Kangaroo Point Medical Centre

Skin Checks and Skin Cancers

Kangaroo Point Medical Centre offers a wide variety of services related to the detection and treatment of skin cancer. These include diagnosing sun spots and moles that can develop into cancerous lesions. The most common forms of skin cancers are melanoma (the most aggressive), squamous cell carcinoma (notorious for spreading to lymph glands) and basal cell carcinoma (invade and erode surrounding tissues).

Detection of pre-cancerous skin lesions

Actinic Keratosis (AK)

AKs are also known as solar keratoses or sunspots and most commonly appear as scaly lesions on the skin in areas of sun exposure. Major risk factors for the development of AKs include chronic sun exposure, fair skin, age, and being male.

Typical locations for AKs include the scalp, face, lateral neck, forearms, and hands. When it occurs on the lips it is called Actinic cheilitis.

AKs need to be monitored as they may progress to one of the most common skin cancers, squamous cell carcinoma (SCC). The risk that an individual AK will progress is low, but approximately 60% of SCCs arise in areas of preexisting AKs. In addition, patients with AKs are at an increased risk for the development of SCCs or basal cell carcinomas (BCCs) in other places.

The diagnosis of AK is often made based on their typical appearance and scaly feel. There are additional technologies such as Mole Mapping and the use of optical spectroscopy  that can increase accuracy of detection. A biopsy can be performed if the diagnosis is uncertain; such as to differentiate an AK from SCC. In particular, if lesions are rapidly growing, greater than 1cm in diameter, hardened, or eroded. Although biopsies can be tainting, In well experienced hands they cause little to no scarring and minimal pain.

Atypical Nevi

Flat moles that often present with multiple shades are called atypical (dysplastic) nevi. These  spots on the skin often share some common features of melanomas, such as large diameter, irregular borders, and multiple colours.

Individuals with atypical nevi have a higher risk of developing a melanoma than individuals without atypical nevi. The risk of melanoma increases with the number of atypical nevi and is greatest in individuals who have personal or family history of melanoma.

Atypical nevi are most often seen on the trunk and extremities of the body, however they can develop anywhere on the body, including the scalp, breasts, buttocks, and genitalia.

People who have dysplastic nevi should avoid excessive sun exposure with no protection and see a skin specialist for frequent skin checks. Mole Mapping is  a very useful technology for keeping a record of unusual spots on the skin and monitoring any changes. In association with the use of elastic spectroscopy (latest technology in skin cancer detection) lesions can be more accurately diagnosed decreasing the need of unnecessary biopsies.

Detection of skin cancers:

Melanoma

Melanoma is the most serious form of skin cancer. In Australia, it is the third most common cancer diagnosed and its incidence increases with age. When detected early, the cure rates can be close to 99%.

Often the first sign of melanoma is a change in the shape, colour, size, or feel of an existing mole. However, melanoma may also appear as a new mole. People should tell their doctor if they notice any changes on the skin. The only way to diagnose melanoma is to remove tissue and check it for cancer cells.

Surgery is the most common treatment for melanoma,  however this depends on how far the cancer has progressed. For early stage melanoma, a wide removal with 1cm margins may be all that is required. The skin surrounding the melanoma is removed to reduce the risk of recurrence of the melanoma at that site. This may be effective in preventing adjacent melanocytes (cells that produce melanin which gives skin its colour) from  evolving into melanoma. For later stage melanoma, more extensive surgery with lymph node removal may be required to plan definitive treatment.

Basal cell carcinoma (BCC)

BCC is the most common form of skin cancer and the most frequently occurring form of all cancers. BCCs arise from abnormal, uncontrolled growth of cells that lie in the surface of the skin, basal cells.

Due to BCCs being slow growing, most are curable and cause minimal damage when diagnosed and treated early. Treatments include prescription creams, scraping and cauterisation or surgery to remove the cancer.

Squamous cell carcinoma (SCC)

SCC of the skin is the second most common form of skin cancer, characterised by abnormal, accelerated growth of squamous cells. When caught early, most SCCs are curable. The biopsy results are usually enough to inform the doctor the aggressiveness of that particular squamous cell skin cancer.​​

For most patients with low-risk SCCs, surgical excision is recommended rather than destructive treatments such as dry ice (cryotherapy).

Merkel cell carcinoma (MCC)

MCC is a rare type of skin cancer that usually appears as a flesh-colored or bluish-red nodule, frequently on your face, head or neck. MCCs most often develop in older people. Long-term sun exposure or a weak immune system may increase the risk of developing MCC.

MCC tends to grow fast and to spread quickly to other parts of your body. Treatment options for MCC often depend on whether the cancer has spread beyond the skin, however it includes surgery, radiation therapy or immunotherapy.