Thousands of New Zealand's are diagnosed with malignant skin cancer every year. So, 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 summertime is usually when we think the most about developing skin cancer. But the severity of sun exposure is not limited to the warmer months – the dangers of ultraviolent radiation are present year-round.
Avoiding exposure across all seasons is the best defence against skin cancer – 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, and regularly applying (every three-to-four hours) a broad spectrum sunscreen to protect against UVA and UVB rays.
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. As with any medical condition, the best defence 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! Do not put off having your skin checked.
This is the most common type of skin cancer and fortunately the least likely to spread. Lesions typically appear in sun-exposed areas and are 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. Unlike other skin cancers, basal cell carcinoma (BCC) 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 a BCC is removed and the laboratory has confirmed an adequate safety margin, they are very unlikely to recur in the same place. However, the same sun exposure that prompted one to grow can also effect other areas – discovery of a second BCC elsewhere is not uncommon.
This is a very common type of skin cancer, usually affecting sun-damaged, fair skin people, with men twice as likely to develop lesions.
Squamous cell carcinomas vary in size – from just a few millimetres across, to tumours many centimetres in diameter. They have both a slow growth pattern and rapidly enlarging pattern – which can manifest over a matter of weeks. They are often crusty, red and can be tender. SCC involving the lips can be very serious with spread to local lymph nodes, although the majority of SCC’s at other skin sites are usually less aggressive with spread (metastasis) uncommon. While very early SCC’s sufferers can trial non-surgical treatments, most patients 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.
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 effect both young and old. On the global stage, New Zealand is one of the most at-risk nations of developing melanoma. Regular skin checks aren't just essential – they are life-saving.
Because melanoma are potentially life-threatening, early diagnosis and urgent surgical excision is of utmost importance. Safe and correct removal gifts the best chance of survival, so it is important to have melanomas treated by skilled medical professionals. A skilled surgeon can perform necessary wider excisions and proceed with further surgery as required. For example, this could involve lymph node clearance, which is performed under general anaesthetic in a private hospital, by one of our fellowship-trained specialist plastic surgeons (FRACS) Mr Bialostocki and Mr Adams. Melanoma 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 act quickly if you discover any tell-tale signs of melanoma on the skin as the only cure is early surgical removal.