Skin cancer

Each year in Australia around 2,000 people die from skin cancer; yet most skin cancers are preventable, and the majority of skin cancers can be successfully treated, if found early.

While prevention is better than cure, being familiar with your own skin should help you to detect any suspicious lumps or spots as soon as they develop, at a stage when they have a better chance of being successfully treated.

Types of skin cancer

The three main types of skin cancer are: 

• basal cell carcinoma
• squamous cell carcinoma
• melanoma.

These are named after the type of cell they start from.

Basal cell carcinoma

This is the most common but least dangerous form of skin cancer. It most often occurs on the head and neck, followed by the upper body. These cancers are often red and slightly raised, with a scaly area that can bleed if knocked. They often become ulcerated as they develop.

Squamous cell carcinoma

This cancer grows over a period of weeks or months and may spread to other parts of the body if not treated quickly. It occurs most often (but not only) on areas exposed to the sun. This can include the head, neck, hands and forearms. This cancer looks like thickened, red, scaly spots.

Melanoma

Melanoma is the most dangerous form of skin cancer. Melanoma can grow quickly, developing over weeks to months. If caught early, it is usually treatable. However, if detected in a later stage, it may have already spread to other parts of the body and can be fatal.  Common melanomas appear as a new spot or as an existing spot, freckle or mole that changes colour, size or shape. They are usually flat with an irregular, smudgy outline and are often more than one colour. Even mild sunburn and tanning can contribute to skin cell damage that can lead to melanoma. Nodular melanoma is a highly dangerous form of melanoma that looks different from common melanomas – they are raised and are even in colour (often red or pink and some are brown or black). This type of melanoma grows quickly and can be life threatening if not detected and removed quickly.

Prevention of skin cancer

Whenever UV levels reach 3 or above, a combination of sun protection measures (broad-brimmed hats, clothing, sunscreen, shade, and if practical, sunglasses) are needed. Don't just wait for hot and sunny days to use sun protection as UV can still be damaging, even on cool, cloudy days.

The sun protection times indicate when the UV is forecast to be 3 or above and are available:

• as a free SunSmart app
• online at www.sunsmart.com.au
• online at www.bom.gov.au/uv
• in the weather section of newspapers
• as a free website widget.

Check the sun protection times each day, and during those times use a combination of five SunSmart measures: 

• slip on some sun-protective clothing that covers as much skin as possible
• slop on SPF 30 or higher sunscreen. Make sure it is broad spectrum (protects against UVA and UVB rays) and is water-resistant. Put it on 20 minutes before you go outdoors and reapply every two hours (even if the label states it is four hours water resistant). Never use sunscreen to extend the time you spend in the sun
• slap on a broad-brimmed hat that protects your face, head, neck and ears
• seek shade
• slide on some sunglasses – make sure they meet Australian/New Zealand Standard AS/NZS 1067. Optometry Australia recommends using eye protection all year. 

Take extra care during the middle of the day when UV levels are most intense.

Use the same SunSmart measures for the rest of your family too. 

Read about skin cancer and sun safety for children.

Be aware of your skin

All Australians should become familiar with their skin. Be aware of your entire body as skin cancers can sometimes occur on parts of the body that are not exposed to the sun. 

Use a hand-held mirror to check the skin on your back and the back of your neck, or ask someone else to look for you. Don't forget your armpits, inner legs, ears, eyelids, hands and feet. Check between your fingers and toes. Use a comb to move sections of hair aside and inspect your scalp.

Be alert to new or changing moles, freckles and spots. If you notice anything unusual, see your doctor straight away. If you don't have a regular doctor, you can make an appointment with any doctor for a skin examination.

If you are considering using a skin cancer clinic, first find out about the services offered and the expertise of the staff.

Skin cancer – what to look for

Using the ABCDE system can be a good way to check for changes to your skin. While performing this skin check, remember that if you notice anything unusual (including any of the ABCDE changes, or the development of a new spot), you should visit your doctor. 

The ABCDE system reminds you to check five sorts of changes:

• Asymmetry (unevenness) – one half of the spot doesn't match the other
• Border – the edges of the spot are irregular, ragged, notched or blurred
• Colour – the colour of the spot is not the same all over and may include shades of brown or black, red, white or blue
• Diameter – the spot is larger than 6 mm across (about 1/4 inch) or is growing larger
• Evolution or elevation – the spot may change in shape or size (enlarge) and a flat spot may become raised in a matter of a few weeks.

Also be aware of any mole or freckle that:

• changes over a period of months
• grows in size
• changes shape
• becomes mottled in colour
• has a persistent itch.

If you notice anything new or unusual on your skin, see your doctor.

Read more about how to check for skin cancer.

Where to get help

• Your GP (doctor)
• Local community health centre
• Pharmacist
• NURSE-ON-CALL. Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
• Cancer Council Victoria. Tel. 13 11 20 for information and support
• Resources in other languages, Cancer Council Victoria.Tel. 13 14 50