FAQ’s

What is Skin Cancer

Skin Cancer is the most common form of cancer in Australia, accounting for 80% of all new cancers diagnosed each year.

There are three main types of skin cancer:

• Basal Cell Carcinoma
• Squamous Cell Carcinoma
• Melanoma

Basal Cell Carcinoma and Squamous Cell Carcinoma are the most common types of skin cancer and are sometimes call non-melanoma skin cancer. These types of skin cancers are slow growing and easily treated.

They rarely lead to death but if left untreated these cancers can cause massive destruction at the site of the tumour and may spread in some cases.

Melanoma is the least common of the three types, but the most dangerous.

Melanoma usually begins as a new small spot, mole or freckle that changes colour, shape or thickness over months.

They can also develop in already existing moles and in other parts of the body, such as the eye or mouth and they can progress to internal organs and cause death if not diagnosed and removed early in their development.

• Basal Cell Carcinoma

  What is Basal Cell Carcinoma?

  Basal Cell Carcinoma (BCC) develops in the basal cells of the skins’ surface (epidermis) and is the most common but least dangerous type of skin cancer. BCC accounts for about 70-85% of all skin cancers.

  What Causes BCC?

  BCC is usually the result of long-term exposure to the sun, which is why the most commonly affected areas are the frequently exposed parts of the body, such as the face, neck or upper torso.

  Can it be cured?

  Yes it can be cured. Generally BCC’s have few risks associated with them because they are so slow growing and don’t spread to other areas. However, if neglected they can cause massive destruction to surrounding tissue such as the nose or eye. It is rare for BCC to lead to death.

  What does BCC look like?

  A BCC usually looks like a pink ‘pearly’ lump, which doesn’t go away within a few weeks or months. This lump then becomes ulcerated but usually has no other symptoms associated with it such as itchiness, burning or tenderness. It is a very slow growing ulcer with rounded edges and may bleed. BCC can also look like non-cancerous skin conditions such as psoriasis or eczema.

  Commonly a BCC will have two or more of the following features.

  • Basic characteristics of BCC:
  • Small, shiny, pink or pearly looking lump
  • Ulcerated lump with rounded edges
  • Blood vessels on the edges
  • Very slow growing, usually over several years
  • May develop a crust
  • Ulcer that doesn’t seem to heal
  • Bleeding

  What are treatment options?

  There is a variety of treatments available for BCC’s, including excision, destruction by freezing or electrical burning, medicated cream and medication-enhanced light therapy (PDT). The correct treatment depends upon the type the type of BCC, and experienced doctors can assist in deciding on the most appropriate treatment.

  Treatment of BCC’s are almost always successful and procedures leave relatively little scarring.

  BCC may sometimes reoccur at the same site or in another area so it is advisable that you have regular check ups.

  Who’s at risk of developing BCC?

  Anyone can develop skin cancer, regardless of skin type. Statistics show that one in two Australians will develop some sort of skin cancer.

  Until recently, most people affected with BCC were the middle-aged and elderly, in particular men who work outdoors. In the past few years the number of cases of BCC has increased greatly and the average age of onset has steadily decreased.

  Factors that may increased your risk include:

  • you don’t protect your skin from the sun
  • you work outdoors
  • you tend to spend a lot of time outside
  • you have infrequent but intense sun exposure
  • you were born or lived in Australia during your childhood
  • you have a fair complexion, blue or green eyes, red or fair hair and you tend to tan poorly or burn easily
  • you live close to the equator. For example, the rate of diagnosed skin cancers in Tasmania are much lower than those in Queensland
  • you have already had some sort of skin cancer.

  What can I do?

  Take steps to help prevent and reduce the risk of BCC caused by UV radiation.

  These should include:

  • Stay out of the sun between 11am and 3pm (daylight saving hours) or between 10am and 2pm all other times of the year.
  • Stay in the shade. However, be sure to choose your shade carefully as UV can reflect off certain surfaces and you may still burn
  • Wear clothing that gives you good protection from the sun
  • Wear wide-brimmed hats to protect your face, neck and ears
  • Use sunscreen. Sunscreen with SPF of at least 15+ with broad spectrum and water resistance should be used regardless of your skin type.
  • Protect you lips with either sunscreen or lip balm with SPF.

  If you are concerned about developing any form of skin cancer, talk to your doctor about the disease. Your doctor will outline what symptoms you should look out for and an appropriate check-up schedule for you.

  Check your own skin regularly

  It is recommended that you check your own skin every two to three months, along with your yearly skin check by your doctor. Conducting your own skin exam can be the best way to detecting the early warning signs of cancer.

  Get to know your skin, your moles, freckles, blemishes and birthmarks. Be aware of any changes in the size, shape, and colour or number of spots and any sores or blemishes on your skin that don’t heal. These may be the early warning signs of skin cancer.

  If you notice anything new or unusual, see your doctor as soon as possible.

• Cancer

  Cancer is a disease that affects our body’s cells – our body’s building blocks.

  Our body constantly produces new cells in order to replace old, worn out cells, to heal damaged cells or to help us grow.

  Normally, our cells grow and reproduce themselves in an orderly way. Sometimes, however, this normal process is disrupted in some way and cells grow and reproduce themselves in an uncontrolled manner, producing a lump.

  This lump is called a tumour.

