Skin cancer is among the most treatable cancers, particularly when detected early. Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) have extremely high cure rates, while early-stage melanoma also has survival rates exceeding 99%. If it’s so treatable, why do people still die from it? It is because of late detection in diverse skin tones, rare aggressive subtypes, or lack of access to Mohs.
In Australia, often called the ‘skin cancer capital of the world’, statistics show that 2 in 3 Australians will be diagnosed with some form of skin cancer by the age of 70. Treatment options range from simple excisions and topical medications to advanced therapies like Mohs surgery, radiation, and immunotherapy. Early detection is critical, as it allows for minimally invasive procedures with rapid recovery. Regular skin checks, self-exams, and prompt dermatological evaluation ensure that most skin cancers are successfully treated with long-term remission.
Types of Skin Cancer and Their Curability
Basal Cell Carcinoma (BCC)
BCC is the most common skin cancer, accounting for nearly 80% of all cases. It grows slowly, rarely spreads, and is highly curable. Early detection allows removal via excisional surgery, topical treatments, or Mohs micrographic surgery. Cure rates exceed 99% for early-stage BCC, making it the most manageable skin cancer type.
Squamous Cell Carcinoma (SCC)
SCC develops from prolonged UV exposure and is slightly more aggressive than BCC. Early-stage SCC responds exceptionally well to surgical excision, curettage, and electrodessication or Mohs surgery. The five-year cure rate ranges from 95 to 98%, while advanced or untreated SCC may require more intensive treatments.
Melanoma
Melanoma is less common but more dangerous due to its ability to spread rapidly. When caught in early stages, surgical removal is usually curative, with a five-year survival rate of around 99%. Advanced melanoma may require targeted therapy, immunotherapy, or radiation. Modern treatments have dramatically improved outcomes, even for metastasised cases.
Critical Factors in Treatability: Skin Tone and Rare Subtypes
While the statistics for skin cancer survival are overwhelmingly positive, treatability is not a “one size fits all” metric. Two specific factors, skin pigment and cancer subtype, drastically change the clinical outlook.
Skin Cancer in Skin of Colour (Melanin-Rich)
A common misconception is that high melanin levels provide total immunity to skin cancer. While the incidence of skin cancer is lower in Black, Hispanic, and Asian populations, the mortality rate is often higher.
- Late-Stage Discovery: Because lesions can look different on darker skin (often appearing as purple, brown, or even greyish patches), they are frequently misidentified as benign conditions like eczema or hyperpigmentation.
Acral Lentiginous Melanoma (ALM): This specific, aggressive subtype of melanoma often appears in non-sun-exposed areas, such as the palms of the hands, soles of the feet, or under the nails. Because these areas are rarely checked during routine exams, the cancer is often diagnosed at a later stage, significantly reducing the “99% treatability” seen in early-stage cases.
High-Risk and Rare Subtypes
Beyond the common BCC and SCC, certain subtypes require more aggressive, immediate intervention:
- Amelanotic Melanoma: These are “colourless” or pinkish moles. Since they lack the typical dark pigment of a standard melanoma, they often go unnoticed by patients until they have reached a dangerous depth ($>1\text{mm}$).
Merkel Cell Carcinoma: This is a rare but highly aggressive form of skin cancer. While less common than BCC, it grows much faster and requires specialised immunotherapy early on to maintain a positive prognosis.
Common Skin Cancer Treatments
RF treatments like Thermage, Profound RF, or Morpheus8 use electromagnetic energy to heat the dermis, causing instant collagen contraction and stimulating new collagen formation.
Mohs Micrographic Surgery
In our clinical experience, patients choosing Mohs surgery for nasal lesions see significantly better cosmetic outcomes and a lower 5-year recurrence rate compared to standard excision. Layers of cancerous tissue are removed one at a time and examined microscopically until no cancer cells remain. It preserves healthy skin, minimises scarring, and offers the highest cure rates (up to 99%).
Excisional Surgery
Excision involves cutting out the tumour along with a margin of healthy tissue. It is commonly used for both melanoma and non-melanoma cancers, offering very high success rates with minimal recurrence.
Curettage and Electrodessication
This procedure involves scraping the tumour with a curette, followed by cauterisation with an electric needle. It is commonly used for small BCC and SCC lesions with high efficacy.
Topical Treatments
Prescription creams like imiquimod and 5-fluorouracil are effective for superficial BCC, SCC, and precancerous lesions. These are applied directly to the affected area, providing a non-invasive treatment option.
Cryotherapy
Liquid nitrogen is used to freeze and destroy small, superficial lesions. It is effective for very early-stage skin cancers and precancerous growths.
