Skin Cancer Frequently Asked Questions

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1 What happens at the clinic? On arrival you will fill out a short questionnaire which includes previous skin cancer diagnosis and treatment, family history and other relevant medical history. The doctor will then call you into the room and discuss any relevant points from the questionnaire and any spots you are concerned about. After this you will be asked to undress in private to your underwear (a hospital gown can be provided if desired) Your partner or a family member is welcome to attend the examination if you wish. If assessing a child under 18 years, a parent / carer must be present. Your examination A full body examination (underwear is left on) is a routine and vital part of a skin cancer check. It is strongly recommended to have all of your skin examined in detail as skin cancer can occur anywhere even on those parts of the body that have seen relatively little sun recently. The doctor will use a magnifier to scan the skin and any suspicious spots will be examined in more detail with more sophisticated equipment. Photographs may be taken for discussion or future reference. Do I need a referral? A doctors referral is not needed, you can simply call (08) for an appointment. How long does it take? Depending on the number of moles / sun spots present, your examination should take 15 to 30 minutes. What will happen if a suspicious lesion is detected? If a pre-cancerous sun spot is detected it may be treated with cryotherapy (freezing) or special cream. If a skin cancer is suspected, a biopsy (removal of a small part to confirm diagnosis) or an excision (removal of the entire lesion) is arranged. KINGS PARK HEALTH (08)

2 Surgical Procedures If a skin cancer is suspected, arrangements are made for either a biopsy or excision. This will be performed at a further appointment. The planned procedure will be fully discussed so you understand what is involved, including risks, complications, and other potential treatment options that may be available. All equipment used, including sutures, is of the highest quality. All reusable instruments are fully sterilised with Australian standards approved and maintained equipment. Testing of specimens All specimens are sent to a pathology service for testing. This gives us the diagnosis and also confirms if the skin cancer has been completely removed. When will I get my results? The pathology report and what this means will be discussed in simple terms at the follow-up appointment. Any sutures placed to close the skin wound will generally be removed at this time. Follow-up If you agree, you will be entered into a computerised recall system to receive a follow-up reminder, usually via SMS. Follow up interval is between 3 to 12 months, depending on your risk factors. What are the risk factors for skin cancer? They include skin type (fair vs dark), numbers of dark moles present, previous UV exposure (sun tanning lamps), previous skin cancers diagnosed, occupational exposure (arc welding) and drugs that supress the immune system (organ transplants, immunotherapies) KINGS PARK HEALTH (08)

3 What if a mole appears or changes between appointments? If a new mole appears or a pre-existing mole changes, please book an urgent review as soon as possible. Do not wait to see if it will go away Remember, the best and sometimes only way to cure a skin cancer is to diagnose and remove it as soon as possible. **EARLY DETECTION AND TREATMENT SAVES LIVES** At what age should skin cancer checks start? People of all ages need to regularly check their skin for changes as skin cancer affects everyone. Melanoma is the most common cancer in the 15 to 24 year old age group. Australians over the age of 40 are at the highest risk, 3 monthly self-checks with 12 monthly clinic checks are recommended. Sun damage is cumulative and may take years or even decades to appear in the form of visible symptoms. This means that damage incurred when you were a child or teenager may not present visibly until you are well into middle age or older. What is skin cancer? Skin cancer is the most common form of cancer in Australia. Skin Cancer is a disease of the skin cells caused mostly by cumulative exposure to ultraviolet radiation (UVR) from the sun. Cancer is a group of diseases in which cells start to grow and divide abnormally, resulting in the development of abnormal tissue which can invade and destroy adjacent normal tissues. Some cancers may also spread (metastatic) to other locations in the body causing damage there as well. Skin cancer is normally divided into two categories: Melanoma and non-melanoma skin cancers. KINGS PARK HEALTH (08)

4 What is a Melanoma? Melanoma is the least common form of skin cancer but the most deadly. If not treated early enough it can spread to other parts of the body. Melanoma appears as a new spot or more rarely in a pre-existing mole that changes colour, size or shape. A melanoma usually has an irregular outline or shape and can be more than one colour often different shades of brown mixed in with red. Sometimes melanomas are just very black and look different to other adjacent moles. Sometimes they can present just as a rapidly growing, fleshy red lump with no brown or black at all. A melanoma can grow over weeks to months and can appear anywhere on the body, including areas that are not exposed to the sun. They require very early diagnosis and removal to maximise the chance of a cure. What is a non-melanoma skin cancer? These include many different skin cancer types, but the most common of these being: Basal Cell Carcinomas the most common skin cancer type in Australia, usually triggered by cumulative exposure to ultraviolet radiation from the sun. Hence they are often found on those parts of the body most exposed to the sun (face, arms, legs, back) They may be flat, red and rather innocuous looking or pink and lumpy with a discrete border. If they are large enough they will often form an ulcer in the centre and will often bleed. They generally cause local tissue destruction and rarely spread. Squamous Cell Carcinomas also common particularly in older Australians on sun damaged skin. They can be red, flat and scaly or raised and lumpy with a crusty top or cap. They do have the potential to spread to other parts of the body, particularly if they are on the lip/ear or if they grow over 1cm elsewhere on the body. Early diagnosis and removal minimises the risk of spread. KINGS PARK HEALTH (08)

5 What are the main risk factors for skin cancer? Risk is increased for people who: Are exposed to ultraviolet radiation during childhood/adolescence and, Have repeated exposure to ultraviolet light over their lifetime. Have had episodes of sunburn Have a light complexion Are older Have had a previous non melanoma skin cancer Have a personal history or family history of melanoma Have a large number of moles (naevi) Are immunosuppressed (medication for organ transplants, rheumatoid arthritis, inflammatory conditions) What is ultraviolet radiation (UVR)? It is the part of sunlight which causes sunburn and skin damage leading to premature aging and skin cancer. Damage to the skin occurs as soon as the skin is exposed to UVR. The effects of UVR on the skin are cumulative so the damage builds up over a lifetime even without sunburn burning. It is not related to heat and can be present even on a cloudy day. Light coloured and shiny surfaces such as sand, snow, concrete and water all reflect UVR. UVR is at its maximum between 10am and 2pm (11am and 3pm daylight savings) KINGS PARK HEALTH (08)