  There are two types of tumours, benign or malignant.

  A benign tumour does not spread to other parts of the body. They are not usually cancerous, however, some can be precancerous, meaning they can lead to cancer if left untreated.

  A malignant tumour is a mass of cancer cells, which in its early stages may be confined to its original site.

  If left untreated, the tumour cells can spread to nearby tissue, becoming an invasive cancer.

  Some cancer cell can also spread to other parts of the body via the lymphatic system or in the bloodstream.

  Once these breakaway cells reach a new site they may develop into further tumours.

  This process is called metastasis or often referred to as a secondary cancer.

• Complaints

  This practice acknowledges that patient complaints are an important source of customer feedback.

  Under the Health Services Act 1987 people with complaints should try to resolve them directly with the health service provider.

  If a satisfactory outcome is not achieved then complaint can be directed to the Health Services Commissioner for action by calling 03 8601 5200.

• Melanoma

  What is Melanoma?

  Melanoma develops in our skins melanocytes. Melanocytes can be found all over our skin because they supply our skins pigment, melanin. The most concentrated sites of melanocytes are moles.

  Melanoma is the least common type of skin cancer, accounting for less than 5%, but it is the most dangerous of all. It is the cause of most skin cancer deaths if not detected early.

  Melanoma can develop in or near an existing mole or appear on normal looking skin. These cancer cells can then invade the skin around them or even spread to other parts of the body through the lymphatic system or the bloodstream. If this metastasis occurs, further tumours may develop in other bodily organs. These secondary cancers can be very difficult to treat and may be fatal.

  What causes Melanoma?

  The main cause of Melanoma is thought to be linked to sun exposure. People with fair skin or who burn easily are the ones at greatest risk because their skin contains less melanin.

  Having said this, Melanoma can also appear anywhere on the body, not only in the places which get lots of sun and it sommetimes runs in families. People with a close relative who have had Melanoma are at increased risk of developing this cancer.

  What are the symptoms?

  Melanoma generally causes no symptoms at all, but there may be some itchiness or tingling in the early stages. Most melanomas start as minor changes in colour, size or shape; however in the later stages they may become hard or lumpy, painful to touch and even bleed.

  Can it be cured?

  Yes, Melanoma can be cured. Almost three quarters of people who have had a Melanoma removed will have no further problems, but removal of the tumour in its early stages is crucial. Further surgery or chemotherapy can be used to treat a patient if the cancer has spread to other organs.

  What are the treatment options?

  Currently, the only way to treat Melanoma effectively is surgery. If a Melanoma is confirmed after a mole or other lesion has been removed, most people will have a wider excision around the area where it was growing. This will remove some healthy-looking skin to ensure that any Melanoma cells which were near the mole but not visible are removed.

  What does Melanoma look like?

  Melanoma can slowly develop in an already existing mole or it can suddenly appear as a new mole. It then changes in colour, shape or size. Typically, Melanomas have an irregular outline and are multicoloured as opposed to a normal mole or freckle, which generally have smooth edges and equal colour.

  A method of remembering the signs and symptoms of melanoma is the popular mnemonic ABCDE.

  Asymmetrical in shape

  Melanomas are typically not uniform in shape where normal (benign) moles or freckles are usually round or symmetrical.

  Border is irregular

  Melanomas often have a jagged or uneven border; normal moles have smooth, even borders.

  Colour is uneven

  Melanomas are usually multicoloured ranging from brown, tan to black and in some cases, red, blue and white. Benign moles are usually uniform in colour.

  Diameter is greater than 6mm

  Melanomas generally have a diameter greater than 6mm; normal moles or freckles are usually smaller than this.

  Elevation of a mole

  Melanoma may sometimes grow vertically making it raised from the skin, generally benign mole are flat.

  Melanoma can appear anywhere on the body, not only in the places which get lots of sun. The most common site of melanoma in men is the back, and in women, the backs of the legs.

  Who’s at risk of developing melanoma?

  People with fair skin or who burn easily are at greatest risk because their skin contains less melanin and family history plays a role also. It is important to remember though that anyone can develop skin cancer. Statistics show that one in two Australians will develop some sort of skin cancer. There are several factors that contribute to an increased risk of developing Melanoma.

  • A family history of Melanoma
  • Previous Melanoma
  • Fair skin and light coloured eyes
  • Lots of freckles
  • Previous severe sunburns
  • Many dysplastic nevi (unusually shaped moles which are noncancerous)
  • Many ordinary moles, more than 50 (most people have around 30)
  • A weakened immune system
  • Excess exposure to UV radiation
  • Use of solariums – artificial UV radiation.

  Anyone, even those with none of the above risk factors, can develop melanoma, however those with one or more risk factors are more likely to do so.

  If you have any of the above risk factors, you should check your skin periodically yourself, and have a yearly exam by your doctor.

  What can I do?

  Take steps to help prevent and reduce the risk of melanoma caused by UV radiation. These should include:

  • Stay out of the sun between 11.00am and 3.00pm (daylight saving hours) or between 10.00am and 2.00pm all other times of the year.
  • Stay in the shade. However, be sure to choose your shade carefully as UV can reflect off certain surfaces and you may still burn.
  • Wear clothing that gives you good protection from the sun.
  • Wear wide-brimmed hats to protect your face, neck and ears.
  • Use sunscreen. Sunscreen with SPF of at least 15+ with broad spectrum and water resistance should be used regardless of your skin type.
  • Protect you lips with either sunscreen or lip balm with SPF.
  • Protect your eyes by wearing sunglasses that meet Australian Standards. Wrap around style and closely fitting sunglasses offer the best protection.

