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Sources and references Will I get more skin cancers?
If you’ve had skin cancer, you have a higher risk of getting more. You’ll need regular checks-ups to see if the cancer has come back and check for new ones. It’s common to have check-ups every 3–6 months if you had a high-risk cancer, and every year for low-risk cancers. People who have a weakened immune system may have more frequent check-ups. Your doctor will tell you how often they need to examine you.
It’s very important to avoid more skin damage, check your skin often, and see your doctor if you notice a change.
Sun protection and UV
After a skin cancer diagnosis, you need to take special care to protect your skin from the sun’s UV radiation. UV radiation is not the same as sunshine – UV levels can be high on a cloudy day or at the snowfields.
The UV index shows the intensity of the sun’s UV radiation. It can help you work out when to use sun protection. An index of 3 or above means that UV levels are high enough to damage unprotected skin. Using a sunscreen daily when the UV level is forecast to be 3 or above has been shown to reduce the risk of skin cancer. But when UV levels are 3 or more, you need to use more than one type of sun protection, including protective clothing, a hat, sunscreen, sunglasses and seeking shade.
The recommended daily sun protection times are the times of day the UV levels are expected to be 3 or higher. The daily sun protection times will vary according to where you live and the time of year.
Some medicines and health conditions may make the skin more sensitive to UV radiation, causing it to burn or be damaged by the sun more quickly or easily. Ask your doctor if this applies to you and if there are any extra things you should do to protect your skin. You may need to use sun protection all the time, whatever the UV level is.
Vitamin D
UV radiation from the sun causes skin cancer, but it is also the best source of vitamin D. People need vitamin D to develop and maintain strong, healthy bones. The body can absorb only a set amount of vitamin D at a time. Most people can get enough vitamin D through incidental exposure to the sun, while using sun protection. When the UV index is 3 or above, this may mean spending just a few minutes outdoors on most days of the week, depending on where in Australia you live and the time of year. However, people with naturally very dark skin tones, who do not burn, may need longer sun exposure to get enough vitamin D.
After a diagnosis of skin cancer, talk to your doctor about the best ways to get enough vitamin D while reducing your risk of getting more skin cancers. Your doctor may advise you to limit your sun exposure as much as possible when the UV index is 3 or above. In some cases, this may mean you don’t get enough sun exposure to maintain your vitamin D levels. Your doctor may advise you to take a supplement. Overexposure to UV is never recommended.
How to protect your skin from the sun
Most skin cancers are caused by exposure to the sun’s UV radiation. When UV levels are 3 or above, use all or as many of the following ways to protect your skin as possible. After a diagnosis of skin cancer, it is especially important to check your skin regularly and follow SunSmart behaviour.
Do:
Slip on clothing
Wear clothing that covers your shoulders, neck, arms, legs and body. Choose closely woven fabric or fabric with a high ultraviolet protection factor (UPF) rating, and darker fabrics where possible.
Slop on sunscreen
Use SPF 50 or SPF 50+ broad-spectrum, water-resistant sunscreen and apply every morning. Apply 20 minutes before going outside and reapply every 2 hours, or after swimming, sweating or activity that rubs it off. For an adult, use about 7 teaspoons of sunscreen to cover the full body. If you’re wearing protective clothing, use 1 teaspoon for each exposed arm, leg, or face, neck and ears.
Slap on a hat
Wear a hat that shades your face, neck and ears, such as a legionnaire, broadbrimmed or bucket hat. Check that the hat meets the Australian Standard. Choose fabric with a close weave that doesn’t let light through. Baseball caps and sun visors don’t offer full protection.
Slide on sunglasses
Protect your eyes with sunglasses that meet the Australian Standard (with a lens category of 2, 3 or 4). Wraparound styles are best. Sunglasses should be worn all year round to protect both the eyes and the delicate skin around the eyes.
Seek shade
Use shade from trees, umbrellas, buildings or any type of canopy. UV radiation is reflective and bounces off surfaces, such as concrete, water, sand and snow, so shade should never be the only form of sun protection you use. If you can see the sky through the shade, even if the direct sun is blocked, the shade will not completely protect you from UV radiation.
Check daily sun protection times
Each day, use the free SunSmart Global UV app to check the recommended sun protection times in your local area, and use sun protection when the UV is 3 or above. For more information, visit sunsmart.com.au. You can also find sun protection times at the Bureau of Meteorology website or the BOM Weather app or in the weather section of daily newspapers.
Don't:
Don't use solariums
It is not safe to use solariums. Also known as tanning beds or sun lamps, solariums give off artificial UV radiation and are banned for commercial use in Australia.
Changes to your appearance
Skin cancer treatments such as surgery, curettage and electrodesiccation, and cryotherapy often leave a scar. In most cases, your doctor will do everything they can to make the scar less noticeable. Most scars will fade with time. Skin treated with radiation therapy may change in colour, and appear lighter or darker depending on your skin tone.
