Alexandra Stewart Encourage Skin Cancer Checks Interview

Aussie blokes considerably underestimate their risk of skin cancer and most delay doctor visits: new findings

Less than one-in-three Aussie blokes (32 per cent) consider themselves at high risk of skin cancer, despite 82 per cent reporting at least one known risk factor, such as fair hair, skin that burns easily, or spending time outdoors each week.

Moreover, most men (61 per cent) have delayed a doctor visit despite their concern about a health issue, with more than a quarter of full-time workers claiming to be too busy at work and unable to spare the time.

These Australasian College of Dermatologists (ACD) survey findings aim to reinforce the importance of early skin cancer diagnosis, treatment and prevention among men for Australia's most common cancer.

According to Dr Alex Varol, dermatologist and Fellow of the Australasian College of Dermatologists, Sydney, who has witnessed the devastating impact of skin cancer throughout her career, early diagnosis is key to successful treatment.

"As experts in the diagnosis, surgical and non-surgical treatment and management of skin cancer, including melanoma, dermatologists unfortunately see a huge number of male patients with some form of skin cancer.

"Men are at higher risk of developing both non-melanoma and melanoma skin cancer than women, but are often more reluctant to visit a doctor to have their skin checked. Often it's not until they know someone who has been diagnosed with skin cancer, that they too, suddenly realise they could be at risk of the disease," said Dr Varol.

"Removing the primary melanoma at the origin will resolve 90 per cent of cases of the disease, which makes early detection and diagnosis absolutely critical.

"It's crucial that all Australians, particularly men, prioritise their skin health, by performing regular self-skin checks for changing or non-healing marks, and visit a doctor as soon as they notice anything suspicious," Dr Varol said.

Professor David Whiteman, Deputy Director, QIMR Berghofer Medical Research Institute, Brisbane, who recently developed an online tool designed to identify individuals at high risk of melanoma in just 90 seconds, says skin cancer is an exceptionally common cancer.

"An estimated two-in-three Australians will develop skin cancer by 70 years of age, and skin cancer – a disease caused by sun exposure between 95-99 per cent of the time – accounts for roughly 80 per cent of all cancer diagnoses in Australia.

"The risk of developing melanoma and other skin cancers increases with age. This risk starts to rise noticeably at 50 years of age, and the risk curve becomes markedly steeper with advancing age," said Prof Whiteman.

Prof Whiteman is joining dermatologists and male skin cancer patients Australia-wide today, to urge men to pay more attention to their skin.

"What's most concerning about the new ACD survey findings is that Australian men are failing to recognise they are at risk of skin cancer, despite our country's high level of UV exposure.

"Melanomas are a deadly form of skin cancer and can quickly spread to other areas of the body. It's crucial men do not delay a visit to their doctor if they notice changes in their skin, no matter how busy they might be," Prof Whiteman said.

The average Australian man spends around 15 hours outdoors each week, significantly heightening his risk of skin cancer. But even those men who report multiple risk factors (54 per cent) for skin cancer, fail to consider themselves at high risk of the potentially fatal disease, the survey findings revealed.

Father-to-two, electrician and golf and motorcycle enthusiast, Jeffrey, 59, Sydney, was diagnosed with skin cancer last year after a chance meeting with a doctor on a job site who spotted a suspicious-looking mole on his neck.

Jeffrey, whose father was similarly diagnosed with skin cancer in his late 60s, promptly visited his General Practitioner (GP), and was immediately referred to a dermatologist, who subsequently diagnosed him with melanoma.

"I'm so fortunate that the doctor who I was working for at the time, spotted a suspicious-looking mole on my neck and recommended I visit my doctor urgently for examination. It was such a coincidence, and I will remain forever thankful to him, because he probably saved my life. I couldn't imagine leaving my wife and my two daughters behind, or how horrible the situation could have proven had I not acted promptly.

"I'd always planned on getting my skin checked in my sixties, around the same age that my dad was diagnosed with skin cancer, but because I was a bit younger, I just put it on the backburner," said Jeffrey.

