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Skin cancers are one of the most commonly diagnosed cancers in Australia. These malignancies of the skin are often forms of carcinomas (cancers arising from tissues that line organs) or melanomas (cancers arising from melanocytes).
The skin is the largest organ in our bodies that protect us from injury, loss of bodily fluids and help regulate body temperature. There are three layers of the skin: epidermis (top layer), dermis (middle layer) and hypodermis (bottom layer). The epidermis is the water-resistant outer layer of the skin that acts as the body’s first line of defence. It contains squamous cells (upper layer of the epidermis), basal cells (lower layer of epidermis) and melanocytes. The dermis contains the skin’s connective tissues, as well as hair follicles, sweat glands, blood vessels, lymph nodes and nerves. The hypodermis, also known as subcutaneous tissue layer, stores fat (adipose cells), and also contains connective tissue, blood vessels and nerve cells.
Skin cancers are more common in men, and is often diagnosed over the age of 40. However, anyone can develop this disease.
There are three primary forms of skin cancers, which are classified by the cells they originate from.
Basal cell carcinomas (BCCs) are the most common form of skin cancer, and develop from the basal cells in the skin. Basal cells are responsible for producing new skin cells as the old ones die. BCCs are often slow growing, are rarely aggressive, and often have a good prognosis.
Squamous cell carcinomas (SCCs) are the second most common form of skin cancer, and develop from squamous cells in the skin. Squamous cells are responsible for the filtration and diffusion of substances to pass through the skin. SCCs can be aggressive, and can have a good prognosis when caught early.
Melanoma is a rare form of skin cancer that develops from melanocytes, which are the cells that produce pigment in the skin. While melanomas are most commonly in the skin (cutaneous melanoma), they can also develop in the eye (ocular melanoma) or in mucosal surfaces (mucosal melanoma).
For more information on melanomas, please refer to the Rare Cancers Australia Knowledgebase.
These types of skin cancers are very rare:
If skin cancer is detected, it will be staged and graded based on size, metastasis (whether the cancer has spread to other parts of the body) and how the cancer cells look under the microscope. Staging and grading helps your doctors determine the best treatment for you.
In most cases, BCCs and SCCs rarely need staging and grading as they are often slow-growing or don’t have other high-risk features. If your skin cancer does require staging, it will be staged using the TNM staging system:
This system can also be used in combination with a numerical value, from stage 0-IV:
Cancers can also be graded based on the rate of growth and how likely they are to spread:
Once your tumour has been staged and graded, your doctor may recommend genetic testing, which analyses your tumour DNA and can help determine which treatment has the greatest chance of success. They will then discuss the most appropriate treatment option for you.
Treatment is dependent on several factors, including location, stage of disease and overall health.
Treatment options for skin cancer may include:
For more information on the treatment options, please refer to the Rare Cancers Australia treatment options page.
Risk factors that may increase the likelihood of developing skin cancers include:
Not everyone with these risk factors will develop the disease, and some people who have the disease may have none of these risk factors. See your general practitioner (GP) if you are concerned.
Symptoms of skin cancers often vary by subtype.
Symptoms of BCCs may include:
Symptoms of SCCs may include:
For the symptoms of melanoma of the skin, please refer to the Rare Cancers Australia Melanoma (Cutaneous) page.
Not everyone with the symptoms above will have cancer, but see your GP if you are concerned.
If your doctor suspects you have a melanoma, they will order a range of diagnostic tests to confirm the diagnosis, and refer you to a specialist for treatment.
Your doctor will collect your overall medical history, as well as your current symptoms. Following this, they may examine your body to check for any abnormalities. More specifically, they will examine the suspicious mole, spot or freckle.
The doctor will take images of your body using magnetic resonance imaging (MRI), a computed tomography scan (CT scan), positron emission tomography scan (PET scan) and/or ultrasound, depending on where it is suspected the cancer is. The doctor may also look at other parts of the body and looks for signs of metastasis. Additionally, a blood test may be taken to assess your overall health and help guide treatment decisions.
Once the location(s) of the cancer has been identified, the doctor will perform a biopsy to remove a section of tissue using a needle. The tissue sample will then be analysed for cancer cells.
While it is not possible to predict the exact course of the disease, your doctor may be able to give you a general idea based on the rate and depth of tumour growth, susceptibility to treatment, age, overall fitness, and medical history. Generally, early-stage skin cancers have a better prognosis and survival rates. However, if the cancer is advanced and has spread, the prognosis may not be as good and there may be a higher risk of cancer recurrence. It is very important to discuss your individual circumstances with your doctor to better understand your prognosis.
Some references are to overseas websites. There may be references to drugs and clinical trials that are not available here in Australia.
Page last updated: 17/05/2022