Talk to your radiation therapy team about the best options for skincare. Talk to your doctor or nurse about treatments that can help improve the appearance of scars, such as silicone gels and tapes and non-perfumed creams (e.g. sorbolene). Steroid injections to flatten out lumpy scars may also be an option for some people.
You may worry about how scars look, especially on the face. Cosmetics, your hairstyle or clothing may help. You can talk to a counsellor, friend or family member about how the changes make you feel.
Look Good Feel Better
Look Good Feel Better is a national program that helps people manage the appearance-related effects of cancer treatment. Workshops are run for men, women and teenagers. For information about services in your area, call 1800 650 960 or visit the Look Good Feel Better website.
I had skin cancer removed from my arm followed by a skin graft from the same arm. I have a large ‘indent’ from the removal of the cancer and a large scar at the donor site. I didn’t expect the amount of pain and appearance changes."
David
Seeking support
Useful websites
You can find many useful resources online, but not all websites are reliable. These websites are good sources of support and information.
Australian
- Cancer Council Australia
- Cancer Council Online Community
- Cancer Council podcasts
- Guides to Best Cancer Care
- Bureau of Meteorology
- Cancer Australia
- Cancer Council Australia Sun safety
- Carer Gateway
- Department of Health, Disability and Ageing
- Healthdirect Australia
- Melanoma and Skin Cancer Advocacy Network (MSCAN)
- Services Australia
- Skin Cancer College Australasia
- The Australasian College of Dermatologists
International
Question checklist
Asking your doctor questions will help you make an informed choice. You may want to include some of the questions below in your own list.
Diagnosis
- What is this spot on my skin?
- Will I need a biopsy or excision?
- What is my biopsy result? Do I have skin cancer?
- What type of skin cancer is it?
- Did the biopsy or excision remove all the skin cancer?
- Are there clinical guidelines for this type of cancer?
Treatment
- What treatment will I have?
- Will I need further treatment or follow-up? If so, what do you recommend?
- Do I need to see a dermatologist or surgeon?
- I’m thinking of getting a second opinion. Can you recommend anyone?
- How long will treatment take?
- If I don’t have the treatment, what should I expect?
- Are there any out-of-pocket expenses not covered by Medicare or my private health cover? Can the cost be reduced if I can’t afford it?
Side effects
- Will I have a lot of pain? What will be done about this?
- Can I work, drive and do my normal activities while having treatment?
- Will there be any scarring after the skin cancer has been removed?
- When will I get my results and who will tell me?
After treatment
- Is this skin cancer likely to come back?
- How often should I get my skin checked?
- Where can I go for follow-up skin checks?
- Will I need any further tests after treatment is finished?
- How can I prevent further skin cancers?
Sources and references
This edition has been developed by Cancer Council NSW on behalf of all other state and territory Cancer Councils as part of a National Cancer Information Subcommittee initiative.
All updated content has been clinically reviewed by Prof Victoria Mar, Director, Victorian Melanoma Service, Alfred Hospital and Monash University, VIC and Prof Anne Cust, Acting Director, The Daffodil Centre, The University of Sydney and Cancer Council NSW, and faculty member, Melanoma Institute Australia.
This edition is based on the previous edition, which was reviewed by the following panel: Prof Victoria Mar (see above); Tracey Bilson, Consumer; Raelene Buchan, Consumer; Alison Button-Sloan, Consumer; Dr Margaret Chua, Radiation Oncologist, and the Skin Radiation Oncology team, Peter MacCallum Cancer Centre, VIC; Prof Anne Cust, (see above); A/Prof Paul Fishburn, Skin Cancer Doctor, Norwest Skin Cancer Centre, NSW and Faculty of Medicine, University of Queensland; Danielle Goss, Melanoma Clinical Nurse Specialist, Amie St Clair Melanoma (part of Melanoma Institute Australia), Wagga Wagga, NSW; Louise Pellerade, 13 11 20 Consultant, Cancer Council WA; Dr Shireen Sidhu, Head of Dermatology, The Royal Adelaide Hospital, SA; Dr Amelia Smit, Research Fellow – Melanoma and Skin Cancer, The Daffodil Centre, The University of Sydney and Cancer Council NSW; Dr Tony Tonks, Plastic and Reconstructive Surgeon, Canberra Plastic Surgery, ACT.
We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.
Thanks also to Sydney Melanoma Diagnostic Centre for providing the dysplastic naevus photograph on page 11, A/Prof Paul Fishburn for providing the sunspot photograph on page 10, A/Prof Andrew Miller for providing the age spot photograph on page 10, and Prof H Peter Soyer for providing the other photographs on pages 9–11.
Cancer Council 13 11 20
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Guide to best cancer care
This skin cancer guide explains the standard of high-quality cancer care that all Australians can expect, from diagnosis, to treatment, recovery, and living with cancer.