  If you are concerned about developing melanoma, talk to your doctor about the disease. Your doctor will outline what symptoms you should look out for and an appropriate check-up schedule for you.

• Squamous Cell Carcinoma

  What is Squamous Cell Carcinoma?

  Squamous Cell Carcinoma (SCC) develops in the squamous cells of skin and is the second most common type of skin cancer in Australia, accounting for about 15-20% of all skin cancers.

  What causes SCC?

  As with other skin cancers, excessive exposure to the sun is one of the main causes of SCC. Skin type is also a factor though and usually people with fair skin who don’t tan easily are the most at risk.

  The most commonly affected areas are the face (particularly the lower lip), ears, neck, forearms, back of the hands and lower legs.

  What does SCC look like?

  SCC’s grow quite quickly, usually over a period of a few months, and may spread to other parts of the body through the lymphatic system or the bloodstream. If this metastasis occurs, further tumours may develop in other bodily organs. These secondary cancers can be very difficult to treat and may be fatal.A SCC looks like a thick red or fleshy lump with scaly spots. It usually has steady growth and at first, may look like an ulcer or wart. It may also be tender to touch and bleed easily.Basic characteristics of SCC:

  • Thick red, fleshy lump
  • Scaly or crusty
  • Tender to touch
  • Bleeding
  • Grows quickly, over few months
  • Not usually painful or itchy

  Can it be cured?

  SCC should be diagnosed and removed as early as possible because of its metastatic ability. Over 99% of people who have a SCC removed are completely cured.

  It is advisable that you have regular check ups over the next few years to ensure all cancer cells have been excised

  Who’s at risk of developing SCC?

  Anyone can develop skin cancer, regardless of skin type. Statistics show that one in two Australians will develop some sort of skin cancer.People most affected with SCC are the elderly, outdoor workers, fair skinned people, anyone who uses solariums and has had excessive UV exposure. There are several factors that may contribute to an increased risk of developing skin cancer:

  • you don’t protect your skin from the sun
  • you work outdoors
  • you tend to spend a lot of time outside
  • you have infrequent but intense sun exposure
  • you were born or lived in Australia during your childhood
  • you have a fair complexion, blue or green eyes, red or fair hair and you tend to tan poorly or burn easily
  • you live close to the equator. For example, the rate of diagnosed skin cancers in Tasmania are much lower than those in Queensland
  • you have already had some sort of skin cancer

  What can I do?

  Take steps to help prevent and reduce the risk of SCC caused by UV radiation. These should include:

  • Stay out of the sun between 11am and 3pm (daylight saving hours) or between 10am and 2pm all other times of the year.
  • Stay in the shade. However, be sure to choose your shade carefully as UV can reflect off certain surfaces and you may still burn
  • Wear clothing that gives you good protection from the sun
  • Wear wide brimmed hats to protect your face, neck and ears
  • Use sunscreen. Sunscreen with SPF of at least 15+ with broad spectrum and water resistance should be used regardless of your skin type.
  • Protect you lips with either sunscreen or lip balm with SPF.

  If you are concerned about developing any form of skin cancer, talk to your doctor about the disease. Your doctor will outline what symptoms you should look out for and an appropriate check-up schedule for you.

  Check your own skin regularly

  It is recommended that you check your own skin every two to three months, along with your yearly skin exam by your doctor. Conducting your own skin exam can be the best way to detecting the early warning signs of cancer. et to know your skin, your moles, freckles, blemishes and birthmarks. Be aware of any changes in the size, shape, and colour or number of spots and any sores or blemishes on your skin that don’t heal. These may be the early warning signs of skin cancer.

  If you notice anything new or unusual, see your doctor as soon as possible.

• The Skin

  The skin is our body’s largest organ. It has many important jobs such as, protecting us against heat, cold, infection and injury.

  The skin has two layers, the epidermis and the dermis.

  The epidermis is the top layer of skin and mainly contains flat cells called squamous cells.

  Under these squamous cells are round cells call basal cells and also, cells called melanocytes that make the pigment (colour) called melanin found in skin. When skin is exposed to sunlight our melanocytes produce more melanin and our skin tans.

  The dermis is underneath the epidermis.

  The dermis contains blood vessels, lymph vessels, nerves, glands that make sweat, which help cool the body, and some glands that make sebum, an oily substance that stops the skin from drying.

  The sweat and sebum reach the surface of the skin through pores.

Risk factors

Skin cancer is the most common form of cancer in Australia with statistics showing that one in every two people will develop some sort of skin cancer in their lifetime.

Each year, over 380,000 Australians are treated for the disease and over 1,400 people die from it.

There are three main types, Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC) and Melanoma.

BCC accounts for about 70-85% of all diagnosed skin cancers. It is the most common, but least dangerous form of skin cancer.

SCC accounts for about 15-20% of all diagnosed skin cancers and is more dangerous than BCC.

Melanoma is the least common of the three, accounting for less than 5% of all diagnosed skin cancers each year, but it is the most dangerous because it can spread to other parts of the body very quickly and further tumours can develop. It is the cause of most skin cancer deaths if not detected early.

