First Light Healthcare


GP Dr Paddy McLisky answers commonly asked questions about most common skin cancers, warning signs and how you can perform your own skin checks



My name is Patty McClisky and I’m a GP working at Cape Byron Medical Centre. I run the Skin Cancer Clinic here. We do skin cancer checks, head-to-toe checkups looking for anything suspicious that might have grown on people’s skin. We also take biopsies into excisions flaps and skin grafts if needed in the clinic.

What interested you about this field of medicine?

I’ve always thought with skin being the largest organ in the body, as a doctor it’s the first organ that you’re going to see. You see people’s skin every time you speak to them and for us to see patients it’s a great opportunity to diagnose disease on the skin because the skin is already right in front of us.
I think living on the east coast of Australia, particularly, there are a lot of people who are at risk genetically and by their lifestyle of getting skin cancers so there’s a large burden of disease that we need to address. Also, personally I had a melanoma myself when I was 30 years old, and so going through that journey also spurred my interest in skin.

What are the most common skin cancers?

So the most common skin cancers are called basal cell carcinomas and those are followed by squamous cell carcinomas. Neither of these is actually a melanoma, so although people often think of melanoma as being the prototypical skin cancer, it’s not the most common.
Basal cell carcinomas are often pink – they can be pink and shiny; squamous cell carcinomas can be pink and scaly and even sometimes have pigment in them so they could be brown or black.

What are some of the warning signs of skin cancer?

So the most important warning sign I would say would be if anyone notices something on their skin that looks out of place. That may be because this spot seems to be new, it might be growing quickly, it might look different to their other spots, a wound that won’t heal – something that’s bleeding or ulcerated would certainly be something to be concerned about.
But I think generally if people take note of their skin and keep an eye on their skin they should hopefully be able to notice when something changes or is out of place.
To go a bit further on that, to summarise as in what actually looks suspicious, my brief guideline would be melanoma typically looks brown and ugly (ugly meaning that it’s asymmetrical in its colour or its pattern rather than in its shape) squamous cell carcinoma might be pink and scaly, and basal cell carcinoma could be pink and shiny.
So brown and ugly, pink and scaly, or pink and shiny.
The caveat to that would be anything that’s a firm growing nodule or anything that’s changing rapidly.

Can people perform their own skin checks?

I certainly encourage people to keep an eye on their skin and to keep an eye on the skin of their loved ones.
I think that it’s certainly worthwhile, depending on your risk factors, at least having one skin check with a professional to look at the areas that you can’t see very well, for example the back of your neck between your toes, behind your ears. Keeping an eye on your own skin is a good idea. The difficulty with keeping an eye on your own skin is for one you may not recognise the signs of a skin cancer, if you’re not trained in that way, but two is that these things can start out very small and sometimes the magnification is the only clue we have.
So in the skin clinic in Cape Byron, I use this dermatoscope and this gives me magnification so that I can really zoom in on each spot and have a look and see whether there are some small features that might be sinister, and these can be really subtle things that you might not see with your naked eye.

By Cape Byron Medical Centre Team