Australia has one of the highest rates of skin cancer in the world. It has been estimated that at least 2 in 3 Australians will be diagnosed with some form of skin cancer before the age of 70 years.
The major cause of skin cancer is the sun’s ultraviolet (UV) radiation. Unlike sunlight it cannot be seen or felt. Australia experiences some of the highest levels of UV radiation in the world because we are close the the equator and have many clear, blue-sky days. UV levels vary throughout the year and throughout the country, however in North Queensland our UV exposure is year round with levels always above 3. UV radiation also contributes to degenerative ageing of the skin, which results in wrinkling and loss of skin tone and elasticity.
Physical features that increase risk of sun damage include:
Fair skin, freckles, light eye colour, light or red hair colour, a tendency to burn rather than tan, family history.
The best treatment for skin cancer and skin ageing is to protect your skin by using all 5 sun protection measures during times of exposure to the sun’s UV radiation.
The 5 sun protection measures are:
Slip on sun protective clothing – clothing should cover as much skin as possible, closely woven fabric with a UV protection factor of 50+
Slop on SPF 30+ or higher broad spectrum and water resistant sunscreen – apply generously and evenly to clean, dry skin 20 minutes before going out into the sun and reapply every 2 hours. Regular sunscreen use has been shown to reduce the incidence of melanoma and squamous cell carcinoma, both in the short and long term.
Slap on a broad brimmed hat – a hat should shade your face, ears and neck
Seek shade – shade forms a barrier between you and the sun that protects you from direct UV radiation. Beware of indirect UV radiation reflected off surfaces eg water, snow, grass or sand as this can still cause sunburn.
Slide on some sunglasses – wear close fitting, wrap around style. Exposure to UV radiation over long periods can lead to more serious damage to the eyes
Cancer Council of Australia's current recommendation includes opportunistic screening and skin self-examination in the management of skin cancer treatment. Cancer Council recommends that people get to know their own skin and seek medical attention immediately if they notice any changes in their skin – size, shape, colour, elevation, bleeding, crusting, itchiness. Regular skin self-examination may increase the probability of detecting skin cancer at an early and treatable stage.
Structure of normal skin:
The two primary layers of skin (epidermis and dermis) are composed of epithelial, mesenchymal, glandular and neurovascular components.
Common conditions linked to sun damage:
Pre-cancerous skin changes - Solar keratosis – presents as superficial, discrete, abnormal scaly skin spots. Usually found on areas of the body that are chronically exposed to the sun and may develop to squamous cell carcinoma. Risk factors – caucasion, over 40 years, fair skin, older age, sun exposure.
Melanoma – caused by the malignant transformation of melanocytes, due to unrepaired DNA damage. It can develop on any part of the skin.
Basal Cell Carcinoma – a locally invasive, slow growing skin cancer, arising from the basal cells in the lower part of the epidermis. BCCs account for 75% of all skin cancers.
Squamous cell carcinoma in situ (Bowen’s Disease) – refers to a lesion that shows full thickness epidermal dysplasia on histology. If left untreated may develop into invasive squamous cell carcinoma.
Squamous Cell Carcinoma – can present as a scaly lump that usually starts as a superficial, red sun spot before progressing into deeper layers of skin. SCC is the second most common skin cancer. Aggressive SCCs can be fatal.
Other rare skin cancers – account for about 0.7% of all cancers diagnosed in Australia.
Photoageing – is the contribution of sunlight and UV radiation to premature or excessive ageing.
For the majority of skin cancers complete excision with a safety margin represents the main treatment modality, and provides tissue for definitive diagnosis and assessing the adequacy of surgery.
If you are concerned about any moles or spots take the opportunity to come in and have your skin checked by our highly skilled GPs. Toogood Family Medical Centre operates Skin Cancer Cairns and provides a convenient, accessible and affordable opportunity to receive early detection, diagnosis and treatment of skin cancers and melanoma. Your GP can assess your skin cancer risk and develop a skin surveillance management program.