University of Newcastle researcher Conjoint Associate Professor Fiona Day from HMRI’s Cancer Detection and Therapy research program wants Australians to know about the other kinds of skin cancers. 

Fiona is a Medical Oncologist at Newcastle’s Calvary Mater Hospital and treats patients for squamous cell carcinoma (SCC).  

She says, “Skin cancers are the most common malignancies in Australia and their incidence is rising.  While melanoma is the most likely skin cancer to spread elsewhere in the body, squamous cell carcinomas are more common and also cause substantial harm.   

“Squamous cell carcinomas (SCCs) are strongly related to sun exposure and to increasing age. Some people are particularly at risk, for example those that work outdoors and people who need to take immunosuppressive medications for other health problems,” says Fiona.  

Many SCCs occur in the head and neck region (70 per cent) due to this area’s constant sun exposure, with the next most common areas being the legs, arms and hands.  

While the majority of SCCs can be cured with surgery and/or radiotherapy, the treatment can be disfiguring due to the need for excision of segments of the ears, nose, lips, eyes and sometimes skin grafts.  

Radiotherapy may also cause chronic changes to the skin and underlying structures with resultant cosmetic effects. People who have had one SCC are more likely to be diagnosed with another SCC in the future, and need treatment again.  

David’s story of survival 

One of Fiona’s patients, David Graf, has had over 40 SCCs excised from his face, ears, legs (shins and behind his knees) and chest, 

David, 78, has his first SCC cut off his ear in 2005.  

He says, “The local GP did it.” 

David, who was living in Armidale at the time, says that his work as an engineer meant he spent a lot of time outdoors.  

He also says that his childhood was sunsoaked, between fishing, the beach and playing cricket.  

“We just didn’t know back then. My mother has auburn hair and fair skin so my genes aren’t really suited to Australian sun,” says David.  

In 2021, David’s doctor found an inoperable SCC that had metastasised. He then had to have radiation that caused 16kgs weight loss, mouth ulcers and pain.  

“I couldn’t eat. It affected my speech and swallowing,” says David.  

In October last year, David started immunotherapy with Fiona.  

“The MRIs and PET scans are showing that things are under control. There are no real side effects – I’m just a bit tired,” says David.  

When it comes to things to look out for, David says that SCCs look like little sores.  

“You rub them and they’re rough. If you scratch them, they bleed and they don’t heal. The last one I had was in the corner of my eye. My doctor now checks my mouth and between my toes. They’re still coming up. I have lumps around my head now and they tend to appear on the right side of my face which is the side that’s exposed to the sun when you’re driving,” he says.  

Fiona explains that about one in twenty SCCs cannot be cured due to their large size or because they have spread to the lymph nodes or elsewhere in the body. SCCs may also spread along nerves and affect the sensation and muscles of the face.  

“For these patients, treatment is aimed at controlling the cancer and its symptoms for as long as possible. Immunotherapy has recently proven highly effective for incurable SCC and is transforming the lives of patients affected by this cancer,” says Fiona.  

One thing David wants everyone to know is that a regular brain scan will only investigate the top of your head.  

“You need a skull base MRI to determine whether you have a problem with the cheek or jaw. If you are concerned, you need to request this type of MRI so that you have peace of mind. I want people to know this because that’s where they found one of my cancers. A regular brain scan wouldn’t have picked it up,” says David.  

How to protect yourself from SCC 

1. Practice sun safety: 

• Slip on protective clothing that covers as much skin as possible, preferably clothing that carries an ultraviolet protection factor (UPF), which is a guarantee of how much UV protection a fabric provides.

• Slop on SPF 50+ (or higher) broad-spectrum, water-resistant sunscreen. Reapply every two hours, especially after swimming or sweating. 

• Slap on a wide-brimmed hat to protect your face, ears, and neck. 

• Seek shade during peak UV hours (10 am–3 pm). 

• Slide on sunglasses that meet Australian standards to protect your eyes. 

2. Check your skin regularly: 

• Look for new or changing spots, sores that don’t heal, or rough patches of skin that bleed easily. 

• Pay attention to areas often exposed to the sun, like the face, neck, arms, and hands. 

3. See your doctor: 

• Have any unusual or persistent skin spots checked by a GP or dermatologist. 

• If required, get a biopsy to confirm the diagnosis. 

Sun safety is your best defense against skin cancer.