Diagnosing skin cancer (non-melanoma)

Saturday 1 March, 2014

Download PDF Order FREE booklet

On this page: Recognising a skin cancer | Skin biopsy | Prognosis | Staging | Which health professionals will I see? | Skin cancer clinics | Key points


Recognising a skin cancer 

Normal, healthy freckles and moles usually have a smooth edge and an even colour. Skin cancers don’t all look the same but there are some signs to look out for including:

  • a spot that is different from other spots on the skin
  • a spot, mole or freckle that has changed in size, shape or colour
  • a sore that doesn't heal
  • a spot that bleeds.

It’s important to get to know your skin. Checking your skin every three months or as recommended by your GP will help you notice any new or changing moles, freckles and spots, and learn what is normal for you.

How to check your own skin

Find a room with good light and a full length mirror or, if you are on your own, a handheld mirror to check difficult-to-see areas.

Undress completely and examine your skin, each body part at a time, until you have checked your whole body. Pay particular attention to your face, neck, shoulders, arms, back of your hands, back, legs, bottom of the feet and between the toes.

If you see anything new or different on your skin, make an appointment with your GP or a dermatologist straightaway. Skin cancers that are found and treated early need less invasive treatment and have a better outcome (prognosis).

See the SunSmart website for further information on how to conduct a skin check.

Skin biopsy

Your doctor will look at all your skin, including any spots you have identified as changed or suspicious. If a skin cancer is suspected, the doctor will usually take a tissue sample (biopsy) to confirm the diagnosis. A biopsy is a quick and simple procedure, and is usually performed in the doctor’s office.

Your GP or specialist will give you a local anaesthetic to numb the area. A small piece of tissue will be taken from the skin spot or the spot will be completely cut out. You will usually have stitches to close the wound and help it heal.

The tissue that is cut out will be sent to a laboratory where a pathologist will examine the cells under a microscope. It takes about a week for the results of your tests to be ready.

If all the cancer is removed during the biopsy, this will probably be the only treatment you need. For more information on how to protect your skin after treatment, see follow up.

Dealing with the diagnosis

Most skin cancers do not pose a serious risk to your health. However, being told you have cancer can come as a shock and you may feel many different emotions. If you have any concerns or want to talk to someone, see your doctor or call Cancer Council 13 11 20.

Prognosis

Prognosis means the expected outcome of a disease. The doctor most familiar with your situation is the best person to talk to about your prognosis.

Most skin cancers are successfully treated if found early. Nearly everyone with non-melanoma skin cancer that has treatment will be cured.

Staging

Usually a biopsy is the only information a doctor needs to determine the stage of a non-melanoma skin cancer.

Staging is a way to describe its size and whether it has spread beyond its original size. In some cases of SCC, lymph nodes may be examined to see if the cancer has spread.

Which health professionals will I see?

If you have a suspicious spot, there are a number of health professionals you may see.

  • General practitioner (GP): Your GP knows your medical history, and can examine your skin (including areas that are not exposed to the sun).
    GPs often treat skin cancers but may refer you to a specialist, such as a dermatologist or plastic surgeon, if necessary.
  • Dermatologist: Your GP may refer you to a dermatologist. A dermatologist is a doctor who has completed specialist training in preventing, diagnosing and treating skin diseases, including skin cancer.
  • Plastic surgeon: A plastic surgeon is trained in complex constructive techniques, as well as surgical treatment, if the cancer has spread to other parts of the body.
Tips
  • Obtain a referral from a GP. You can see a dermatologist without a GP referral, but under Medicare you will be billed for a non-referred consultation. This means that you will not be reimbursed by Medicare and you will have to pay for the appointment.
  • Ask before the appointment for the full cost of each procedure and how much is refunded by Medicare.
  • Check if there is a long waiting list. If there is a spot on your skin of particular concern, your GP may be able to request an earlier appointment.
  • If you live in regional Australia, there may not be a dermatologist based in your local area. However, many regional areas have visiting dermatologists. Your GP should be able to advise you.
  • Many public hospitals in metropolitan cities have dermatology outpatient clinics where care can be provided by specialist dermatologists without charge. Your GP can refer you to these. However, these clinics often have long waiting lists.

Skin cancer clinics

Skin clinics offer a variety of services and fee arrangements. Clinics are usually operated by GPs who have an interest in skin cancer, although some clinics are operated by dermatologists who are specially trained in this area.

Skin cancer clinics may not necessarily offer a higher level of expertise than your family GP. In deciding whether to go to a skin clinic, it is important you find out about the services offered and the expertise of the staff.

Choosing a skin clinic

There are four main points to consider when choosing which skin clinic to attend:

  • qualifications and experience of the medical staff
  • costs – some clinics bulk bill for the initial consultation but require upfront payment for further appointments or surgery (which may not be refundable by Medicare); others require upfront payment for all appointments
  • diagnosis and treatment services offered
  • information and follow-up provided.

Cancer Council does not operate or recommend any specific skin cancer clinics or doctors.

Key points

  • Although not all skin cancers look the same, you can look out for certain signs, such as a spot or sore that is different from other spots on the skin, that has changed in size, shape or colour, that bleeds or that doesn’t heal.
  • Your general practitioner (GP) can examine your skin, treat some cancers and advise you about appropriate care. GPs can also refer you to specialists, if needed.
  • A dermatologist is a skin specialist trained in preventing, diagnosing and treating skin diseases.
  • You should have a referral from your GP to see a dermatologist but you can make an appointment without one. You may have to pay for your appointment without Medicare reimbursement and sometimes there is a long waiting list.
  • Some people go to a skin cancer clinic that is operated by a GP or specialist dermatologist.
  • When choosing a skin cancer clinic, consider the staff qualifications, costs and services offered. Cancer Council does not operate or endorse any particular clinics or doctors.
  • Your doctor will do a biopsy to determine if the spot on your skin is cancerous. This means some tissue is cut out and examined under a microscope. You may have stitches to close up the wound.
  • It takes about a week for the biopsy results to be ready. If you feel anxious about the biopsy or cancer diagnosis, talk to your doctor or call Cancer Council 13 11 20. 

Reviewed by: Dr Richard Lewandowski, Plastic and Reconstructive Surgeon, Director of Surgery, Mater Adults Hospital, QLD; Prof H Peter Soyer, Chair, Dermatology Research Centre, The University of Queensland, School of Medicine, Acting Head, South-West Cluster & PA-Southside Clinical School, Deputy Head, School of Medicine, Director, Dermatology Department, Princess Alexandra Hospital, QLD; Carole Arbuckle, Helpline Consultant, Cancer Council Victoria; Irena Brozek, Research and Development Officer, Health Strategies, Cancer Council NSW; Julie Fraser, Consumer; Jenny Lawrence, Consumer; Dr Matheen Mohamed, Consultant Dermatologist, St Vincent’s Hospital Melbourne, VIC; Margaret Whitton, Clinical Nurse Consultant, Department of Dermatology, Royal Prince Alfred Hospital, NSW.

Updated: 01 Mar, 2014