(Melanoma, BCC, SCC)
Australia has one of the highest rates of skin cancer in the world, and melanoma is the third most common cancer in both Australian men and women.
There are different types of skin cancers. The most common are ‘keratinocyte’ or ‘non-melanoma’ skin cancers. These include basal cell cancers and squamous cell cancers. These types are so common in Australia that their numbers are not recorded. Melanoma (mentioned above) is the other main type of skin cancer.
- Melanoma is one of the three major types of skin cancer. It is the least common but carries a risk of becoming aggressive and causing death.
- Best outcomes are achieved with early detection and treatment.
- Melanoma occurs when there is uncontrolled abnormal growth of melanocytes (pigment cells) within the skin.
- Risk factors for the development of melanoma include pale skin and fair hair, recurrent sunburns (especially in childhood/youth), tanning bed use, family history of melanoma and dysplastic naevus syndrome (an inherited condition which causes hundreds of abnormal moles over the body).
- Melanomas often have no symptoms.
- The first sign is generally a change in an existing mole, or the appearance of a new mole.
- Suspicious moles are moles that bleed, have different colour shades or become blotchy, get bigger, increase in height or develop a raised area.
- Also watch for weepy, bleeding or scaly spots that don’t heal, new moles that suddenly appear and you have never noticed before and moles that itch.
- Rarer forms of melanoma can appear as dark areas or bands around or under the nails, or brown pigmentation on the genitals.
- Melanomas can also occur on the scalp.
What are the ABCDE signs of melanoma skin cancer?
A good way to remember the signs of melanoma skin cancer is to remember the ABCDE rule
A A is for asymmetry or moles that can’t be roughly cut in half
B B is for Borders that are irregular
C C is for Colour that is not mostly uniform
D D is for Diameter – moles that are spreading out
E E is for Elevation – moles that are increasing in height
- This is a non-melanoma skin cancer and the most common type of skin cancer in Australia. They occur in the ‘basal layer’ of the epidermis, which is the outermost layer of the skin.
- BCCs are almost always not life-threatening, but cause problems by growing big and deep if left untreated.
- BCC accounts for about 70% of non-melanoma skin cancers.
- These cancers can appear anywhere on the body but most commonly develop on parts of the body that receive high or intermittent sun exposure (head, face, neck, shoulders and back).
- BCCs often have no symptoms and tend to grow slowly without spreading to other parts of the body.
- BCCs often appear as a pearly lump, or a scaly dry area that is pale or bright pink.
- If left to become large, they may ulcerate.
- Squamous Cell Carcinoma (SCC) accounts for about 30% of non-melanoma skin cancers.
- It begins in the upper layer of the epidermis and usually appears where the skin has had most exposure to the sun (head, neck, hands, forearms and lower legs).
- SCC generally grows quickly over weeks or months and may become scaly or painful.
Signs of squamous cell carcinoma of the skin include:
- A new sore or thickened or red scaly spot
- A rapidly growing lump that looks like a sore that doesn’t heal
- A raised area on an ulcer or old scar
- A scaly, rough patch on your lip that may progress to an open sore
- A red sore or rough patch inside your mouth
- A firm, red nodule
- A flat sore with a scaly crust
- A raised red patch or wart like looking sore on in the genital or anus areas
- Treatment for skin cancer depends on the type, location and stage of the cancer and the individual’s general health.
- A biopsy is often recommended as the first investigation to find out what type of skin cancer a suspicious lesion is. This information often helps direct treatment.
- Almost all skin cancers will be excised (removed by surgery) with a ‘safety margin’ of normal surrounding skin.
- Depending on the factors mentioned above, other treatments may be recommended instead or in combination with surgery. These include
- Topical treatments – chemotherapeutic agents applied to the skin.
- Photodynamic therapy – chemotherapy cream activated by light.
- Graft or flap repair – if the wound left behind from a skin cancer surgery is quite large or tight, skin may need to be used from a nearby region to help close the wound.
- Mohs surgery – not offered by our clinic, but is a form of staged skin cancer excision.
- Lymph node biopsy or removal – if required, dye is injected into the skin in the area of a skin cancer and suspicious lymph nodes are removed and examined for cancer spread.
- Radiotherapy – x-ray treatment can be used as a sole treatment, as a adjunct (together with surgery), or following systemic therapy.
- Systemic therapy – this includes chemotherapy, targeted therapy and immunotherapy. These treatments are used for aggressive skin cancers or those that have spread from the skin to other parts of the body.
Celebrities such as Hugh Jackman, who shared a selfie of his bandaged nose on social media after having skin cancer removed, along with fitness trainer Shannon Ponton who was diagnosed with melanoma after noticing a suspicious mole on a trip to Bali, are among the many celebrity advocates for melanoma.
You will be asked about your family history, your work history (outdoor workers are at higher risk), any previous skin cancers, your history of sunburn and sun exposure and also the frequency and type of sun protection you use.
If you have taken photographs of any moles, or simply have moles that concern you, please show these to your doctor or tell them your concerns.
Just as we have ABCDE for DETECTING skin cancer, another good way to PREVENT skin cancer is to remember the 5 “s” s of prevention
1 SLIP on protective clothing
2 SLOP on SPF
3 SLAP on a hat
4 SLIDE on sunglasses
5 SEEK shade
Also remember to:
- Make a habit of leaving the house with sunscreen on
- Check your sunscreen expiration and it becomes unstable with time and is often not effective if expired
- Download the free SunSmart safety App to know when you need sun protection in your local area
- When the UV is over 3 all five forms of sun protection are required, including shade, sunscreen, protective clothing (arms and legs), broad brim hat and sunglasses.
- Use the SunSmart App to send you reminders to reapply sunscreen every two hours
- Use one teaspoon of sunscreen per limb – don’t forget behind your ears, tops of your head (including part line), eyelids, tops of feet, behind the knees.
- Make your sunscreen as accessible as your toothpaste at home (bathroom bench)
- In the car, shed, beach bag or other bag keep a sun care bag at the ready with glasses, hat, sunscreen, water
- Take breaks in shade where possible and remember working on grass where possible is better than reflective surfaces such as concrete, sand or water.
- If wearing a shirt collar, your can turn it up to protect your neck