Know the risks of skin cancer

Dr. Jim Muir: My name‘s Doctor Jim Muir, I am a specialist dermatologist, I only deal with diseases of the skin. Being in Queensland I spend most of my time dealing with skin cancer. I work in private practice, I work at the Mater Public Hospital in Brisbane.

Malignancy means skin growing out of control. It’s reproducing itself in a disorganised way and it’s producing more of itself. And with some malignancies they have the ability then to go into your bloodstream or your lymphatic stream to spread to other parts of your body. With melanoma that’s what kills you, it’s not the malignant melanoma in your skin per say that’s dangerous. It’s the fact that that melanoma can then grow out of control and spread to your liver or your brain, lungs or your bone and that’s what ultimately kills you.

If you want to identify suspicious moles on your skin, the first thing is to be aware of what your skin is like. The earliest sign of malignancy is often just change. That way you can go to the doctor and say, look I’m a bit worried about this one and the reasons I am worried are that—it’s changed in some way, its starting to bother me, its starting to itch, ooze or ulcerate and then you can get it sorted out. Remember it’s very easy for the doctor to confirm or deny whether something is a skin cancer. They are very readily accessible, it’s usually a very easy and simple operation just to remove a mole and look at it under a microscope. It’s not like lung cancer, breast cancer or bowel cancer where there is a lot of to do to sort it out.

So you can take an active role in surveilling your skin and helping your doctor to help you. The big thing to remember about sun damage is that is it cumulative over your lifetime. The sun damage you get when you are five, ten and twenty-five contributes to your premature ageing and your increased risk of skin cancer when you are older.

So just in everyday life, especially in an area like Queensland where there is lots of sun around, you will get incidental sun exposure that contributes to your total burden of sun damage and increases your risk of skin cancer. So you should be taking some sun protective measures everyday. You should wack on sun block at the start of the day and will protect you from the 10 or 15 of 20 minute sun exposure that you get, even if you are in an office job going to and from work.

Well I think you’ve got to live. One of the things that always annoys me with some people is that they’ve been told they should never go out in the sun. That’s just crazy, we live in Queensland we have great things to do outdoors and I think people should live their lives. They should do whatever it is they want to do, and if it involves outdoor exposure they you should just take simple measures that will reduce the amount of sun damage you get when you are outdoors.

If you have a choice between, going outdoors with sun protection or without sun protection—use sun protection. Use your factor thirty sunscreen, put it on half an hour before you go out in the sun because that means it binds onto the skin and will stay there when you get sweaty and wet. Use clothing wherever you can. So if you are going surfing wear a rash top that will save you a lot of money in the long run, because you are only going to have to put sun block on the areas that are exposure. If you are playing cricket where a long sleave shirt, wear a broad brimmed hat. If you are going to be out in the sun for a long prolonged period of time repeat your application of sun block every couple of hours, because you will sweat it off and wipe it off on your clothing.

If you want to look old when you are forty-five or older than you would otherwise, then get your sun exposure now. Cause that is what is going to get your wrinkles and that is what is going to cause premature aging.

Dr. Michael Kimlin: So with UV it’s really important not to equate feeling hot with actual sunlight or UV exposure. So that’s why it’s really important particularly in these cooler months in Queensland that people protect their skin during winter because you can’t feel or see UV. Now our UV levels here in winter are actually as high as summer time levels in Europe. So we need to look after our skin all year long. And because you can’t see it or feel it, you need to look at these daily protection strategies such as sunscreen and clothing.

UV indexes are a way that we have come together as a scientific community to come up with a very simple to use scale, that the higher the number equals the higher the UV exposure. That’s what the UV index is. Anything over a UV index 11 is considered extreme so you really do need to take caution with anything over UV index 11.

In Brisbane in summer we had UV indices in the middle of the day of somewhere around sixteen, seventeen or perhaps even eighteen. And in winter we are getting peak UV indices of around about eight or nine during winter. So remember the higher the number the more chance you have of accruing having skin damage. So you need to keep an eye on the newspaper and the weather report, because there you will get the UV index value to give you a guide on what sun protection you should do the next day.

Feeling heat we don’t have detectors in our skin to detect UV. We do have detectors in our skin to detect heat incase we pick up a hot cup of tea. But unfortunately because Mother Nature hasn’t given us UV sensors in our skin, we are unable to actually detect when damage is occurring to our skin, until it is too late and we have sunburn.

So, we can still get burnt on a cold, cloudy day and in fact sometimes even more at risk on a cold cloudy day, because the light can actually be scattered all around and you can get sun burnt quite bad. A great example is that on a winter’s day you can still get sun burnt, especially if you go skiing out in the snow. Where even in the middle of winter you can get enough sunlight exposure, even in a few hours to get sun burnt.

So I think it is important that people realize that there is a disconnect between what you feel and what the temperature is outside, and what the burning capability of the sun is.

Look a UV index as I said is a guide to let you know how strong the sun is and in Queensland it is strong all the time. So we should be thinking of sun protection all year and ways we can reduce sun exposure; sunscreen, hats and sun avoidance. I think sun avoidance is something that we really need to think about, because it is a very cheap and simple way of reducing individual sun exposure. As simple as instead of eating your lunch outdoors or having a coffee outdoors, going inside even for an hour or two can actually reduce your exposure significantly.

How to protect your skin? Well a good way to protect your skin is to avoid the sun, that’s certainly getting out of the sun is the best way to reduce your exposure. But thinking about appropriate clothing, and believe it or not wearing even something as simple as a long sleeve shirt and long sleeve pants can reduce your exposure significantly. Hats and sunscreen as well are a good way to reduce exposure.