Skin Cancer

Beating the Skin Cancer Epidemic

The risk of cancer increases with age, and the number of adults seeking treatment is increasing dramatically, in line with our ageing population. Of all cancers, skin cancer is by far the most common in Australians. The total number of new skin cancers diagnosed – both melanoma and non-melanoma – amounts to about 80 per cent of all new cancers diagnosed each year overall*.

Australia has one of the highest melanoma rates in the world. Two in three Australians will be diagnosed with skin cancer by the time they are 70*. Around 434,000 Australians are treated for non-melanoma skin cancer annually* – which is more than 1,000 people every day.

In times past, we were not as aware of the dangers of exposure to ultraviolet (UV) light – both natural and artificial – as we are today. Now we know there is no such thing as a ‘healthy tan’ and more than 95 per cent of skin cancers are caused by exposure to the sun*.

Not surprisingly, outdoor workers such as farmers, forestry workers and builders, who have spent their working life in the sun, often without adequate protection, present in the highest risk category.

The prevalence of skin cancer is an epidemic – and with the arrival in retirement years of the baby-boomers, who enjoyed their halcyon days soaking up the sun, it’s only really just starting.

Certainly, if we are not careful when we are young, it will come back to haunt us when we are older. The good news is, if skin cancers are identified early, they can usually be cured. But if ignored, the consequences can be more serious.

Sometimes people come in to have a single mole checked, only to find that another lesion, lump or mole that they haven’t considered, is of much greater concern.

*Cancer Council Australia – Skin cancer facts and figures, updated March 2014.

At the Austin Clinic our skin cancer doctors are Dr Lishuang Chen, Dr Harold Judelman and Dr Susan Austin.

 

You, your partner and your family will know better than anyone else if something on your skin is new or changing – these are two important early warning signs. Become familiar with your spots and moles, and check your skin regularly.

The Skin Cancer College Australasia promotes a simple, but very effective mantra: SCAN Your Skin.

SCAN means look for a spot or mole that is…

Sore, scaly, itchy, bleeding, tender and doesn’t heal within six weeks.

Changing in appearance, size, shape or colour.

Abnormal: Looks different, feels different, or stands out when compared to others. New: Most melanomas – and all other skin cancers – arise this way.

It is important to check your face, neck, ears and back as well as the front and back of the torso and buttocks, arms, legs, hands (including palms), feet (including soles), and between your fingers and toes (including nails), groin, genital areas and scalp. It may be helpful to use a hand mirror. To check areas that you cannot see you may want to ask you partner or a person that you trust to check you.

Visually scan your skin every 2-3 months because some skin cancers can grow fast over weeks or months.

A general skin check is recommended every year or as advised by your doctor.

How long does a skin check take?
A thorough skin check can take 30 – 45 minutes. This includes some time for the doctor to discuss your medical history – which can have an impact on your risk of developing skin cancer.

What equipment does the doctor use?
A doctor who has been trained to use a dermatoscope will take a close up look at any spots of concern to assist in a diagnosis. A dermatoscope is a bit like a torch with a magnifying glass attached to the end. Using a dermatoscope is painless, and greatly assists the doctor in deciding if a spot or mole is of concern. If uncertain, the doctor may take a dermatoscopic photograph of a spot or mole using our Molemap photographic system, so it can be monitored over time for any changes.

What happens if the doctor finds a lesion or spot, which could be skin cancer?
Your doctor will tell you straight away if you have any moles or spots, which require testing. To test the mole or spot the doctor will either take a small biopsy (sample) of it, or completely excise (cut out) the spot of concern – under local anaesthetic of course. In most cases another appointment will be made to remove the abnormal mole or spot. This type of minor surgery can be carried out at our clinic, under local anaesthetic.

After it is removed, the mole or spot is sent to a pathology laboratory for testing. Receiving the test results can take several days.

What happens if skin cancer is found?
In most cases, when found early, skin cancer can be easily and successfully treated with surgery, topical treatments or Photodynamic Therapy (PDT). Most skin cancers are cured once they are removed. Other non-surgical treatments such as topical creams, radiotherapy, or Photodynamic therapy may be used but this will depend on the type of skin cancer found.

What happens after the skin check?
Depending on your level of risk for developing skin cancer, your doctor may recommend regular follow up skin checks. The frequency for follow up skin checks can vary from every few months, to once every year or two. At the Austin Clinic we have a system in place to send you a skin check reminder if you would like, but it is also a good idea to keep your own record of when a follow up skin check is due.

At the Austin Clinic we also safely remove skin tags, moles and bumps by Radiosurgery where applicable. Please see Moles, Lumps and bumps (link to Moles, Lumps and Bumps pg) page.

Who is at risk?
You have a greater risk of developing skin cancer if you fall into any of the following categories.

  • Have a large number of moles and/or freckles
  • Have used solarium’s or tanning booths
  • Work outside
  • Have fair skin
  • Have had a diagnosis of Melanoma or other skin cancer in the past
  • Have a family history of Melanoma or other skin cancer
  • If you have ever suffered sunburn
  • If you are taking immunosuppressive medications

It is important to know that:

  • Skin cancer is not a seasonal condition. It can develop any time of the year, including winter.
  • Skin cancers including melanomas can develop anywhere, including areas that are usually covered by clothing or hair.
  • A small number of melanomas are pink or lack pigment, although most melanomas are either black or brown.
  • Early melanomas are often not raised and not easily felt with the hand, so it is important that you look at the skin and do not rely on how it feels.

There are many different types of skin cancer that can be treated in several ways. Often superficial skin cancers can be treated with liquid nitrogen, which freezes the skin cancer and causes it to disappear from the skin. It is common for the lesion treated to scab or go pink after the treatment; this may take from 1 to 3 weeks to heal depending on your skin type and the location of the lesion.

For more serious skin cancers, minor surgery may be required. At the Austin Clinic we perform most of our skin cancer surgery on site. After a lesion has had an initial diagnosis by your doctor during a skin check, the doctor may biopsy the lesion to find out what type of lesion it is and if it does need to be excised.

Excisions are usually done under local anaesthetic onsite so you are still able to drive yourself to and from the clinic. An excision usually takes 30 minutes to an hour per lesion. With most lesions you will be out-of-pocket $200 – $330 after the Medicare rebate has been established. More complicated surgery or multiple excisions done on the same day may incur a higher cost. “Happy gas” is also available at an extra cost.

If you have had a skin cancer excised, it is wise to keep a close eye on your skin and watch for any changes. Your doctor may suggest more regular skin check’s after a skin cancer has been diagnosed.

Certain types of skin cancers can also be treated with Photodynamic Therapy (PDT). For PDT a light sensitising cream is applied to the lesion and then covered. It is left to incubate for a period of 3 – 4 hours then the lesion is exposed to LED red and blue light for a total of half and hour. The light activates the cream, which causes destruction of the skin cancer cells. This type of treatment can be preferable if the lesion is suitable as there is less chance of scarring. After the treatment the lesion will scab and may become red or inflamed. Generally the skin will heal completely between 2 – 4 weeks afterwards and may be red for several weeks. This is dependant upon the location of the lesion as some parts of the body heal slower than others.

The most effective management of skin cancer is early detection and treatment. The Austin Clinic is dedicated to the prevention, diagnosis and treatment of skin cancers. It offers local, cost-effective access to advanced knowledge, diagnostic techniques, and treatment options. You, however, are the person most familiar with your skin, so SCAN your skin thoroughly and repeat often. It’s a simple habit to get into, and one that might save your life.

For more information about skin cancer, have a look at: http://www.scanyourskin.org