Skin Cancer: When is Treatment No Longer Timely?
Understanding the Urgency of Skin Cancer Treatment
Many of my patients ask, “Is it ever too late to treat skin cancer?” The reassuring answer is that in most cases treatment is still worthwhile, but early detection makes an enormous difference.
Australia has the highest rate of skin cancer in the world, largely due to strong UV exposure and our predominantly fair-skinned population. This means regular skin checks and prompt review of any suspicious spots are essential to maintaining good skin health.
Skin Cancer in Australia: The Current Picture
Skin cancer is Australia’s most common cancer. Each year around 1.1 million non-melanoma skin cancers (NMSC) are treated, that’s more than 3,000 procedures every day. The lifetime risk of developing some form of skin cancer approaches two in three Australians.
In 2023 alone an estimated 18,257 Australians were diagnosed with melanoma, making it the nation’s third most common cancer.
The three major types of skin cancer behave quite differently:
Basal cell carcinoma (BCC): Slow-growing, rarely spreads and often managed with simple excision.
Squamous cell carcinoma (SCC): Slightly more aggressive and may spread to lymph nodes if left untreated.
Melanoma: Less common but responsible for the majority of skin cancer deaths due to its potential to spread promptly.
How Skin Cancer Stage Affects Treatment
Skin cancers are staged from Stage 0 (very early) to Stage IV (advanced or metastatic). The stage at diagnosis strongly influences treatment options, recovery, and long-term outcomes.
| Stage | Definition | Typical Management | 5-Year Relative Survival (Melanoma) |
|---|---|---|---|
| I | Thin, localised | Simple excision | ~99% |
| II | Thicker, localised | Excision ± sentinel lymph node biopsy | 90–95% |
| III | Spread to nearby lymph nodes | Surgery + systemic therapy | 60–70% |
| IV | Distant metastasis | Immunotherapy or targeted therapy | ~26% (historical cohort) |
For most non-melanoma skin cancers cure rates exceed 95% when detected early and treated appropriately. However, high-risk SCC’s that spreads along nerves or to other sites carries a poorer outlook, with five-year survival dropping below 50%.
Why Early Detection Makes All the Difference
When found early skin cancers are usually curable with minimal treatment. Early intervention often means:
Smaller, simpler procedures
Faster recovery and better cosmetic outcomes
Lower treatment costs and fewer side effects
Reduced risk of recurrence or metastasis
According to the Australian Institute of Health and Welfare, the five-year survival rate for melanoma is 93.6% and even higher for those diagnosed in the earliest stages.
Early detection also helps patients avoid more invasive or prolonged treatments such as lymph node surgery, radiotherapy, or systemic therapy. These treatments, while effective, can cause side effects like fatigue, hormone changes, or scarring.
Importantly, the 30% reduction in melanoma mortality seen in Australia since 2013 is largely due to earlier diagnosis, not just advances in medication. Regular mole checks and routine skin examinations remain the most powerful tools for improving outcomes.
Modern Treatments Offer Hope - Timing Is Key
Thanks to advances in medicine even metastatic melanoma can often be managed successfully. Immunotherapy and targeted therapies have transformed outcomes, helping many patients live longer and healthier lives.
However, once skin cancer reaches an advanced stage treatment becomes more complex, lengthy and physically demanding. This reinforces why early detection is so important - it improves both survival and quality of life while minimising treatment-related side effects.
Protecting Your Skin Every Day
The best way to reduce your risk of skin cancer is to protect your skin from UV damage. Consistent sun-safe habits make a lasting difference:
Apply a broad-spectrum SPF 50+ sunscreen daily, reapplying every two hours when outdoors
Wear protective clothing and a wide-brimmed hat
Seek shade, especially during peak UV hours
Use UV-blocking sunglasses
Check the UV index before spending extended time outside
While modern treatments have improved survival for advanced cases, prevention and early detection remain the most effective ways to reduce risk. If you notice a spot that’s changing, bleeding or not healing it’s always worth having it checked by your doctor or booking a skin check with a qualified skin cancer clinic.
Written by Dr Emily Alfonsi
MBBS, FRACGP, DRANZCOG
Medical Director, Shade Skin
Dr Emily is a skin cancer doctor with advanced training in diagnosis and treatment. She has personally detected and treated hundreds of skin cancers and is passionate about early intervention and patient education.