One of the major causes of skin cancer is over-exposure to the sun. Most Australians will have developed irreversible skin damage by the time they are 15 years old.

All it takes is one blistering sunburn to more than double a person’s risk of skin cancer later in life.

Fortunately, with current methods of treating the disease, skin cancer is now almost always curable if detected early enough.

Under these squamous cells are round cells call basal cells and also, cells called melanocytes that make the pigment (colour) called melanin found in skin. When skin is exposed to sunlight our melanocytes produce more melanin and our skin tans.

The dermis is underneath the epidermis.

The dermis contains blood vessels, lymph vessels, nerves, glands that make sweat, which help cool the body, and some glands that make sebum, an oily substance that stops the skin from drying.

The sweat and sebum reach the surface of the skin through pores.

• Tanning

  The Truth About Tanning

  It is fair to say that the high rates of skin cancer in Australia are probably, in some way, due to the popular but unwise belief that having a tan is healthy.

  The truth is, every time we expose ourselves to the sun or solarium we are damaging our skin.

  A tan doesn’t protect your skin; it actually causes irreversible damage. Over exposure to UV can cause freckles, blotches, wrinkles and worst of all, skin cancer.

  While the sun helps your body produce vitamin D, deliberately exposing yourself to sunlight doesn’t provide you with any health benefits whatsoever.

  More than enough sunlight is received for Vitamin D production by simply sitting near a window or from as little as a few minutes outside during the day.

  Skin aging and skin cancer are delayed effects which don’t usually present themselves for many years after exposure.

  Since the damage being done is not immediately evident many young people are unaware of the damage they are doing to their skin by tanning.

  While most skin cancers can be easily treated and cured, if not detected early skin cancer such as Melanoma can be fatal.

• UV Radiation

  Spending time outdoors does wonders for the body and mind but our sun has a shady side.

  Ultraviolet radiation (UV radiation) is part of sunlight.

  When UV rays reach the surface of the skin, our skin’s melanocytes (the cells that produce our skins pigment) react and produce melanin to protect itself. This is otherwise known as a suntan.

  Overexposure to UV radiation from the sun or artificial sources is a major contributor to Australia’s high incidence of skin cancer.

  It can also lead to a painful sunburn, premature aging of the skin, wrinkles, spots and dry and leathery textured skin.

  The three types of UV rays, UVA, UVB and UVC

  UVA has a relatively consistent intensity all year round. These rays penetrate the skin deeper than UVB and contribute to the skin aging prematurely, wrinkles, and sunburn and skin cancer.

  UVB rays are stronger than UVA and their intensity increases during the summer months, at higher altitudes and the closer you are to the equator. UVB exposure can cause cataracts, premature skin aging and is the most common cause of sunburning. Long-term exposure can cause skin cancer and even alter your immune system.

  UVC rays are the strongest rays and the most dangerous, however the ozone layer filters these rays and they do not reach the Earths surface.

  What factors affect UV levels

  There are a number of factors that affect the levels of UV radiation and considerably increase the risk of sunburn and skin damage.

  Time of year

  UV radiation can be up to 10 times more in summer than in winter when the sun is higher with less atmosphere to pass through. At this time of year you can get sunburn in as little as 15 minutes on a fine January day. September through to April is the highest risk period for Australians.

  Time of day

  At least 60% of the days UV radiation occurs when the sun is high in the sky in the middle of the day between 10am and 2pm or 11am and 3pm during daylight saving.

  Where you live

  Areas closer to the equator have higher UV exposure. This means Australia has higher levels of UV radiation compared to North American or Europe.

  Cloud cover

  On lightly overcast days UV levels can be similar to those on a clear day as UV rays can penetrate the clouds. UV radiation intensity is reduced when there is heavy cloud cover and when there are scattered clouds, UV radiation rises and falls as the clouds pass in front of the sun. It is important to remember however, that even on a cloudy day, you can get sunburn.

  UV is independent of temperature

  A cooler temperature doesn’t mean you can’t get sunburn. UV rays don’t cause the temperature to be high or low, infrared rays from the sun are responsible for this as they heat up the earth.

  Altitude

  At higher altitudes UV exposure is greater because the air is cleaner and thinner and less UV rays are filtered out. For example, UV rays can be up to 30% higher at an altitude of around 2,000 metres than at sea level.

  Reflective surfaces

  Some surfaces reflect large amounts of UV rays. Water surfaces can reflect an extra 5%, concrete can reflect up to 85% and snow can reflect up to 95% of the suns rays! This is on top of what you are already receiving from direct sunlight!

  Ozone levels

  Some UV radiation is absorbed by the ozone layer. Ozone levels fluctuate from day to day and seasonally and the depletion of the ozone layer also contributes to the amount of UV being filtered through.

  Artificial uv radiation by solariums

  There has been recent research, which leaves little doubt that UV radiation emitted by solariums can contribute to a person’s risk of developing skin cancer. The Cancer Council of Australia strongly recommends people do not use solariums because they add to their UV radiation exposure.

  Facts

  Sun Facts

  Even on a cloudy day you can get sunburn. As much as 80% of the suns rays can penetrate fog, mist or light cloud cover.

  You can get sunburn even in the water. Water surfaces can reflect an extra 5% of the sun’s rays back at you. This is on top of what you are already receiving!

