We operate a Skin Cancer Clinic at our centre, where the doctor is able to assess, diagnose and remove moles/lesions.
Dr Dissanayake has removed over 10 000 lesions over the past 15 years; he has extensive experience in the area of skin cancer and has attained Certificates in Primary Care Skin Cancer Medicine and Skin Cancer Surgery and maintains continuing Professional Education with updated advanced knowledge in the managment of Skin Cancer. He is a pioneering member of the Skin Cancer Society of Australia and attends both national and international conferences.
Skin cancer is the uncontrolled growth of abnormal cells in the skin.
The skin is the largest organ in the body. It covers the body, protecting it from injury, regulating its temperature and preventing it from becoming dehydrated. Skin, like all other body tissues, is made up of cells. It has two main layers called the epidermis and the dermis.
This is the top, outer layer of the skin. It contains three different kinds of cells:
Basal cells multiply constantly and the older cells move upwards in the epidermis. When they flatten out and form a layer they become squamous cells. The top layer of your skin is made up of dead skin cells that eventually fall off.
When skin is exposed to the sun, melanocytes make extra melanin to protect the skin from getting burnt. This is what causes skin to tan. Melanocytes are also found in non-cancerous (benign) spots on the skin called moles or naevi. Most moles are brown, tan or pink in colour and round in shape.
This is the layer underneath the epidermis. It contains the roots of hairs, sweat glands, blood and lymph vessels and nerves.
There are three main types of skin cancer: basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), which are non-melanoma skin cancers, and melanoma. There are other rare skin cancers, such as those that start in the sweat glands and hair follicles.
Melanoma is not discussed in detail here, refer to our melanoma page.
BCC makes up about 70% of non-melanoma skin cancers.
Basal cell carcinoma:
Often BCCs have no symptoms. They tend to grow slowly and don't usually spread to other parts of the body. The earlier a BCC is found, the easier it will be to treat. However, if BCC is left untreated or grows larger than 5cm, it may grow deeper into the skin and damage nearby tissue. This may make treatment more difficult and increase the chance of the BCC returning.
SCC accounts for about 30% of non-melanoma skin cancers.
Squamous cell carcinoma:
SCCs tend to grow quickly over several weeks or months. It is possible for SCCs to spread to other parts of the body – particularly the lips, ears, scalp or temples – if left untreated.
Bowen's disease looks like a red, scaly patch. It is an early skin cancer found in the outer layer of the skin (epidermis) and is often called squamous cell carcinoma in-situ.
Melanoma is the least common type of skin cancer but it is the most serious.
Melanoma:
Left untreated, a melanoma may spread deeper into the skin where cancer cells can escape and be carried in lymph vessels or blood vessels to other parts of the body. The earlier melanoma is diagnosed, the better the chance of cure.
Australia has the highest rate of skin cancer in the world. Two out of three Australians will be diagnosed with some form of skin cancer before the age of 70.
BCC and SCC are the most common types of non-melanoma skin cancer. In Australia, about 430,000 cases of BCC and SCC are diagnosed and treated each year. BCC can develop in young people but is most common in people aged over 40 years. SCC occurs mostly in people aged over 50.
More than 10,300 cases of melanoma are diagnosed in Australia each year.
The main cause of skin cancer is exposure to ultraviolet (UV) radiation. The sun produces UV radiation but it can also come from other sources, such as solarium tanning machines.
Most parts of Australia have high levels of UV radiation all year round. This radiation cannot be seen or felt but can cause:
Skin cancer is related to two factors: a person’s total lifetime exposure to UV radiation and the pattern of exposure they have had. Research suggests that while skin cells are often damaged in childhood, it may be sun exposure in adulthood that triggers these damaged cells to turn cancerous.
The UV Index shows the intensity of the sun's UV radiation. An Index of 3 (moderate) or above indicates that UV levels are high enough to cause skin damage and sun protection is needed.
The daily SunSmart UV Alert identifies sun protection times for more than 200 locations across Australia. It also forecasts the maximum UV Index. You can check the SunSmart UV Alert on the weather page of most daily newspapers, via a free app for smartphones or on the SunSmart website.
Anyone can develop skin cancer, regardless of their skin colour or general health. However, the risk is higher for people who have:
People with olive or very dark skin have more natural protection against skin cancer because their skin produces more melanin than fair-skinned people. However, because UV radiation is so strong in Australia, very dark and olive-skinned people still need to protect their skin.
Not all spots that appear on your skin are cancerous. However, freckles, moles or sunspots are warning signs that your skin has had too much sun exposure and you may be at greater risk of developing skin cancer.
A mole (naevus) is a normal growth on the skin. Moles develop when the pigment-producing cells of the skin (melanocytes) grow in groups.
Moles are very common. Some people have many moles on their body and this can run in families. Overexposure to the sun, especially in childhood, can also lead to more moles growing on the skin.
Moles that have an irregular shape and an uneven colour are called dysplastic naevi. People with many dysplastic naevi are at a higher risk of developing melanoma. If you have these moles, check your skin regularly for any changes and look for new skin spots. If you notice any changes, see your doctor immediately.
Red, scaly spots on the skin that feel rough are called sunspots (solar keratoses). They usually occur in people aged over 40 on areas of skin exposed to the sun, such as the head, neck, hands, forearms and legs. Rarely, solar keratoses may develop into squamous cell carcinoma.
Dermoscopy is the use of a special skin microscope. It allows the doctor to see beneath the skin's surface. The ability to see elements deeper within the skin provides the doctor with more information to make a decision regarding a suspicious skin lesion or mole.
Molescan has developed their own brand of dermatoscope and accompanying software that works as a second-opinion for the doctor, improving accuracy and efficiency. This technology also has the ability to store images of lesions on your patient file, allowing for exact comparisons to be made in follow-up consultations.
As changes to a mole or lesion are one of the biggest indicators of skin cancer, this function of the technology is invaluable to skin cancer detection.
The first aim of this is to allow very early detection of skin cancer. Dermoscopy has been shown to increase detection of early melanomas by 84.6% vs 60.9% without dermoscopy. The second aim is to increase specificity to prevent unnecessary cutting out of a skin lesion or mole that then turns out to be normal or not cancerous.
Most skin cancers are detected by people themselves or by family members. Early detection is crucial if skin cancer is to be cured. Unlike many other cancers, skin cancer is often visible, making it easier to detect in the early stages.
Make sure you check your entire body as skin cancers can sometimes occur on parts of the body not exposed to the sun.
When the UV is 3 or above use a combination of the following:
