Skin Cancer Screening

• Skin cancer is caused by cumulative ultraviolet radiation over your lifetime
• Skin cancer does not just affect people who sunbake
• Daily sun exposure that occurs during normal activities such as driving the car, gardening and hanging out the washing increases your risk of skin cancer
• Your hobbies may influence your chance of skin cancer. For example cricketers, surfers, golfers, sailors, and gardeners may have increased risk of skin cancer.

Importance of Skin Cancer Screening

Skin Cancer screening will detect skin cancer lesions early . This means that they can be managed prior to progressing to more dangerous lesions that require surgical excision to manage. Skin cancer has a high cure rate when detected early.

What happens during a skin check?

Your doctor will first ask you questions about your past medical and dermatological history. A skin cancer can even occur on non sun-exposed areas such as on the feet, scalp and back. Your doctor will therefore exam all of your skin in a systematic fashion. The dermatologist will wear magnifying loupes so as to see the skin more clearly and at times will exam your moles with a special instrument that magnifies the features of your moles. Dermatologists are highly trained in skin examination and can recognize abnormal features rapidly and accurately.

Types of Skin Cancers

• Actinic Keratoses
• Basal Cell Carcinoma
• Squamous Cell Carcinoma
• Melanoma

Actinic Keratoses (AK)

Actinic keratoses are pre-cancerous lesions. Without treatment a significant proportion of these will develop into skin cancer (SCC or squamous cell carcinoma). Squamous cell carcinoma's can be potentially life threatening skin cancers and usually require surgery to manage.

Basal cell carcinoma (BCC)

Basal cell carcinoma's (BCC's) are the most common type of skin cancer in Australia. There are multiple different types of BCC’s (eg superficial, nodular and sclerosing variants).

The type of BCC that you are diagnosed with will dictate the modality of treatment selected, with most being curable lesions. Untreated however, they usually grow slowly over a number of months or years, invading the skin only and not spreading to the lymph nodes or internal organs.

Squamous Cell Carcinomas (SCC’s)

Squamous cell carcinomas often arise from a pre-existing actinic keratosis (sun spot). They vary in severity and also depth of penetration into the skin. For example, a Bowens disease (also known as a “Squamous cell carcinoma in situ”) is not as deep within the skin. This is important to know as the site, size and severity of a squamous cell carcinoma dictates the appropriate modality of treatment. There are multiple possible modalities including cryotherapy (dry ice), curettage and cautery ('scraping'), topical 5-flurouracil (Efudix), Imiquimod (Aldara), Photodynamic therapy (PDT) and Surgical excision.

Information about the nature of a squamous cell carcinoma is determined by a skin biopsy.

Melanoma

Melanoma is a potentially fatal skin cancer. Early detection is life saving. Individuals at risk of melanoma include those with fair skin, family history or personal history of melanoma, history of multiple sun burns, or a large number of atypical dysplastic moles.

Self examination of moles is essential. Look for a change in size, shape or colour of your mole. The ABCDE rule is a helpful guide.

• Dermatologists are equipped with skills to detect these lesions early. If you are at risk of melanoma see your dermatologist on an annual basis for a skin check.

Skin Self Examination

After seeing your dermatologist it is important to regularly exam your own skin. Your dermatologist will explain how to do this. One helpful tool is to take photographs of your skin or to have professional photographs taken. This way you can simply compare your skin to your photographs. If there is a difference between your skin and your photographs in any area then it is important to see your doctor.

Sun Protection and Avoidance

Sun avoidance is as essential as sun protection. Wear a broad brimmed hat, sunglasses, protective tight weaved clothing and choose to sit in the shade. Sunscreen needs to be used correctly. Apply generous amounts, 20 mins prior to going out in the sun, and reapply every 2 hours. A moisturizer containing SPF that is applied in the morning will not protect you at lunchtime.