Skin Cancer - should I be worried?


Skin cancer is one of the most common forms of cancer in Australia; accounting for ~ 80% of all new cancer diagnoses annually. By the time they are 70 years of age, 2 in 3 Australians will have been diagnosed with skin cancer.


The most common cause of skin cancer is exposure to the sun or more specifically overexposure to ultraviolet radiation (UV) from the sun.


There are 3 main types of skin cancer

1) Basal cell carcinoma

2) Squamous cell carcinoma and

3) Melanoma


A common misconception is that melanoma is the only form of skin cancer which can kill you. Unfortunately, whilst melanoma is the most aggressive and dangerous form of skin cancer, it is not the only type of skin cancer that can be fatal.


So, what is the best way to protect yourself from skin cancer?

By far and away the best way to protect yourself from skin cancer is to prevent it. Wearing sun cream when you are out in the sun, particularly between the hours of 11am and 3pm when the UV index is at its highest, wearing hats and sunglasses.

The Cancer Council of Australia recommends you SLIP on some sun-protective clothing covering as much skin as possible, SLOP on some broad spectrum, water resistant SPF 30+ sun cream, 20 mins before going outdoors and every 2hrs after, SLAP on a hat, SEEK shade and SLIDE on some sunglasses which meet Australian standards.


This mantra is taught in all Australian schools.

The tricky thing about UV is that it can still be high even on overcast days. There are some useful apps such as the SunSmart app which will tell you what the UV index is likely to be each day. When the UV index is over 3; you need to instigate the mantra above. The UV index can also be found out by googling the Bureau of Meteorology.


Using fake tans, tinted car windows and avoiding solariums are other ways to reduce your risks of skin cancer. The idea behind fake tan is that it saves you from damaging your skin cells getting a real tan. Fake tan itself offers no protection from the sun.


The idea behind the tinted car windows is to reduce the risk of sunburn. A common misconception is that you cannot get sunburnt whilst in a car – you can!

Early detection and management are the best way to reduce your risk of becoming very unwell, disfigured or even dying from skin cancer. This involves having annual skin checks with your GP, or dermatologist, knowing your skin and being aware of skin cancer symptoms and checking with your doctor when something changes. Things we recommend you look out for include crusty, non-healing sores, small lumps that don’t go away, new spots or freckles, any freckles which change colour, shape or thickness, anything which itches or bleeds, any freckle or mole which gets bigger. You are never wrong to go to your doctor to have them look at a skin lesion that you are concerned about. History of a changing lesion will trump anything we see under the microscope.


When your doctor does a skin check they will use good light and a dermatoscope.

A dermatoscope is a hand held microscope. If your GP finds something they are concerned about, they will either refer you to a dermatologist or perform a biopsy using local anaesthetic. Results of the biopsy will then dictate what management needs to be undertaken next. The standard age to begin annual skin check is 50 years. However, skin cancer is a cancer which we often see in much younger Australians and as such we often recommend you consider regular skin checks from a much younger age such as 20 years.


References

1. The Cancer Council of Australia: https://www.cancer.org.au/health-professionals/clinical-guidelines/skin-cancer.html

2. The Bureau of Meteorology

3. The SunSmart App