Having since learned that an Australian dies every five hours from skin cancer,5 and after experiencing various other scares himself following his initial melanoma diagnosis, Jeffrey encourages every adult to visit their GP for a skin check, particularly men, especially if they recognise a changing mark on their skin.

"I urge every man, particularly those aged 50 and above, to visit their GP for a skin check sooner, rather than later, because they may fail to notice a suspicious mark on their skin that requires a second, professional pair of eyes.

"Maintaining skin health is critical. Burying your head in the sand could literally kill you," Jeffrey said.

The ACD survey findings also revealed exposure to someone who has been diagnosed with skin cancer is a strong risk factor that determines personal, perceived risk. Among the survey respondents who knew someone who had been diagnosed with skin cancer, 46 per cent considered themselves at high risk of developing the disease themselves. In contrast, only 12 per cent of the survey respondents who knew no-one who had been diagnosed with skin cancer, considered themselves to be at high risk of the disease.

If you notice any new or unusual marks on your skin, visit your GP immediately and they will discuss your options with you and advise whether you may need a referral to a dermatologist for expert skin health advice.

To learn more about skin cancer and the important role played by a dermatologist in the diagnosis, treatment and prevention of skin cancer, visit www.dermcoll.edu.au.

Interview with Alexandra Stewart

Question: What do you hope to achieve by being involved in this particular campaign surrounding skin cancer?

Alexandra Stewart: My hope is to bring some reality to the consequences of not having a suspicious mole checked. My reality is that my father may have lived a much longer life. He would have been a part of the milestone events and celebrations that happen within my life and within the life of his other children. The greatest achievement would be to get the message out there that early detection of skin cancer really can save lives.


Question: Are you able to talk us through your experiences with skin cancer?

Alexandra Stewart: Quite frankly, living through my father's skin cancer was horrendous, particularly during his last seven months. He had obviously let a suspicious mole go unchecked which lead to his malignant melanoma, but he also became less diligent with his follow-up assessments. The cancer spread beyond a manageable point. I was there when the oncologist told him that he didn't have much time left. It was awful. I could see the desperation in his face about wanting more time. It was a look of panic, fear and guilt all rolled into one. He now wished that he had had the mole checked when he first noticed changes in it years ago.

At this point more serious surgery was needed which meant he became much less independent - something he hated. It was at this time that I had to push for certain medications for him just to get him that small amount of extra time that he craved. It was not long before the treatments became less effective and he passed away. The time for me was hectic. I was trying to run my business and make sure he received the care he needed, all while living two hours away from him. I moved in with my brother for some time to be in the same town. My father needed me at his appointments so there was no other option than to be available at short notice. It wasn't ideal for my family but I wouldn't have changed it.


Question: And, could you tell us about your breast cancer diagnosis and treatment?

Alexandra Stewart: I was diagnosed in 2005, a year before my father's diagnosis. I had felt a tiny lump and had it checked in 2004 but the doctor felt it couldn't have been breast cancer because of my age and it was probably just hormonal. The lump sat there unchanged until it grew very rapidly and was painful. It was then I needed a second opinion. Cancer's timing is never convenient but a diagnosis only nine weeks before my wedding was a bit hard to take. I had a right mastectomy one week after diagnosis followed with chemotherapy. The chemotherapy made me violently ill and I would have to be admitted to hospital after every session to control the nausea. I hated everything about chemo because before that, I had still felt well. Now I looked unwell too. A year later I had my left breast removed as a precautionary measure. My husband and I felt we just had to do everything available to us to ensure longevity and peace of mind. I have had many surgeries to deal with my breast cancer and the treatment side-effects and I am now many years into remission.


Question: What advice do you have for women wanting to encourage the men in their life to have skin cancer checks?

Alexandra Stewart: I would say it is absolutely worth encouraging all the men in your life to have regular skin cancer checks, particularly if you think you have noticed any changes with moles or freckles etc. Sometimes using statistics will help encourage a man to take action. Others respond to a story about a real life scenario.


