Skin cancer: the warning signs
How do I spot a skin cancer?
Skin cancers don’t all look the same, but there are signs to look out for, including:
- a spot that is different from other spots on the skin
- a spot that has changed size, shape, colour or texture
- a sore that doesn’t heal
- a sore that is itchy or bleeds.
There is no set guideline on how often to check for skin cancer, but checking your skin regularly will help you notice any new or changing spots. If you have previously had a skin cancer or are at greater risk of developing skin cancer, ask your doctor how often to check your skin.
If you notice anything new or changes to your skin, make an appointment with your GP or dermatologist straightaway. Skin cancers that are found and treated early need less invasive treatment and have a better outcome (prognosis). Visit sunsmart.com.au/skin-cancer/ checking-for-skin-cancer for more information about checking your skin.
The signs of skin cancer
The signs of non-cancerous skin cancer
What about other skin spots?
Some spots that appear on the skin are not cancerous.
A mole (naevus) is a normal growth on the skin that develops when the skin’s pigment-producing cells (melanocytes) grow in groups.
Moles are very common. Some people have many moles on their body – this can run in families. Overexposure to the sun, especially in childhood, can also increase the number of moles.
People with many dysplastic naevi have a greater risk of developing melanoma.
Sunspots (solar or actinic keratoses)
Anyone can develop sunspots, but they occur more often in people over 40, generally on skin that’s frequently exposed to the sun, such as the head, neck, hands, forearms and legs. They are a warning sign that the skin has had too much sun exposure, increasing the risk of skin cancer.
What causes skin cancer?
The main cause of all types of skin cancer is overexposure to UV radiation. When unprotected skin is exposed to UV radiation, the structure and behaviour of the cells can change.
UV radiation is produced by the sun, but it can also come from artificial sources, such as the lights used in solariums (sun beds). While commercial sun beds are now banned in Australia, people who used a solarium before age 35 have an almost 60% greater risk of melanoma.
Most parts of Australia have high levels of UV radiation all year round. UV radiation cannot be seen or felt and it is not related to temperature, but it can cause:
- premature skin ageing
- damage to skin cells, which can lead to skin cancer.
To help understand when to protect yourself from the sun, see The UV Index and sun protection times.
Who is at risk?
Anyone can develop skin cancer, but it’s more common the older you are. The risk is also higher in people who have:
- fair or freckled skin, especially if it burns easily and doesn’t tan
- red or fair hair and light-coloured eyes (blue or green)
- experienced short, intense periods of exposure to UV radiation, e.g. on weekends or holidays or when playing sport, especially if it caused sunburn
- actively tanned or used solariums
- worked outdoors
- a weakened immune system, which could be caused by taking certain medicines after an organ transplant (immunosuppressants) or being HIV-positive
- lots of moles on their body
- moles with an irregular shape and uneven colour (dysplastic naevi)
- a previous or family history of skin cancer
- certain skin conditions such as sunspots.
People with olive or very dark skin naturally have more protection against UV radiation because their skin produces more melanin than fair-skinned people. However, they can still develop skin cancer.
How common is skin cancer?
Australia has one of the highest rates of skin cancer in the world. Skin cancer is the most common cancer diagnosed in Australia. About two in three Australians will be diagnosed with some form of skin cancer before the age of 70.
Almost 770,000 new cases of BCC and SCC are treated each year. BCC can develop in young people, but it is more common in people over 40. SCC occurs mostly in people over 50. More than 12,000 people are diagnosed with melanoma each year. It is among the five most commonly diagnosed cancers in all age groups.
If you notice any changes to your skin, there are a number of health professionals you can see to help make a diagnosis. They will examine you, paying particular attention to any spots you think are suspicious. Your doctor may use a handheld magnifying instrument called a dermatoscope to see the spot more clearly. Many skin cancers are diagnosed with only a physical examination, but others require a biopsy.
Which health professionals will I see?
General practitioner (GP)
A GP treats the majority of people with skin cancer using some types of surgery and by prescribing creams or gels (see below). They may refer you to a dermatologist or surgeon if necessary.
This is a specialist doctor who is trained in preventing, diagnosing and treating skin conditions, including skin cancer. They can provide general and cosmetic surgery and prescribe topical treatments.
When you make the appointment, ask the receptionist about the cost of the procedure and how much will be refunded by Medicare, and check if there is a waiting list. If there is a spot on your skin of particular concern, your GP can request an earlier appointment.
