Skin Cancer & Prevention

Cumulative UV radiation is the primary cause of all three major skin cancer types. Episodic intense exposure, particularly sunburning in childhood and adolescence, significantly elevates melanoma risk. People with fair skin, red or blonde hair, light eyes, and a tendency to burn are at highest risk, though skin cancer affects all skin types. Additional risk factors include personal or family history of skin cancer, a large number of moles or atypical (dysplastic) moles, immunosuppression, and a history of actinic keratoses.

How is it diagnosed?

Dermoscopy, which involves non-invasive magnified, polarised light examination, is the standard of care for skin lesion assessment. In experienced hands it significantly improves diagnostic accuracy over the naked eye. Suspicious lesions are biopsied under local anaesthetic and assessed histopathologically. For melanoma, Breslow thickness and other histological features determine staging and further management. Photography and sequential dermoscopic monitoring are used for patients with multiple atypical lesions or a strong personal or family history.

Surgical excision under local anaesthetic is first-line for most skin cancers, with margins guided by tumour type, size, site, and histological subtype.

Mohs micrographic surgery allows real-time margin assessment during the procedure, offering the highest cure rates for high-risk BCCs and SCCs, particularly on cosmetically sensitive areas such as the nose, eyelids, ears, and lips, while preserving as much healthy tissue as possible.

Non-surgical treatments for selected BCCs and SCCs include topical therapies (imiquimod, 5-fluorouracil), photodynamic therapy (PDT), radiotherapy, and curettage and electrocautery for low-risk superficial lesions.

Advanced and metastatic disease is managed in a multidisciplinary setting. Checkpoint immunotherapy, including pembrolizumab and nivolumab, and BRAF/MEK-targeted therapies are available in Australia for eligible patients with advanced melanoma and have achieved outcomes that were unimaginable a decade ago.

Ongoing surveillance following any skin cancer diagnosis is essential, as the risk of a subsequent skin cancer is substantially elevated, and regular specialist review provides the best opportunity for early detection.

When detected early, the vast majority of skin cancers are highly treatable. The most important thing you can do is make regular skin checks part of your healthcare routine.