  Snow reflects the sun like a mirror, reflecting up to 95% of its rays.

  Dry surface can also reflect the sun. Concrete can reflect up to 85% of the sun’s rays.

  Research shows as little as one severe sunburn in childhood increases the child’s risk of Melanoma or other skin cancers later in life.

  UV Facts

  UV rays are most intense when the sun is high in the sky, between 11am and 3pm during daylight saving time (between 10am and 2pm all other times of the year).

  UV rays are at their most intense during the summer however, it is important to remember that UV reaches the earth everyday, even in winter, and precautions should be taken all year round.

  At higher altitudes UV exposure is greater because the air is thinner and cleaner.

  Areas around the equator have higher UV exposure.

• Who is at risk?

  Every single person in Australia has the possibility of developing skin cancer, but some people have a greater risk of doing so.

  If any of the following describe your physical appearance or personal history, be aware that your risk of developing skin cancer is increased.

  Living in Australia

  UV levels in Australia are higher and more severe than those in Europe. This is because we are located closer to the hole in the ozone layer above Antarctica.

  Another contributing factor is that Australia is closer to the sun during summer than Europe is during its summer, due to the earth’s orbit, consequently adding another 7% of UV intensity.

  These factors, along with the fact that Australia has clearer atmospheric conditions means that we are exposed to much higher levels of UV radiation than Europeans.

  Skin Type

  People with a light or fair skin tone who burn easily or tan poorly have an increased risk of developing skin cancer, especially those with blond, red or light brown hair and blue, green or grey eyes.

  This is because their skin contains less melanin, the pigment in skin, which gives us our colour.

  Having dark or olive skin adds to your natural protection against skin cancer because your skin produces more melanin.

  However, you must still protect yourself because the amount of UV radiation in Australia is so intense.

  Darker skinned people can still develop Melanoma, especially on their hands, under their nails and on the soles of their feet

  Long-term sun exposure and sunburn

  Skin cancer is strongly linked to UV radiation exposure. UV penetrates skin, which causes changes to cells that lead to sunburn, premature aging of the skin, wrinkles, spots, dry and leathery textured skin, DNA damage and skin cancer.

  UV causes cancer through a cumulative process so the damage being done today may not be seen for years to come. The more your skin is exposed the greater the risk, even if your skin doesn’t burn.

  Outdoor workers are at an increased risk of developing skin cancer, especially Squamous Cell Carcinoma, due to their years of prolonged exposure to the sun.

  Family and personal history

  The environment plays a vital role in the development of skin cancer, but some individuals can be born with a genetic predisposition or vulnerability to developing the disease.

  Your skin type is genetic; if your parents have fair coloured skin then you will more than likely have fair skin also and therefore be at greater risk of developing skin cancer.

  Recent research has identified certain mutations in some people’s genes, which play a role in the development of melanoma. Furthermore, about 10% of people who develop melanoma have family members who have also had the disease, indicating a probable genetic relationship.

  You are also at increased risk if you have already had skin cancer or a pre-cancerous lesion. This is because you have probably had a lot of sun exposure in your past.

  Moles and atypical moles

  Almost everyone has a few moles. However, people with a larger number of moles have a greater risk of developing Melanoma, especially if those moles are unusual in appearance. Unusual moles may be larger than normal (more than 5mm in diameter), irregular in shape, variable in colour, asymmetrical or raised.

Prevention

Spending time outdoors does wonders for the body and mind. It is important to remember though, that you skin needs protection from the outdoor elements, especially the sun.

Protecting ourselves against the sun isn’t just about not getting a painful sunburn. Sun damage causes the skin to age prematurely, leading to wrinkles, spots and dry and leathery textured skin, but worst of all, it can lead to skin cancer.

Most people generally believe they are sun smart. They know to protect themselves against skin cancer when they are going to be in the sun for a long period of time, like when they go to the beach or pool in summer.

What most people don’t do is protect themselves against the harmful rays of the sun in their everyday activities.

Exposure to the sun day after day adds up, for example, when gardening, riding a bike, walking to school, going to a football game or driving to and from work in your car. It is important that people realise this and get into a routine of protecting themselves everyday.

• Protecting the kids

  One of the major causes of skin cancer is over-exposure to the sun during childhood or adolescence.

  Many Australian children will develop irreversible skin damage by the time they are 15 years old.

  One blistering sunburn early on can double a persons the risk of skin cancer later in life.

  However, if we prevent our kids for getting sunburn and we teach them how important protecting their skin is, then altogether, we can reduce the rate of skin cancer and skin cancer deaths in the future.

  Kids will be kids, they will want to play outside and we shouldn’t stop them from doing this, but with the correct precautions and education we can make their time outdoors much safer.

  By establishing safe sun habits in your family’s everyday routine you could be saving your child’s life. Baby steps is all it takes…

  Use sunscreen

  Use sunscreen everyday, regardless of the weather and time of year.

  Sunscreen with SPF of 30+, broad spectrum and water resistance work best. It should be applied at least 20 minutes before going outside and reapplication is recommended every two hours, especially if your kids are swimming or participating in any activity, which causes them to sweat or rub off the sunscreen.

  Don’t forget their lips; protect them with either some sunscreen or lip balm with SPF.