Radiation Therapy
Radiation is used for tumours in areas unsuitable for surgery or for patients who cannot undergo surgery. It is precise and effective, though typically reserved for specialised cases.
Immunotherapy and Targeted Therapy
RF microneedling, e.g., Morpheus8, combines tiny needles with RF energy to remodel the skin at deeper layers.
Ideal Candidates for Treatment
- Early Detection: Individuals with small, localised lesions benefit most from minimally invasive treatments.
- Non-Melanoma Cancers: Patients with BCC or SCC usually respond very well to surgery or topical therapy.
- Melanoma Patients: Those diagnosed early have excellent survival rates; advanced cases require multidisciplinary care.
Regular Check-ups: Patients committed to follow-ups and UV protection have lower recurrence risk and better outcomes.
Prognosis and Recurrence
- Non-melanoma skin cancers rarely spread; recurrence rates are 30–50% within five years, making regular skin exams crucial.
- Early-stage melanoma has a five-year survival rate exceeding 99%.
- Advanced or metastasised melanoma requires aggressive therapy, but modern immunotherapy and targeted treatments significantly improve outcomes.
Prevention and Recovery Tips
- Perform monthly self-exams for new or changing moles using the ABCDE rule (asymmetry, border, colour, diameter, and evolving).
- Schedule annual dermatology check-ups, especially if you have a history of sun exposure or previous skin cancers.
- Apply broad-spectrum SPF 30+ daily and avoid tanning beds.
- Maintain a healthy lifestyle with antioxidant-rich foods, hydration, and avoiding smoking.
- Attend all follow-up appointments for early detection of recurrence.
Conclusion
Most skin cancers are highly treatable, particularly when detected early. BCC and SCC have excellent cure rates, while early-stage melanoma can often be completely removed with surgery. Modern therapies like Mohs surgery, immunotherapy, and targeted treatments further improve outcomes for advanced cases. Regular self-exams, dermatology visits, and UV protection are key to early detection, successful treatment, and preventing recurrence. With timely care and ongoing monitoring, patients can achieve long-term remission and maintain healthy skin.
Disclaimer
This content is for informational purposes only and is not a substitute for professional medical advice. Always consult a licensed dermatologist or healthcare provider for diagnosis, treatment, or concerns about skin cancer.
Frequently asked questions
1. Are all skin cancers curable?
Most skin cancers are highly curable, especially when detected early. Basal cell and squamous cell carcinomas have excellent cure rates, while early-stage melanoma can also be successfully treated with surgery and modern therapies.
2. How important is early detection for skin cancer?
Early detection is critical for successful treatment. Small, localised skin cancers are easier to remove, have minimal scarring, and respond well to therapy. Regular self-checks and dermatology visits significantly increase survival rates.
3. What are the main treatment options for skin cancer?
Common treatments include Mohs surgery, excisional surgery, cryotherapy, topical medications, radiation therapy, and advanced options like immunotherapy or targeted therapy. The choice depends on cancer type, stage, and location in the body.
4. Is melanoma skin cancer treatable?
Yes, melanoma is highly treatable when caught early. Surgical removal is usually curative, and advanced melanoma responds well to immunotherapy and targeted therapy. Early detection dramatically increases long-term survival rates.
5. Can skin cancer come back after treatment?
Yes, recurrence is possible, particularly within five years for non-melanoma cancers. Regular dermatology check-ups, self-exams, and sun protection are essential to detect and treat any new or returning lesions promptly.
6. Can skin cancer be treated without surgery?
In some cases, yes. Superficial basal cell or squamous cell cancers may be treated with topical medications, cryotherapy, or photodynamic therapy. Surgery is preferred for larger, deeper, or high-risk lesions to ensure complete removal.
7. How successful is Mohs surgery for skin cancer?
Mohs micrographic surgery has the highest cure rate, up to 99%, particularly for BCC and SCC in sensitive areas like the face. It removes cancer layer by layer while preserving healthy tissue and minimising scarring.
8. Can advanced skin cancer be treated effectively?
Advanced or metastasised skin cancers may require aggressive therapies such as immunotherapy, targeted therapy, chemotherapy, or radiation. Early-stage detection remains ideal, but modern treatments significantly improve outcomes even in complex cases.
9. How can I prevent skin cancer recurrence?
Prevention involves regular dermatologist visits, monthly self-checks, strict UV protection, avoiding tanning beds, and adopting a healthy lifestyle. Early detection of new or recurring lesions ensures prompt treatment and improved long-term outcomes.
10. When should I see a dermatologist about a suspicious spot?
See a dermatologist immediately if you notice new or changing moles; lesions that bleed or itch; or growths that appear irregular in colour, shape, or size. Prompt evaluation increases treatment success and reduces complications.