Australia still has the highest incidence of skin cancer in the world. Two-third of Australians by the age of 70 years will be diagnosed with a skin cancer.
Types of Skin Cancer
Basal Cell Carcinoma (BCC)
Basal cell carcinoma’s (BCC’s) are the most common type of skin cancer in Australia and the least dangerous. 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 best modality of treatment. Untreated however, they usually grow slowly over a number of months or years, invading the local skin only and usually do not spread to the lymph nodes or internal organs. BCCs are often hard to detect in the early stages. Dermatologists are highly skilled at detecting early s skin cancer.
Squamous Cell Carcinomas (SCC)
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 Bowen’s 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 as this 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. SCC’s can spread to local lymph nodes and internal organs if not managed early or treated adequately. Information about the nature of a squamous cell carcinoma is determined by a skin biopsy. Dr Wines will guide you towards the best modality of treatment depending on the results of your pathology.
Melanoma is a potentially fatal skin cancer. Early detection is life saving. Dermatologists are highly skilled in the early detection of melanoma. 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. The Australasian College of Dermatologists recommends 3 monthly self-skin examinations. Melanoma presents as a new lesion on your skin 70% of the time and as a changing existing mole 30% of the time.
Sunspots & Treatment
Many Australians, especially those with pale skin have dry scaly lesions called sunspots (actinic keratosis) on sun-exposed skin. These are unsightly, sometimes itchy and are pre-cancerous lesions. Without treatment a proportion of these will develop into skin cancer (SCC or squamous cell carcinoma). SCC’s can be potentially life threatening skin cancers and usually require surgery to manage.
Actinic keratosis rarely occur in isolation. The presence of one AK usually means that there are many more. As AK’s are caused by the sun, often the skin has other sins of photo damage, such as brown spots, dilated red vessels and irregular texture. Some AK’s are clearly visible; some may be less obvious to the human eye ie microscopic. Hence, to manage AK’s all the affected skin should be managed, not just the sunspots.
There are many excellent treatments to manage sunspots and return your skin to a more rejuvenated state. Topical creams such as 5 Flurouracil (Efudix), Imiquimoid (Aldara) can be used. There are many current technology’s such as Photodynamic therapy and laser resurfacing which manage all the elements of photo damage, including brown spots, dilated vessels and have a superior cosmetic outcome to creams alone. Dr Wines will discuss the correct modality of treatment for you.