  While sunscreen is a very important preventative measure, it shouldn’t be used as the only method of sun protection but rather in conjunction with other methods.

  Play in the shade

  Teach your child to stay out of the sun between 11.00am and 3.00pm during daylight saving hours or between 10.00am and 2.00pm all other times of the year. At these times of the day the sun’s UV rays are at their strongest, with more than 60% of UV radiation reaching the Earth.

  If they are going to be outside during this time, tell them to play in the shade. However, teach them to choose their shade carefully as UV can reflect off certain surfaces and they may still burn.

  Cover them up

  Be sure they are wearing clothes that give them good protection from the sun; clothes should cover as much skin as possible. Clothes with closely woven fabric, shirts with long sleeves and a collar, pants instead of shorts give the best protection but are not always practical for children. A T-shirt and long shorts that cover their legs (at least a large portion of them) are good choices but be sure you also use other methods of protection if they are wearing this type of clothing.

  Put on a hat

  Your child should wear a hat, which shades their face, scalp, ears and neck for the best protection. Baseball caps are ok, but they don’t protect your kid’s ears and neck. If your child is wearing this type of hat be wise and protect the exposed areas with sunscreen.

  Wear sunglasses

  Protect their eyes by having them wear sunglasses that meet Australian Standards. Wrap around and close fitting styles offer the best protection. Exposure to UV can cause eye problems such as cataracts later in life.

  Be their role model

  Children mimic those around them. If you don’t protect your own skin when in the sun your children won’t protect theirs either.

  Be a role model to your kids and adopt sun safe habits yourself. If your kids see you protecting yourself it is more likely they will pick up the habit too.

  Teach them the shadow rule

  If your shadow is shorter than you are it means the sun is high in the sky and UV rays are at their most intense. At this time of day they should seek some shade even if they are using other sun safe methods.

  Always have some sunscreen handy

  Kids often get sunburn when they are outdoors for longer than expected. Always plan ahead and have some sunscreen in your bag or car, or pack it in their backpack when they go to school.

• Protecting your skin

  Listed below are measures we should all take to help prevent skin cancer:

  • Stay out of the sun between 11.00am and 3.00pm during daylight saving hours or between 10.00am and 2.00pm all other times of the year. At these times of the day the sun’s UV rays are at their strongest, with more than 60% of UV radiation reaching the Earth.
  • Stay in the shade. However, be sure to choose your shade carefully as UV can reflect off certain surfaces and you may still burn.
  • Wear clothing that gives you good protection from the sun, your clothes should cover as much skin as possible. Clothes with closely woven fabric give you the best protection.
  • Protect lips with sunscreen or lip balm with SPF. Lip cancer is very common amongst outdoor workers due to their prolonged sun exposure.
  • Use sunscreen. Sunscreen with SPF of at least 15+ with broad spectrum and water resistance should be used regardless of your skin type. It should be applied at least 20 minutes before going outside and reapplication is recommended every 2 hours, especially if you are swimming or participating in any activity, which causes you to sweat or rub off the sunscreen.
  • Wear wide brimmed hats to protect your face, neck and ears.
  • Protect your eyes; wear sunglasses that meet Australian Standards. Wrap around and close fitting styles offer the best protection. Exposure to UV can cause eye problems such as cataracts.
• Self examination

  It is strongly recommended that you examine your own skin every two to three months along with your yearly skin check by your doctor.

  Conducting your own skin exam can be the best way in detecting the early warning signs of cancer.

  Get to know your skin, your moles, freckles, blemishes and birthmarks. Be aware of any changes in the size, shape, and colour or number of spots and any sores or blemishes on your skin that don’t heal. These may be the early warning signs of skin cancer.

  When should I conduct the exam?

  The best time to conduct the exam is after the shower or bath. All areas of the skin should be examined, including the lower back, buttocks, back of the shoulders and back of the thighs.

  What do I need?

  • A full-length mirror
  • A hand held mirror
  • A hairdryer (optional)
  • Body maps (optional)
  • A pen or pencil

  How do I conduct the exam?

  Step 1

  Examine carefully your face, particularly the nose, lips, mouth and the front and back of your ears. Use both mirrors if necessary to get a clear view.

  Step 2

  Check your scalp using a hairdryer or your fingers and mirror to expose each section. If it is possible ask a family member or a friend to help you do this.

  Step 3

  Check the back and palms of your hands, between your fingers and under your fingernails. Continue up your wrists and check both the front and back of your forearms.

  Step 4

  Using the full-length mirror examine your elbows and all sides of your upper arms and underarms.

  Step 5

  Next, move onto your neck, chest and torso. If you are female, lift your breasts to view the underside.

  Step 6

  Using the hand held mirror, with your back to the full-length mirror, examine the back of your neck, shoulders and upper back. Then scan over your lower back, buttocks and the back of your thighs.

  Step 7

  Next, sit down on a chair, prop each leg onto a chair or stool and using the hand held mirror check the front and sides of both legs, from your thighs to your shins. Check your ankles, tops and soles of your feet, between your toes and under your toenails. Use the hand held mirror to examine the genitals.

  Use a body map

  On your first exam, draw dots corresponding to the locations of each mole, freckle, birthmark, bump, sore, scab or scaly patch on your skin. For each dot, note down the approximate size, shape and colour along with the date.

