Skin Cancer

Skin cancer begins when the skin cells are damaged and become cancerous. Ninety percent of skin cancers are caused by too much exposure to the sun’s rays. There are two groups of skin cancers, non-melantoma type such as basal cell carcinoma (BCC) and squamous cell skin carcinoma (SCC) and melanoma, which is the most serious type of skin cancer to have. Melanoma can be very aggressive and is the most likely to spread to other parts of the body. BCCs generally appear on the head, neck, torso and shoulders. They grow slowly and while they can damage surrounding tissue, they are unlikely to spread to other areas of the body. SCC can spread, but rarely kills. They like to grow into a large mass if untreated and are commonly found on areas of the body that catch the sun’s UV rays like the face, ears, lips, scalp, arms, legs, hands, neck and torso.

New Zealand has the highest rate of melanoma and melanoma deaths in the world. It is the most common type of cancer in the country, but is also very preventable. High rates of skin cancer in New Zealand are due to our low ozone layer, our outdoor lifestyle, a high amount of UV radiation over the summer, as well as a high proportion of people in our population with fair skin.

There are certain risk factors associated with skin cancer. Spending a lot of unprotected time in the sun, especially as a child, the use of tanning or sunbeds, having pale skin that burns easily or skin that has a lot of moles, having fair or red hair, relatives with skin cancer, and having had one or more severe sunburns can increase the risk of skin cancer.

Prevention is the best way to decrease your risk of developing skin cancer. Skin needs to be protected from the sun. The “Slip/Slop/Slap/Wrap” routine needs to be followed when outside from September to April especially from 10am to 4pm when the suns UV rays are strongest.

• Slip – into the shade and plan outside activities for when the sun’s UV levels are lower. Slip on clothing that covers as much skin as possible. Tighter weave fabrics and darker shades give more sun protection.
• Slop – on lots of broad-spectrum sunscreen with an SPF of at least 30. Broad-spectrum means that it gives protection against both UV-A and UV-B rays. Apply 20 minutes before heading outside and reapply every two hours or after swimming.
• Slap – on a hat that has a wide brim or flaps to ensure the face, ears and neck are covered.
• Wrap – on a pair of sunglasses. Close-fitting, wraparound styles are best.

You need to do the “Slip/slop/slap/wrap” routine all year round when doing activities on the water, in the mountains, around reflective surfaces like snow, ice or concrete, if you have a health condition or are taking a medicine that makes your skin more sensitive to the sun.

Do regular skin self-checks at least every three months. You may need someone else to help you check tricky areas such as your back, neck and scalp. Remember to check armpits, inside of legs, the ears, eyelids, hands and soles of the feet. Things to look out for are:

• a crusty sore that is bleeding or doesn’t seem to heal. It may be painful, itchy or have a burning sensation
• a dry, scaly area that can be pale, shiny or bright pink
• small lumps that may be red, pale or pearly in colour
• new or existing spots or moles that change in colour, shape or thickness.

Non melanoma skin cancer is usually curable. Treatment involves surgical removal, removal by cryotherapy (this uses liquid nitrogen which is extremely cold and ‘burns’ off the lesion), topical treatment with medicines such as fluorouracil or imiquimod, and sometimes radiation therapy. Melanoma treatment may involve surgery, chemotherapy, radiation therapy or targeted therapy.

This blog provides general information and discussion about medicine, health and related subjects. The information contained in the blog and in any linked mate­ri­als, are not intended nor implied to be a substitute for professional medical advice.