Many public hospitals in large cities have dermatology outpatient clinics that provide care for free. Your GP can refer you. In areas without a dermatologist, you may be able to see a visiting dermatologist or a surgeon.
Some skin cancers are treated by specialised surgeons:
- surgical oncologist – can manage complex skin cancers, including those that have spread to the lymph nodes
- plastic surgeon – is trained in complex reconstructive techniques for areas that are difficult to treat, such as the nose, lip, eyelid and ears.
Should I go to a skin cancer clinic?
Skin cancer clinics offer a variety of services and fee arrangements. They are usually operated by GPs who have an interest in skin cancer.
Research shows that clinics may not necessarily offer a higher level of skill than your usual GP. In deciding whether to attend a skin clinic, consider four main points:
- the qualifications and experience of the medical staff – this includes whether they are members of a professional association relevant to treating skin cancer (e.g. Skin Cancer College Australasia)
- what you will have to pay – some clinics bulk-bill for the initial consultation but require up-front payment for further appointments or surgery (which may not be refundable by Medicare); others require up-front payment for all appointments
- the diagnostic and treatment services offered
- the follow-up provided.
Cancer Council does not operate or recommend any specific skin cancer clinics, and does not recommend particular specialists.
If it’s difficult to tell the difference between a skin cancer and
a non-cancerous skin spot, the doctor may need to take a tissue sample (biopsy) to confirm the diagnosis.
A biopsy is a quick and simple procedure that is usually performed in the doctor’s office. You will be given a local anaesthetic to numb the area, and the doctor will take a small piece of tissue from the spot. In some cases, the spot is cut out completely in a procedure called an excision and stitches are used to close the wound and help it heal.
The tissue that is removed will be sent to a laboratory, where a pathologist will examine it under a microscope. The results will be available in about a week.
If all the cancer is removed during the biopsy, this will probably be the only treatment you need.
Can smartphone apps help detect skin cancer?
A number of smartphone apps allow you to photograph your skin at regular intervals and compare photos to check for changes. While these apps may be a way to keep a record of any spot you are worried about or remind you to check your skin, research shows they cannot reliably detect skin cancer and should not replace a visit to the doctor. If you notice a spot that causes you concern, make an appointment with your GP or dermatologist straightaway.
The stage of a cancer describes its size and whether it has spread. Unlike other cancer types, BCCs are rarely staged. Some SCCs may require staging as they are able to spread, although this is uncommon.
Usually a biopsy is the only information a doctor needs to diagnose skin cancer. In cases of SCC, the doctor may also feel the lymph nodes near the skin cancer to check for swelling. This may be a sign that the cancer has spread to the lymph nodes. For more information, speak to your doctor.
Prognosis means the expected outcome of a disease. Your treating doctor is the best person to talk to about your prognosis. Most non-melanoma skin cancers such as BCC and SCC are successfully treated, especially if found early.
While most skin cancers do not pose a serious risk to your health, being told you have cancer can come as a shock and you may feel many different emotions. If you have any concerns or want to talk to someone, see your doctor or call Cancer Council 13 11 20.
- Australia has one of the highest rates of skin cancer in the world.
- Although not all skin cancers look the same, signs include a spot that is different from other spots on the skin; a spot that has changed size, shape, colour or texture; a sore that doesn’t heal; or a sore that is itchy or bleeds.
- Your GP can perform a full body skin check and treat some skin cancers. They can refer you to a specialist, such as a dermatologist, surgical oncologist or plastic surgeon, if necessary.
- A dermatologist is a specialist doctor trained in preventing, diagnosing and treating skin conditions, including skin cancer.
- Surgical oncologists are trained to perform surgery to treat skin cancer. In some cases, a plastic surgeon may be the treating specialist.
- Some people visit a skin cancer clinic, which is usually operated by a GP with an interest in skin cancer.
- When choosing a skin cancer clinic, consider the staff’s qualifications and experience, the costs, and the services and information offered.
- Your doctor may perform a skin biopsy to determine whether the spot is cancerous. A biopsy is when tissue is removed and examined under a microscope. You may have stitches to close up the wound.
- The biopsy results will be ready in about a week. In some cases, a biopsy will be the only procedure needed to treat the skin cancer.
Last Reviewed: 31/01/2018
Reproduced with the kind permission of The Cancer Council New South Wales.
Cancer Council NSW. Understanding Skin Cancer. Last Updated January 2018. https://www.cancer.org.au/content/about_cancer/ebooks/cancertypes/Understanding_Skin_Cancer_booklet_January_2018.pdf
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