  For each exam after that, find each spot on your skin, record the new date and note down any changes in colour, size or shape. If there are changes, consult your doctor immediately.

  Record on the body map any spots that were not there at the time of your last exam.

  What else can I do?

  A regularly scheduled skin examination by your doctor is key to the detection of skin cancer, as it often takes a trained eye to spot the disease in its early stages.

  If you are concerned about developing any form of skin cancer, talk to your doctor about the disease. Your doctor will outline what symptoms you should look out for and an appropriate check up schedule for you.

• Sunscreen

  It’s a frightening but true statistic: Australia has the highest rate of skin cancer in the world.

  One in two Australians will develop a form of skin cancer at some point in their lives. This high rate of skin cancer is mainly due to over-exposure to UV radiation.

  Apart from skin cancer, UV radiation also causes premature aging of the skin, wrinkles, spots and dry and leathery textured skin

  What is sunscreen?

  Sunscreen is a chemical barrier. It works by filtering out most of the sun’s UV rays from reaching your skin. It is a common misconception that sunscreen gives you 100% protection from the sun – this is not true. Sunscreen only screens out UV, it doesn’t block it, a small amount of UV will always reach the skin.

  Sunscreens can come in many different forms, including creams, lotions or gels. All work equally well, so choose the one that works best for you depending on your skin type and activity.

  All products available do not use the same ingredients; if your skin reacts to one sunscreen, talk to your chemist or doctor about choosing a different one, which contains different ingredients.

  What is SPF?

  SPF stands for ‘Sun Protection Factor’. The SPF numbers are based on the time unprotected skin would normally take to burn. Skin can take as little time as 10 minutes to burn; an SPF of 15+ would protect your skin for 150 minutes, or ten times longer. However, because the SPF of a sunscreen is measured in a laboratory using artificial UV light, it is not always an accurate guide to the actual degree of protection a certain sunscreen will give you at different times of the day or of the year.

  What does broad spectrum mean?

  All sunscreens with an SPF number will filter out the UVB part of sunlight. If the sunscreen is labelled ‘broad spectrum’ it means it will filter out both UVA and UVB. It is known that exposure to UVB causes skin cancer, however, recent studies suggest that UVA also increases the risk of skin cancer. UVA penetrates the skin deeper than UVB and have a relatively consistent intensity all year round.

  It is recommended that you always use a maximum strength sunscreen with SPF 30+, water resistance and broad spectrum.

  When should sunscreen be used?

  Most people don’t realise that the majority of their sun exposure happens during their everyday activities like riding their bike, walking to school or driving to and from work in their car. It is very important that people realise this and get into a routine of protecting themselves everyday. It should be applied 20 minutes before going outside, allowing it to bind to the skin and reapplication should be made every two hours, especially if you are swimming or participating in any activity which causes you to sweat or rub off the sunscreen.

  Always follow the directions on the bottle correctly and apply sunscreen generously. If too little is used the protection given will be considerably less (about 50-80%) than that specified on the label.

  Should I only use sunscreen to protect myself?

  Sunscreens shouldn’t be used as the only method of sun protection. It should be used in conjunction with other methods such as:

  • Spend less time in the sun, especially between 11am and 3pm during daylight saving, or 10am and 2pm during other times of the year, when UV rays are at their strongest.
  • Stay in the shade, but choose your cover carefully as UV can reflect off certain surfaces.
  • Wear clothes that give you good protection and cover as much skin as possible. Closely woven fabrics give the best protection.
  • Wear wide-brimmed hats to protect your face, neck and ears.

  What else should I do?

  Besides using a broad-spectrum sunscreen with SPF of at least 15+ in conjunction with the protective methods mentioned, a regularly scheduled skin examination by your doctor is key to detecting skin cancer, as it often takes a trained eye to spot the disease in its early stages.

  You should also examine your own skin every two to three months. The best time to do this is after a shower or bath, standing in front of a mirror. For areas hard to view, use a hand held mirror. Get to know your skin, your moles, freckles, blemishes and birthmarks. Be aware of any changes in the size, shape, and colour or number of spots and any sores or blemishes on your skin that don’t heal. These may be the early warning signs of skin cancer.

  If you notice anything suspicious, contact your doctor as soon as possible.

Treatments

There is no single method to treat all skin cancers and precancerous lesions. Choice of method is dictated by the size of the lesion, its location, its type (often confirmed by biopsy), and whether it is a primary or recurrent lesion. Also considered is the patient’s age, health, occupation and preference for treatment method.

• Surgery – lowest recurrence rate, best long term cosmetic result
• Cryotherapy – good for small lesions, pre-maligant or sun spots
• Non-surgical treatments – PDT, Aldara, Efudex
• Radiotherapy – low efficacy
• Chemotherapy – low efficacy
• Palliative care

Digital diagnostic computers including Molescans, Solarscans etc. are computers that indicate if the structure of a lesion is similar to a known cancerous structure. These computers need doctors to use them and interpret their recommendations.

Because of the atypical nature of skin cancers the machines have less than a perfect efficacy rating.

• Biopsy

  What is biopsy?

  Early detection of skin cancer is critical if it is to be properly treated.

  If you have a suspicious or unusual mole or growth your doctor may want to obtain a sample of the skin for diagnosis, this procedure is called a biopsy.

