Skin cancer


Diagnosing skin cancer (non-melanoma)

Recognising a skin cancer

If you notice any changes to your skin, there are a number of health professionals you can see to help make a diagnosis. They will examine you, paying particular attention to any spots you think are suspicious. Your doctor may use a handheld magnifying instrument called a dermatoscope to see the spot more clearly. Many skin cancers are diagnosed with only a physical examination, but others require a biopsy.

Which health professionals will I see?

General practitioner (GP)

A GP treats the majority of people with skin cancer using some types of surgery and by prescribing creams or gels ( topical treatments). They may refer you to a dermatologist or surgeon if necessary.

Dermatologist

This is a specialist doctor who is trained in preventing, diagnosing and treating skin conditions, including skin cancer. They can provide general and cosmetic surgery and prescribe topical treatments.

When you make the appointment, ask the receptionist about the cost of the procedure and how much will be refunded by Medicare, and check if there is a waiting list. If there is a spot on your skin of particular concern, your GP can request an earlier appointment.

Many public hospitals in large cities have dermatology outpatient clinics that provide care for free. Your GP can refer you. In areas without a dermatologist, you may be able to see a visiting dermatologist or a surgeon.

Surgeon

Some skin cancers are treated by specialised surgeons:

  • surgical oncologist – can manage complex skin cancers, including those that have spread to the lymph nodes
  • plastic surgeon – is trained in complex reconstructive techniques for areas that are difficult to treat, such as the nose, lip, eyelid and ears.

Should I go to a skin cancer clinic?

Skin cancer clinics offer a variety of services and fee arrangements. They are usually operated by GPs who have an interest in skin cancer.

Research shows that clinics may not necessarily offer a higher level of skill than your usual GP. In deciding whether to attend a skin clinic, consider four main points:

  • the qualifications and experience of the medical staff – this includes whether they are members of a professional association relevant to treating skin cancer (e.g. Skin Cancer College Australasia)
  • what you will have to pay – some clinics bulk-bill for the initial consultation but require up-front payment for further appointments or surgery (which may not be refundable by Medicare); others require up-front payment for all appointments
  • the diagnostic and treatment services offered
  • the follow-up provided.

Cancer Council does not operate or recommend any specific skin cancer clinics, and does not recommend particular specialists.

Skin biopsy

If it's difficult to tell the difference between a skin cancer and a non-cancerous skin spot, the doctor may need to take a tissue sample (biopsy) to confirm the diagnosis.

A biopsy is a quick and simple procedure that is usually performed in the doctor's office. You will be given a local anaesthetic to numb the area, and the doctor will take a small piece of tissue from the spot. In some cases, the spot is cut out completely in a procedure called an excision and stitches are used to close the wound and help it heal.

The tissue that is removed will be sent to a laboratory, where a pathologist will examine it under a microscope. The results will be available in about a week.

If all the cancer is removed during the biopsy, this will probably be the only treatment you need.

Can smartphone apps help detect skin cancer?

A number of smartphone apps allow you to photograph your skin at regular intervals and compare photos to check for changes. While these apps may be a way to keep a record of any spot you are worried about or remind you to check your skin, research shows they cannot reliably detect skin cancer and should not replace a visit to the doctor. If you notice a spot that causes you concern, make an appointment with your GP or dermatologist straightaway.

Staging

The stage of a cancer describes its size and whether it has spread. Unlike other cancer types, BCCs are rarely staged. Some SCCs may require staging as they are able to spread, although this is uncommon.

Usually a biopsy is the only information a doctor needs to diagnose skin cancer. In cases of SCC, the doctor may also feel the lymph nodes near the skin cancer to check for swelling. This may be a sign that the cancer has spread to the lymph nodes. For more information, speak to your doctor.

Prognosis

Prognosis means the expected outcome of a disease. Your treating doctor is the best person to talk to about your prognosis. Most non-melanoma skin cancers such as BCC and SCC are successfully treated, especially if found early.

While most skin cancers do not pose a serious risk to your health, 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.

Key points

  • Australia has one of the highest rates of skin cancer in the world.
  • Although not all skin cancers look the same, signs include a spot that is different from other spots on the skin; a spot that has changed size, shape, colour or texture; a sore that doesn't heal; or a sore that is itchy or bleeds.
  • Your GP can perform a full body skin check and treat some skin cancers. They can refer you to a specialist, such as a dermatologist, surgical oncologist or plastic surgeon, if necessary.
  • A dermatologist is a specialist doctor trained in preventing, diagnosing and treating skin conditions, including skin cancer.
  • Surgical oncologists are trained to perform surgery to treat skin cancer. In some cases, a plastic surgeon may be the treating specialist.
  • Some people visit a skin cancer clinic, which is usually operated by a GP with an interest in skin cancer.
  • When choosing a skin cancer clinic, consider the staff's qualifications and experience, the costs, and the services and information offered.
  • Your doctor may perform a skin biopsy to determine whether the spot is cancerous. A biopsy is when tissue is removed and examined under a microscope. You may have stitches to close up the wound.
  • The biopsy results will be ready in about a week. In some cases, a biopsy will be the only procedure needed to treat the skin cancer.

Expert content reviewers:

Dr Judy Cole, Consultant Dermatologist, St John of God Dermatology, WA; Irena Brozek, Research and Development Officer, Cancer Council NSW; Shannon Jones, SunSmart Health Professionals Coordinator, Cancer Council Victoria, VIC; David Lemon, Consumer; Dr Margaret Oziemski, Dermatologist, QLD; Megan Trewhella, Nurse Coordinator, Melanoma and Skin Service, Peter MacCallum Cancer Centre, VIC; Chelsey Upston, 13 11 20 Clinical Nurse Specialist, Cancer Council Victoria, VIC.

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