With thousands of New Zealand's experiencing a surgance of malignant skin tumours year-on-year, it's more important than ever before to have your skin checked regularly by a professional. Regardless of age, any new skin spot or change in an existing mole needs to be assessed. Moles with irregular borders, irregular colours, thickening or bleeding should be seen urgently.
The heat of a Kiwi summer is a reminder, for many of us, about the perils of developing skin cancer. Whilst it is timely to turn our attention to the dangers of ultraviolent radiation and the extreme levels it can reach at this time of year, the severity of sun exposure is not limited to the warmer months.
Avoiding exposure year-round is the best defence against skin cancer, and this typically means staying out of the sun between 11am and 4pm. The next level of protection is covering-up, with wide-brimmed hats, and loose fitting, long sleeve, tight-woven clothes or rash-shirts. Sunscreen containing Zinc or Titanium Dioxide, to provide broad spectrum UVA and UVB protection, should be applied generously and reapplied every three-to-four hours, regardless of instructions on the label.
The most common skin cancer types in New Zealand are squamous cell carcinoma and basal cell carcinoma. Our more serious, and deadliest, skin cancer is melanoma which is responsible for over 270 deaths each year. The best defence in the fight against skin cancer, is early intervention. If you are at all concerned about a change in an existing mole or the appearance of a skin spot, please make an appointment to have it assessed, now! Don't wait and see.
This is the most common type of skin cancer, and fortunately is the least likely to spread. Again, these are usually in sun-exposed areas and more common in fair-skinned patients. They can occur during your 20’s but are more common later in life. Their appearance is quite variable, sometimes presenting as a pearly nodule, or a crusty ulcer, or even as a pale / wax thickening not unlike a scar. They do not grow very rapidly, and because of their slow nature, can often be left until they are quite large and therefore complex reconstruction is required.
Once the BCC is removed and the laboratory has confirmed an adequate safety margin, they are very unlikely to recur, however, the same sun-exposure that allowed one to grow will also effect other areas and a second BCC may grow elsewhere. Regular skin checks are important once a skin cancer has been diagnosed, and sun protection becomes even more
This is a very common type of skin cancer, usually affecting sun-damaged fair skin.
Squamous cell carcinomas can be only a few millimeters across to tumours many centimeters in size, with either a slow growth pattern or very rapidly enlarging over a matter of weeks. They are often crusty, red and can be tender. SCC involving the lip can be very serious with spread to local lymph nodes, although the majority of SCC’s involving other skin sites are usually less aggressive with spread (metastasis) being quite uncommon. While very early SCC’s can trial non-surgical treatments, most will require surgical treatment. It is common for a patient with one skin cancer to develop others, usually because of a history of high sun exposure to all sun-exposed skin.
Surgery can range from being very minor, requiring only a few stitches, to more involved and complex reconstructions utilising skin grafts or movements of skin flaps. While the primary focus is on complete removal of the tumour, a reconstruction with the least cosmetic impact is always planned.
This third most common type of skin cancer is also the most notorious due to its high risk and potential to affect both the young and the old. Because New Zealand has one of the highest melanoma risks in the world, regular skin checks are essential.
Melanoma are potentially life-threatening, making early diagnosis and urgent surgical excision of the utmost importance. Since safe and correct removal will give the best chance of survival, it is important to have melanomas treated by skilled medical professionals who are able to perform the necessary wider excision and can proceed with further surgery if required i.e. lymph node clearance, which is done under general anaesthetic in a hospital, Fellowship-trained Specialist Surgeons (FRACS) and specifically trained dermatologists. Investigations may include blood tests and CAT scans. Unfortunately, chemotherapy, radiotherapy and recent work in vaccine therapy have yet to show any advantage compared with thorough surgical removal.
Typical melanoma symptoms can be easily remembered using the ABC below:
Asymmetry – one half of the mole looks different from the other.
Border irregularities – the edge of the mole appears ragged.
Colour variegation – the mole has different colours or hues.
Diameter – this is typically larger than 6mm.
Enlargement or evolution – the colour, shape or appearance has changed.
It is essential to pick up the early melanoma symptoms developing in the skin as the only cure is early surgical removal.