SKIN CANCER

What Is Skin Cancer?

Skin cancer is an unusual growth of abnormal cells in the skin. It occurs when normal skin cells are damaged, for example, by cumulative exposure to ultraviolet radiation (UV) causing sunburn. Most skin-cancers in NZ are caused by exposure to UV radiation from the sun, although using sun-beds also carries with it a high-risk of skin cancer. About 2% of skin cancers (including melanoma) occur where there has been no sun exposure. Therefore, you must see your skin doctor if you are worried about a new or changing spot/mole even if it is in an area that has never been sunburnt (or never sees the sun).

There are three main types of skin cancer:

Basal Cell Carcinoma (BCC)
Squamous Cell Carcinoma (SCC)
Melanoma

Basal Cell Carcinoma (BCC)

BCC is the most common of all skin cancers, making up around 70% of non-melanoma skin cancers.
BCC commonly appears on the head, neck and upper body.
It appears as a red, pale, pearly flat or raised lesion.
A BCC may bleed and become inflamed causing ulceration.
If left untreated, a BCC will continue to slowly spread and cause large sores (ulceration).
Though BCCs do not usually spread to other parts of the body, it is best to treat them early to prevent ulceration and damage to the affected area.

Squamous Cell Carcinoma (SCC)

SCC is the second most common skin cancer, accounting for about 30% of non-melanoma skin cancers.
SCCs usually develop on sun exposed areas of the body, such as the head, neck and hands.
An SCC may look like a sore and may be tender to touch.
It is not as dangerous as melanoma but can be deadly if left untreated on areas like lips, ears, scalp or temples.

Melanoma

Melanoma is the least common skin cancer and also the most dangerous.
It usually arises as a dark, irregularly pigmented patch or lump on the skin
Melanoma may also (rarely) present as a pink to red patch or lump.
Commonly melanoma arises as a brand new spot.
It could also arise in an existing mole that changes in size, shape or colour.
Most cases can be successfully treated if caught early, but it can be fatal if treatment is delayed.
The earlier the melanoma is caught, the better the chance of survival.

What is a Melanoma?

Melanoma is characterised by the uncontrolled growth of melanocytes, the pigment-producing cells that colour skin, hair and eyes. It is treatable if diagnosed early, but if the cancer spreads to other parts of the body (metastasises) the prognosis is poor.

Melanoma can develop within existing moles or within previously normal skin. Early Melanomas are called Melanoma in-situ and have not invaded into the deeper or dermal layer of skin.

What is The Likely Prognosis?

The prognosis for patients with melanoma varies from almost certain cure (Melanoma in-situ) to a much less predictable outlook and is largely dependent on the micro-staging of the primary melanoma. Most patients with melanoma thinner than 1mm have an extremely good chance (better than 95%, 99% in Melanoma in-situ) of being alive and without evidence of further tumour in 10 years. Patients with thicker melanomas have a higher likelihood of developing metastases (secondary deposits of cancer) in the lymph glands or other parts of the body.

How Often Should I Have Skin Checks?

It is recommended that anyone that has had a Melanoma or Melanoma in-situ excised undergoes regular full skin checks for the first year, due to a slightly increased risk of developing a subsequent melanoma. These skin checks should take place three monthly for the first year, then six monthly for the following year, providing no further melanomas are found. Regular self-review of the skin is always appropriate.

Did You Know?

Over 4000 people are diagnosed with either melanoma in-situ or invasive melanoma every year in New Zealand – that’s around 11 every day.
It’s the fourth most common cancer in New Zealand and accounts for nearly 80% of all skin cancer deaths.
Around 300 New Zealanders die of melanoma every year.
New Zealand has the highest melanoma incidence rate in the world.

70% of melanoma cases occur in people aged 50 years and older.
Melanoma rarely occurs in children.
Although Maori and Pacific people have a lower chance of getting melanoma, they often have thicker, more serious melanomas.
Death rates are higher among men and appear to be increasing.
Severe sunburn during childhood can DOUBLE your risk of Melanoma.
Sunbeds emit dangerous UV rays, increasing the risk of melanoma.
Melanoma can arise in normal looking skin, a mole or freckle.
Skin Cancer can occur anywhere on the body, even where there has been no sun exposure.
There is no cure for melanoma that has spread throughout the body.
Melanoma is one of the most preventable forms of cancer.
Melanoma, if detected/treated early, has a survival rate of nearly 100%

What Causes Skin Cancer?

The main cause of skin cancer is exposure to ultraviolet (UV) radiation from the sun. The New Zealand climate and fair skin in particular are a high risk. Other sources of UV radiation, such as sunbeds, can also cause skin cancer.

In rare situations, skin cancer appears where skin has never have been exposed to sun. The available research suggests that while skin cells are often damaged in childhood, it may be sun exposure in adulthood that triggers these damaged cells to turn into cancerous lesions.

Who Is At Risk?

Anyone can develop skin cancer, regardless of their genetics, skin type or general health. This is why it is so important to find a reliable skin cancer doctor with whom you can discuss your risk and plan regular skin-checks.

66% of New Zealanders can expect to develop some type of skin cancer in their lifetime and early detection is the best way to improve the outcome for these cancers. Melanoma is by far the most dangerous type of skin cancer.

The main risk factors for melanoma include:

Exposure to ultraviolet radiation (UVA and UVB)
A history of sunburn in childhood and adolescence
Using sunbeds
Having many irregular or large moles
Multiple moles (>100)
Dysplastic naevi syndrome
Other types of skin cancer
A personal or family history of melanoma
Fair skin, freckles, blue eyes, red hair
Are aged 50 or over

When Should I Worry About A Mole Or Spot?

You should seek urgent medical advice from your skin cancer doctor if you have a mole or spot that:

changes in size, shape or colour
bleeds
has been itchy for a long time
is new and has appeared recently
has an irregular shape compared to other ‘normal’ looking moles.

Tips For Skin Cancer Prevention

Check Your Own Skin Regularly

Regular check-ups detect any suspicious activity early and this is key to beating skin cancers. Many skin cancers are detected by people themselves or by close family members.

Unlike many other cancers, skin cancer is often visible, making it easier to detect in the early stages. We recommend that you undertake your own full body skin check regularly, because skin cancers can occur on parts of the body not exposed the sun, such as the soles of the feet or under the toenails,

If you are worried about any mole, spot or freckle, please see your skin cancer specialist for advice.

Protect Your Skin from Sun Damage

Protect your skin from ultraviolet (UV) radiation as 98% of skin cancers are caused by the sun. We recommend using the UV index, which shows the intensity of the UV radiation emitted by the sun, to know when to protect your skin from sunburn. You can check the SunSmart UV alert on the weather page of most daily Newspapers, TV3, via a free app for smartphones or on the MetService and Dermnet websites.

When the UV index is 3 or above, we recommend you:

Slip on sun-protective clothing
Slop on SPF30+ broad spectrum sunscreen
Slap on a hat
Seek shade
Slide on some sunglasses

Please contact us on 09 477 1111 to make an appointment.