Question: Is there a particular way you'd encourage the men in your life?

Alexandra Stewart: I would say highlight the consequences of not having a skin cancer check. Speak to the part of him that cherishes what is in his life right now, this is usually family. Highlight how it would be for family not to have him around for family celebrations and milestones all because he didn't have a skin cancer check - something that is ridiculously simple and quick.


Question: What would you describe as a suspicious symptom in regards to skin cancers?

Alexandra Stewart: Changes in shape and size of moles and freckles and any changes in the skin around a mole too, such as itchiness.

Alexandra's Story

Dragon boat enthusiast, business owner and breast cancer survivor who lost her father to skin cancer.

Dragon boat enthusiast, business owner and breast cancer survivor, Alexandra, 48, Melbourne, lost her father to skin cancer in 2015, at 77 years of age.

In 2006, a year after she was diagnosed with breast cancer, Alexandra's father, Edward, then aged 63, was also diagnosed with (skin) cancer.

Despite noticing a suspicious-looking mole on his back, and ignoring various calls by his children to have a professional skin check for more than a year, Edward finally visited his GP. But by then, it was too late.

Edward's cancer had metastasised to his bones, and 14 years later he lost his battle to skin cancer.

This is Edward's story, relayed through the eyes of his daughter.

"My father hated going to the doctor. He always had the attitude that things would resolve in time, without treatment," said Alexandra.

"One day dad noticed a strange-looking mole on his back which he showed my brother. But my brother and I just couldn't convince him to promptly visit his GP for a skin check. In fact, he delayed his visit for more than a year."

By the time Edward had finally summoned the courage to visit his GP, it was too late.

"In 2006, dad finally visited his GP for a skin check after his mole started to bleed. By this time, the mole had developed into an aggressive form of melanoma, and had also formed polyps in dad's colon.

"He had to have the mole removed and to undergo a colonoscopy every 12 months thereafter. But dad wasn't diligent with his medical check-ups, which made the situation even worse," Alexandra said.

A few years later, Edward began to experience severe pain in his hip.

"In 2014, my dad started to complain about pain in his hip. He mistakenly assumed he had torn a muscle at the time. Fortunately on this occasion, we managed to persuade him to seek professional advice.

"After undergoing various tests, my dad was informed that the cancer had spread to his bones, and had in fact, almost completely eaten through his hip," said Alexandra.

"The cancer had spread to seven different sites throughout his body, including his bones, brain, lungs, liver and lymph system."

Soon after this devastating news, Edward commenced chemotherapy.

"The doctors started dad on two chemotherapy medications, but made it very clear that there was very little they could do.

"The medications made dad feel really unwell, and he spent days heading to and from hospital. I actually had to relocate to Bendigo to live with my brother, to help look after dad, because he couldn't drive on the medication he was taking," Alexandra said.

Edward passed away in February 2015, after an arduous 14-year-long battle with skin cancer.

"In 2014, just before Christmas, my father started to feel really unwell again. He was also bleeding when he went to the toilet, and although he knew the cancer had returned, he had chosen not to share this information with anyone else.

"Dad passed away two months later," said Alexandra.

One of Edward's biggest regrets in life was not visiting his GP for a skin check as soon as he noticed the suspicious-looking mole on his back.

"In the end, dad definitely regretted not acting quickly enough after first noticing his changing mole. Had he done so, it may have been a completely different story.

"Toward the end of his journey with skin cancer, dad often used the phrase, 'it's better out than in', and hoped to share his personal story with others, so that no one would have to experience the pain and anguish that he went through," Alexandra said.

"Given my personal experience of losing a loved one to skin cancer, I would strongly encourage every Australian adult to visit their GP for a regular skin check. My dad's dermatologists were also very helpful during the treatment process and taught dad a lot about what to look out for on his skin.

"Losing someone to skin cancer is so heartbreaking for all involved, yet the disease is preventable," said Alexandra.

"After all, there's certainly no shame in staying safe."

Interview by Brooke Hunter