differences in the immune system). Having a strong family history of melanoma is a red flag for keeping a closer eye on your skin.

Other risk factors for skin cancer include the same risk factors for many other cancers such as age, diseases and medications affecting the immune system.

How do we prevent skin cancer?

The best way to prevent skin cancer is to prevent overexposure to UV radiation. This means staying out of the sun during the hottest hours of the day, which on the East Coast in summer during daylight savings is 10am-4pm. The best way to check for the UV rating for the day is on your Bureau of Meteorology weather app, or on the website here. If you are out in the sun, then make sure you cover up with UV resistant clothing, you wear sunscreen over sun exposed areas, and you wear a hat.

Photo by Jedd on Unsplash

If you choose to wear a baseball cap rather than a broad brimmed hat, then please make sure you apply sunscreen to your ears.

A note about sunscreen: make sure you apply it at least 20 minutes before you go out in the sun, and reapply every 30 minutes if you’re swimming (even if the bottle says it is 4 hours water resistant!).

How do we check for skin cancer?

It’s really important to be regularly checking your own skin. I advise all patients in Australia to have an annual skin check by a doctor, but I also remind my patients that a skin check is like a “snapshot” in time- we can only see how the skin lesion is at that very moment. So it’s important to still be vigilant and keep an eye out for anything concerning- this means looking out for changes in your skin, like changes in colour, shape, size or symptoms- especially if it becomes itchy or starts bleeding. I usually tell my patients to look out for any mole that looks different from the other moles on their body- skin cancer is like any cancer- abnormal cells. This means they will look different from the benign moles.

Who should we go to if we are concerned?

The first place is always your GP. Depending on their level of experience, they will either examine you themselves with something called a dermatoscope, or they will refer you to a skin specialist or a skin cancer GP for a check. A skin cancer GP, like myself, have done extra studies in diagnosing and treating skin cancers.

A dermatoscope is a handheld device that acts as a magnifying glass to help the user see patterns in the skin lesions. My advice? Always make sure your doctor is examining your skin with one of these.

If you would like a bulk billed skin check, you can book an appointment here with me in Brookvale’s Warringah Mall.

Stay sun safe!