Which types of people are most at risk of developing skin cancer?
- – Fair freckled skin that burns rather than tans;
- – Red hair or fair hair, light coloured eyes (blue/green);
- – Periods of short intense exposure to UV radiation, with weekends, holidays, and sport;
- – Actively tanned, solarium/sunbed use;
- – Worked outdoors;
- – Weakened immune system due to medications, organ transplant or illness;
- – Lots of moles on the body, especially if irregularly shaped;
- – Personal or family history of skin cancer.
What are the most common forms of skin cancer?
BCC Basal Cell Carcinoma
Most common, typically less aggressive. May appear as a pink scaly patch, or small pearly lump which may bleed or itch.
SCC Squamous Cell Carcinoma
Greater potential to spread to lymph glands. Usually appear quickly as a tender lump that has a crusty top.
An odd shaped mole on any part of the body which may be flat or lumpy. Sometimes appear as a pink lump.
What other abnormal growths are there? Are they dangerous?
A noncancerous mole that can look like melanoma. Difficult to diagnose without biopsy. Indicate an increased risk of developing melanomas.
Solar/Actinic Keratosis (Sunspots)
Red scaly spots on sun-exposed skin. Low risk of developing into SCC.
Age spots, barnacles, senile warts. Common warty growths on any part of the body, most people will have one, some have many. They have a waxy feel and appear stuck on the skin.
When would I need a skin cell biopsy? What is the process?
If the diagnosis is not obvious, your doctor may suggest taking a small sample of the spot to be more certain, and therefore more able to advise on the best treatment options.
What treatment options are available? What is the best way to prevent skin cancer?
- – type, size and location of the skin cancer;
- – general health;
- – medications that impact upon bleeding and wound healing.
Skin surgery (excision and suture) remains the gold-standard for the treatment of melanoma and most skin cancers.
Curettage and Cautery can be used to treat small, superficial cancers in some areas of the body. The cancer is scraped off the skin (curettage) and the wound is treated with electrical current (cautery) to stop the bleeding, leaving a shallow wound to heal with simple dressings.
Cryotherapy involves the use of liquid nitrogen to freeze and destroy small superficial spots.
Immunotherapy medications can be applied to the skin to stimulate the immune system to destroy the skin cancer. Imiquimod cream enhances the local immune system. Ingenol Mebutate gel is a plant extract that activates protein kinase C leading to an immune response and cell death.
Photodynamic Therapy involves the application of a cream to the skin cancer and the use of a specific light to activate the cream and destroy the skin cancer.
Radiation therapy treats skin cancer using x-rays to kill cancer cells. This requires consultation with a specialist to determine if the cancer is suitable, and then multiple visits for repeated small doses of xrays specifically targeting the spot.
Is it safe to wear sunscreen everyday? How does it impact Vitamin D levels?
Evidence is stronger than ever that it is safe and effective and can reduce skin cancer risk.
It is recommended that sunscreen be applied every day to sun exposed areas, but it is not a replacement for protective clothing, hats, sunglasses, and sensible levels of sun exposure.
With routine use it does not impact upon Vitamin D levels.
What are some common myths and misunderstandings about sunscreen?
FALSE: Sunscreen and sunscreen ingredients are strictly regulated by the TGA to ensure it is safe and effective. It can be worn on a daily basis without harming your health and should be used alongside other forms of sun protection, whenever UV levels are 3 or above.
Myth 2: Using sunscreen will stop you getting enough vitamin D
FALSE: A number of studies have shown that sunscreen use in real life has minimal impact on Vitamin D levels. In summer, most Australians get enough Vitamin D through incidental sun exposure – for instance while walking to the shops at lunch. Even those who are Vitamin D deficient shouldn’t sunbake or skip sun protection.
Myth 3: If you have a good sunscreen it’s enough to protect you from the sun
FALSE: Sunscreen should always be used in conjunction with protective clothing, seeking shade, a broadbrim hat and sunglasses. Sunscreen is not a suit of armour and shouldn’t be used to extend your time in the sun.
Myth 4: Using a water resistant SPF50+ means you can stay in the sun longer without having to reapply
FALSE: Any sunscreen should be reapplied every two hours, or after swimming, sweating or towel drying, regardless of the level of water resistance advised on the bottle.
Myth 5: You only need a little bit of SPF50+ to be protected
FALSE: To get the correct level of SPF you need to apply the right amount of sunscreen. This should be at least one teaspoon per limb, one for the front of the torso, one for the back, and one for the head. This is seven teaspoons (or 35ml) in total.
What is Vitamin D? Why do I need it?
We get Vit D from the sun, food (fish, dairy, and eggs), and supplements.
The safest way to increase your vitamin D levels is to get short, incidental exposure from your daily life eg walk to the shops, have a morning coffee outdoors.
When tested in the laboratory, sunscreen does block Vitamin D, but used regularly in real life it doesn’t have a significant effect on vitamin D levels, and this is probably because people who use sunscreen are usually out in the sun for longer.
What else can you do reduce skin cancer risk?
- – Stop smoking;
- – Eat healthily;
- – Take Vitamin B3 (nicotinamide) 500mg twice daily. B3 has been shown to produce a significant drop in SCCs in high risk individuals.