How to protect yourself from skin cancer

Introduction

It's never too late to start incorporating sun safety practices into your daily routine.

In the 1980s, the way Australians viewed sun protection changed. The Cancer Council launched the catchy ‘Slip Slop Slap’ television campaign to remind people to ‘slip on a shirt, slop on sunscreen and slap on a hat’.

We now know how important sun protection is for preventing skin cancer1, particularly during childhood2. But what about those born before 1980? Many Australians spent carefree childhoods running around in the sun, without any sun protection at all. Has the damage already been done?

You’ll be pleased to know it’s not too late to prevent further skin cancers from developing. Here we talk about skin cancer in older people, how you can prevent it and what you should do if you see something suspicious.

Skin cancer in Australia

Australia has the unenviable title of being the skin cancer capital of the world1. Every year, more than 11,500 Australians are diagnosed with melanoma and an estimated 434,000 people are treated for non-melanoma skin cancers (non-melanoma cancers aren’t required to be reported to cancer registries). This is around 80% of new cancer diagnoses in Australia each year1.

The most common skin cancers to affect older Australians are non-melanoma skin cancers, now called keratinocyte cancers. These include basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) which have an average age of diagnosis of 76 years old3.

Melanoma is the most dangerous form of skin cancer and has an average age of diagnosis of 65 years of age4. It’s considered more serious because it’s more likely to spread to other parts of the body if it isn’t found and treated early.

Around 99% of non-melanoma skin cancers and 95% of melanomas in Australia are because of sun exposure from ultraviolet (UV) rays5. According to Professor Anne Cust, Chair of Cancer Council’s National Skin Cancer Committee, this means some areas in Australia have more skin cancer than others.

“Everywhere in Australia has high incidence of skin cancer, but it's particularly so in Queensland. So you can see that obviously, climate has a role and the amount of time people spend outside,” she said.

How can we prevent skin cancer?

From sun protection to keeping an eye on our skin, there are many ways we can prevent skin cancer.

Protect your skin from the sun

The best way to prevent skin cancer is to reduce your exposure to the ultraviolet radiation (UV) from the sun, no matter your age. Professor Cust said there are a substantial proportion of older Australians who think that the damage has already been done in their youth and there isn’t anything they can do now to prevent cancer.

“We definitely know that changes in preventive behaviours can influence future skin cancers, no matter what age you are,” she said.

“There was a big sunscreen trial done in Nambour a few years ago. It was a really high-quality study, and it showed that using sunscreen, reduces your risk of skin cancer . When they looked at it by different age groups, it showed that even at older ages, starting to use sunscreen every day, reduced your risk of new skin cancers developing,” she said.

When choosing sunscreen, make sure to choose one with SPF 50 or above. Ultraviolet radiation consists of both UVA (causes ageing and reduces elastin) and UVB (tans and burns the skin) components7 so it’s important to choose a broad-spectrum sunscreen that will protect against both.

As sunscreen in Australia is highly regulated. Professor Cust said that regardless of price, you know it’s a high-quality product.

“The main thing with sunscreen is to just find one that you like the consistency of because the best sunscreen is the one that you wear and that you apply enough of,” she said.

Cancer survivor and CEO of Australian Skin Cancer Foundation Jay Allen agreed that it’s important to not just apply sunscreen in the morning.

“It’s also about reapplying sunblock (throughout the day). And remember to stay out of the sun on the really harsh days, especially during summer,” he said.

In 2007, the Slip Slop Slap message got updated to Slip, Slop, Slap, Seek, Slide so now we’re also reminded to seek shade and slide on sunglasses in addition to wearing a shirt, sunscreen and a hat.

Keep an eye on the UV index, which you can find out through the SunSmart app. If the UV index is three or above, then you should be using sun protection.

Monitor skin for changes

Considering older people are more at risk of skin cancers, it’s important to keep an eye on skin changes. When it comes to looking out for Melanoma, there’s an easy ABCDE guidelines8 to remember.

• A is for asymmetry: normal moles or freckles are typically symmetrical so moles that are not symmetrical in appearance should be investigated.

• B is for border: get checked if the borders aren't even and have jagged edges.

• C is for colour: if it’s not the same colour all over or it's got pigment spots in it, it could be suspicious.

• D is for Diameter: if it’s bigger than six millimetres in size, about the size of a pencil eraser, and is growing, you should get it checked out.

• E is for Elevation: Moles that are raised or have an uneven surface should be investigated.

Professor Cust said it’s also important to know your skin.

“Melanomas can develop from an existing mole, but it can also be a new spot that occurs. So spots that look different to the other moles or spots around them, anything that's changing, you should bring it to the attention of the doctor,” she advised.

Non melanoma skin cancers BCCs and SCCs often look like scaly, itchy or dry areas that can be rapidly growing. Sometimes they may even be a sore that hasn’t healed or looks shiny and bright pink in colour.

“Anything like that, bring it to the attention of the doctor. Sometimes those early precursors to skin cancer can be treated quite easily with creams or freezing,” Professor Cust said.

Get your skin checked regularly

Even if we’re regularly checking our skin, changes can be missed. There might be a mole in a hard to see place like the scalp or the back. Or some people may have many freckles and moles, so keeping track of changes can be difficult.

Which is why it’s important for everyone get checked for skin cancer regularly. You could visit:

• Your GP who could give you a referral to a dermatologist.

• A skin cancer clinic. You can search for local clinics through Health Direct.

• The Australian Skin Cancer Foundation’s Skin Check Truck. Learn more about their free skin checks and where they’re travelling next.

The five-year survival rate for people diagnosed with melanoma is 94% which has increased in the past 30 years9. However early diagnosis is crucial.

“The earlier you go in and get your skin checked, chances are, you're going to be alright,” Mr Allen said.

What about vitamin D?

It’s also important to note that a small amount of sunlight is important for good health. Vitamin D comes mainly from the sun and essential for bone and musculoskeletal health. Older adults are often as risk of Vitamin D deficiency, and it can contribute to hospitalisations for falls and hip fractures10.

The amount of sun exposure a person needs to make enough vitamin D won’t be the same for everyone. It will depend on a person’s skin colour and where they live. To help, experts have recently developed new advice for people with various skin types so everyone knows how much time is safe to have in the sun11.

“If you've got very fair skin, you need less sun exposure than someone with very dark skin to make the same amount of vitamin D. It depends on where you live, so closer to the equator, you will need less time outside to get sufficient vitamin D. And it obviously also depends on the clothing that you're wearing,” Professor Cust explained.

While we can’t turn back the clock on sun exposure, we can be proactive about it now. By remembering to Slip, Slop, Slap, Seek and Slide and getting regular skin checks, you can help protect your skin and enjoy your golden years with health and confidence.

Disclaimer: The information provided on this website is not a substitute for individual health advice from a doctor or skin specialist.