  A biopsy helps your doctor tell the difference between a benign, non-cancerous growth and a skin cancer.

  Performing a biopsy can help your doctor to be sure about the correct diagnosis of the growth, mark or lump on your skin.\

  The biopsy procedure is performed in the doctor’s office and usually no preparation is required on your part.

  What is the process?

  Before the biopsy is performed you will be given a small injection of local anaesthetic to numb the area. This may sting briefly, but the anaesthetic usually takes effect very quickly, and the rest of the procedure is painless.

  Depending on the type and size of the mole or growth, one of the following forms of skin biopsy may be performed:

  Excisional Biopsy: The entire mole or growth is removed in this procedure (excised), along with a small surrounding margin of normal skin. This method is usually performed when a mole or growth could possibly be a melanoma.

  Shave Biopsy: A shave biopsy is usually performed when the lesion is thought to affect the top layer of the skin only or if the lesion is very large. A slice of skin is taken from the affected area using a scalpel or biopsy cutter. Stitches are usually not required for this procedure. However, a small scab will form, which will heal within a week or so.

  Punch Biopsy: A punch biopsy is used to diagnose many less serious skin cancers.

  This is a quick, convenient procedure, which generally produces only a small wound. Punch biopsies provide a sample of cells from the full thickness of the skin.

  An instrument called a punch biopsy cutter is used in the procedure. This is a straw-like instrument with a sharp end, which works like a cookie-cutter.

  The punch biopsy cutter is pushed through the skin and twisted, producing a cylindrical sample of skin, which is then cut from its base with scissors or a scalpel.

  Band-aids, steri-strips or stitches may be used to close the incision. Stitches are generally not required for punch biopsies unless bleeding is slow to stop or the biopsy has to be large.

  Incisional Biopsy: If you have a larger mole or growth your doctor may perform an elliptical incisional biopsy.

  The end sample yielded by this procedure is bigger than that of a punch biopsy.

  The doctor will use a scalpel to cut an elliptical sample from the area. Stitches may be required with this procedure and a fine-line scar may remain.

  Any band-aids or steri-strips can be removed after a day or so and the wound should then be cleaned with antiseptic.

  Once it has been cleaned, the wound can be left open to form a crust, which usually falls off in a few days to a week.

  If you experience any delayed bleeding, or your work requires heavy or dirty duties, you should keep the wound covered.

  If stitches were used to close the incision, you will be asked to make an appointment with your doctor about a week after your biopsy for them to be removed.

  What happens to the sample?

  The biopsy sample is sent to a laboratory where a Pathologist examines it under a microscope.

  The pathologist will determine whether the mole or growth is benign (harmless) or malignant (a skin cancer). The result will take about a week to get back to your doctor.

  So what happens next?

  There are three possibilities: the biopsy may show something which requires no treatment at all; the biopsy may show something which is not a skin cancer but which needs to be treated (often a sun-spot, which needs to be frozen); or the biopsy may show a skin cancer, which always needs to be treated.

  Your doctor will discuss the treatment options with you.

  If the biopsy shows a skin cancer, the treatment recommended by your doctor will depend on the type and stage of the cancer, the size and place of the growth and also your medical history and general health status. In the majority of cases, the treatment will be to remove or destroy the cancer entirely.

  You and your doctor can work together to tailor a treatment plan that suits your needs best.

• Cryotherapy

  What is cryotherapy?

  Cryotherapy is a method that uses extremely cold liquid, liquid nitrogen, which has a temperature of -196°C, to freeze and destroy skin cells that need removal. It is usually used to remove a variety of pre-cancerous lesions, such as sunspots (actinic keratoses), and some early, superficial skin cancers.

  Lesions suspected of being melanoma must not be treated with cryotherapy.

  Melanoma must be removed surgically.

  The goal of cryotherapy is to freeze the skin as quickly as possible, and then allow it to slowly thaw in order to destroy the affected skin cells. New healthy skin cells will then grow in their place.

  How is it performed?

  A special cryospray unit is used to spray liquid nitrogen on to the skin to destroy the area of skin involved.

  Cryotherapy does sting and may be slightly painful at the time of the procedure and for a short time afterwards. The amount of discomfort varies a great deal from person to person. The procedure does not require anaesthesia, as freezing itself has considerable local anaesthetic effect.

  What happens after the procedure?

  After the procedure there may be some redness and swelling, and the area may also blister. Once this blister stage is over, usually within a few days, a crust will form which will fall off in a week or so.

  Activities such as swimming or bathing should be avoided for at least 3 days but gentle showering is allowed and the area should be kept clean to avoid any possible infection.

  Infection is, however, rare. Some sores or scabs may persist for as long as a month or two in lesions frozen on the lower leg, as healing at this site is often quite slow.

  What can I expect in the end?

  Well-performed cryotherapy for sunspots usually produces no significant mark on the skin in most people. However, some people are very sensitive to cryotherapy, and they may be left with a pale discolouration of the skin. Deeper cryotherapy for skin cancers is likely to produce a pale scar, which will last lifelong.

  In most cases the lesion will be removed with the initial procedure. However, in some cases, a second, or even third, treatment may be necessary if the whole lesion has not cleared, especially if it was large or thick to begin with, or if it has recurred.

  Skin lesions which survive two or three treatments with cryotherapy usually need to be biopsied, to ensure that they are not skin cancers.