Be SunSmart and prevent Skin Cancer!
Dr Rodrigo Ferrari Zeni
Skin cancer is the most common cancer diagnosed in Australia, and account for around 80% of all newly diagnosed cancers every year. The rate of skin cancer in Australia is one of the highest in the world, two to three times the rates in the US and the UK. Two in three Australians will develop skin cancer before the age of 70y. The good news is that 95% of skin cancers can be successfully treated if detected early.
Non-melanoma (keratinocyte) skin cancer is the most common cancer diagnosed in Australia. Over 1 million treatments are given each year in Australia for non-melanoma skin cancers.
Australia and New Zealand have the highest rates of melanoma in the world. It is estimated that more than 18,200 people were diagnosed with melanoma in 2023 in Australia. The average age at diagnosis is 65 years old. Melanoma is the third most commonly diagnosed cancer in Australia, and it is estimated that one in 17 people will be diagnosed by the time they are 85y.
The sun's ultraviolet (UV) radiation is the major cause of skin cancer. UV damage also causes sunburn, tanning, premature ageing and eye damage. The good news is you can prevent damage and skin cancer by being SunSmart.
The 5 SunSmart Steps for Protection
1. Slip on covering clothing: Choose clothing that covers as much skin as possible, for example, collared shirts with long sleeves.
2. Slop on SPF50+ water-resistant sunscreen: Apply a generous amount of sunscreen to clean, dry skin at least 20 minutes before you go outside. Reapply sunscreen every two hours or after swimming or excessive sweating.
3. Slap on a hat: Choose a hat that shades your face, nose, neck and ears. Caps and visors do not provide enough protection.
4. Seek shade: Use trees, built shade structures, or bring your own (such as a sunshade tent)!
5. Slide on some sunglasses: Sunglasses should be worn outside during daylight hours. Choose close-fitting wraparound sunglasses that meet the Australian Standard AS/NSZ 1067.
But what about the Vitamin D?
You shouldn't expose yourself to potentially harmful UV to get more vitamin D. Evidence suggests that prolonged sun exposure doesn't cause vitamin D levels to increase further but it does increase your risk of developing skin cancer. Most Australians get enough vitamin D with just 10 or 15 minutes of sun exposure while doing everyday tasks.
The 3 main types of Skin Cancer
1- Melanoma (1–2% of skin cancers).
· Grows quickly over weeks to months. Is the most dangerous and aggressive form of skin cancer. If left untreated can spread to other parts of the body and can be fatal.
· Usually is a enlarging pigmented spot. Can start as a new brown or black spot that grows on the skin, or as an existing spot, freckle or mole that changes size, colour or shape.
· Also can appear as a round, raised nodule on the skin that is pink, red, brown or black and feels firm to touch.
· Can be a lightly coloured area found on the palms of the hands, on the soles of the feet, or under the fingernails or toenails.
· Can grow anywhere on the body, not just areas exposed to the sun.
· Occurs most frequently on the upper back in males and on the lower leg in females.
2- Squamous Cell Carcinoma (SCC) (33% of skin cancers)
· Grows quickly over weeks or months; called invasive SCC if it invades past skin’s top layer; untreated, may spread to other parts of the body (metastatic SCC)
· Look for scaly red areas that may bleed easily, ulcers or non-healing sores that are often painful; a thick scaly lesion or a red, scaly or crusted spot
· Can become inflamed and often feel tender to the touch; may occasionally bleed
· Often found sun-exposed areas, such as head, face, neck, shoulders, arms and legs; most frequently on lips, ears, scalp, backs of the hands.
3- Basal Cell Carcinoma (BCC) (66% of skin cancers)
· Grows slowly over months or years; very rarely spreads to other parts of the body; may grow deeper, and invade nerves and tissue, making treatment more difficult
· Look for round or flattened spots that are red, pale or pearly in colour; or a pink, pearl-like, flat or raised lump.
· May become ulcerated, bleed and fail to heal. Can be itchy, inflamed, ulcerate, weep, ooze, scab or bleed; may “heal” then inflame/bleed/itch again
· Often found in sun-exposed areas, such as head, face, neck, shoulders, arms and legs,
Keep an eye on your skin with the ABCDEFG tool
Check your skin regularly for any new spots or changes in shape, colour or size of existing spots. Consider melanoma when a lesion is prominent, pigmented, and stands out from other moles (‘ugly duckling’) and rapidly growing.
The ABCDEFG for melanoma diagnosis is a valuable tool used by Doctors to identify and describe suspicious lesions. Here you can learn more about it:
A - Asymmetry, Are the halves of each spot different?
B - Border - Are the edges uneven, scalloped or notched?
C - Colour - Are there differing shades and colour patches?
D - Diameter - Is the spot greater than 6 mm across?
E - Elevated - Is it raised?
F - Firm - Is it firm to touch?
G - Growing - Is it growing quickly?
If you notice anything unusual, see your GP as soon as possible.
What is a skin biopsy?
A biopsy is a quick and simple procedure that is usually done in the GP clinic. You will be given a local anaesthetic to numb the area, then the doctor will either:
· completely cut out the spot and a small amount of healthy tissue around it to be tested (excision biopsy), or;
· take a small piece of tissue from the spot to be tested (shave or punch biopsy).
Stitches may be used to close a larger wound. The skin tissue is sent to a laboratory where a pathologist examines it under a microscope. Your doctor will get the results in 1–2 weeks. If all the cancer and a margin of healthy tissue are removed during the biopsy, this may be the only treatment you need. If the doctor has only taken a small piece from a larger spot, and this is found to be cancer, you will need to go back to have the rest of the cancerous spot removed.
GPs can treat most skin cancers. If necessary, they can refer you to a Dermatologist, Plastic Surgeon or Oncologist.
Who is at increased risk for Skin Cancer?
Pale or freckled skin, especially if it burns easily and doesn’t tan
Red or fair hair and light-coloured eyes (blue or green)
Unprotected exposure to UV radiation, particularly a pattern of short, intense periods of sun exposure and sunburn
Actively having tanned, sunbaked or used solariums
Work outdoors or spent a lot of time outside
Been exposed to arsenic
Weakened immune system – this may be from having diseases or using medicines that suppress the immune system.
Having lots of moles with an irregular shape and uneven colour
Previous skin cancer or a family history of skin cancer
People with brown, black, or dark skin colour often have more protection against UV radiation because their skin produces more melanin than fair skin does. However, they can still develop skin cancer.
How often should you get skin checks with your GP?
Opportunistic skin checks are recommended for individuals at above-average risk of developing skin cancer. “Opportunistic” means when any concerning lesions are identified.
Regular skin checks are recommended at least every 12 months for individuals at high risk of developing skin cancer. “High risk” means those with previous skin cancer.
Use the following skin cancer risk assessment tools to determine your risk level:
• Melanoma risk predictor (https://publications.qimrberghofer.edu.au/Custom/QSkinMelanoma
Risk) | QIMR Berghofer Medical Research Institute
• Keratinocyte risk score (https://publications.qimrberghofer.edu.au/p/qimr/qskinriskcalculator)
| QIMR Berghofer Medical Research Institute
Further information
Acess: https://www.cancer.org.au/cancer-information/types-of-cancer/skin-cancer
Download the free app “SunSmart Global UV” available at the App Store and Google Play.
#SunSmart #Skin cancer prevention #Skin cancer symptoms #Skin cancer risk factors #UV protection #Sunscreen SPF 50+ #Skin check #Skin biopsy #Non-melanoma skin cancer #Melanoma #Basal cell carcinoma (BCC) #Squamous cell carcinoma (SCC) #Vitamin D