Skin cancer is the most common human cancer worldwide, it is preventable and highly treatable.
The majority of skin cancers in Australia are caused by overexposure to ultraviolet radiation from the sun and other sources such as solariums. UV radiation is most damaging to the skin when it reaches a moderate UV Index level of 3 or higher. All skin cells can potentially be damaged by the sun and become cancerous.
The three main types of skin cancer are:
- Basal cell carcinoma (BCC)
- Squamous cell carcinoma (SCC)
If the individual’s skin is prone to freckles and moles, it can be difficult to tell the difference between an ordinary spot and skin cancer. If you develop a new spot, lump or any change in your skin, a review by your doctor is recommended. The different types of skin cancer will usually present with their own unique symptoms:
Symptoms of BCC
A Basal Cell Carcinoma (BCC) can develop anywhere but usually appears on areas of the body that receive frequent and intermittent sun exposure such as the head, neck, shoulders, and back. It may present as a pearly lump or a dry, scaly area that is pale or bright pink in colour.
Symptoms of SCC
Squamous Cell Carcinoma (SCC) is often found in areas of the body which receive the most sun exposure, such as the head, neck, hands, and forearms. It may present as a rapidly growing lump, a scaly red spot, or give the appearance of a sore that has not healed.
Symptoms of Melanoma
Melanomas can appear anywhere on the body but are most frequently found in areas which receive the most sun exposure such as the head, neck, shoulders, back, hands and forearms. Signs of a melanoma may be detected through the appearance of a new freckle or mole, or changes in size, shape, or colour of an existing mole.
Surgery is a very common form of treatment for skin cancer and for most skin cancers, especially if detected early surgery may be the only treatment needed.
There are two key components of skin cancer surgery. The first is the complete removal of the skin cancer, including a small amount of normal surrounding skin and tissue (a margin) to cure the skin cancer and reduce the risk of its recurrence. The second key component is the closure of the wound to give the best appearance and function.
Depending on the type, size and location of the skin cancer, reconstructive techniques such as skin grafts or skin flap repairs may be used after removal to have the wound heal appropriately and achieve the best appearance and function possible.
A skin graft is where a piece of skin, ideally similar in colour and texture is taken from another part of the body, where it can be spared, and used to cover the area where the skin cancer was removed. This helps to close a wound that may be too large for the edges to be stitched together or in an area where an important feature may be distorted if directing stitching is used. A skin flap repair may be used for similar reasons and uses skin that is adjacent to the skin cancer that is removed and generally has a good colour and texture match.
Skin cancer surgery is performed in an accredited hospital, usually as a day procedure but an overnight stay may be required if the surgery is more extensive or other medical conditions need to be monitored. Skin cancer surgery can be performed under local anaesthetic (numbing injections), a general anaesthetic or finally local anaesthetic with sedation. Most skin cancer surgery procedures will take less than 60 minutes if multiple skin cancers are being treated at the same time the surgery may take up to 90 minutes.
The purpose of your initial consultation with Dr Avery is to discuss both your concerns and your potential outcome from surgery.
When you arrive at Avery, you will check in with our front-desk team and complete a medical history form, if not already completed. We encourage you to bring a supportive family member or friend who can remain with you throughout the consultation if you like, and be a sounding board during your decision-making process following the consultation.
The consultation with Dr Avery will include an examination of the skin cancer that you referred for, and the area of the body it is located. We will discuss what the surgery involves, how it relates to you specifically given your uniqueness and current state of health, what the possible risks of the surgery are, and then decide if having the surgery is a safe and appropriate choice for you as an individual.
At Avery, our goal is to ensure you are equipped with the knowledge needed for you to feel empowered throughout the decision-making process, surgery and post-surgery.
After skin cancer surgery, the wounds will usually be covered with a dressing except when on the lips or very close to the eyes. The wounds may be sore, red or drain small amounts of fluid. This is normal and expected. At Avery, we will give you wound care instructions before you go home which typically includes how to properly clean the incisions and if required apply topical medications.
As with any operation, you will need to organise somebody to drive you home afterwards.
During the first 2 weeks after surgery, you need to keep your incisions clean and well protected from potential injuries and the sun. Sun exposure to healing wounds may result in irregular pigmentation and the scars can become red or dark.
Healing may take a few weeks or months depending on the size of the incisions. Scars will fade to some degree after a year. Occasionally secondary procedures may be required to refine your reconstruction.
Skin Cancer FAQs
As each person is different, each individual will have different results. The results will depend on the size and nature of the skin cancer, where it was located, and the reconstructive technique needed to repair the wound. Individuals can also vary in the type of scars they produce. Appropriate care of the wound in the post-operative period will also affect the final result.
Although every effort will be made to restore your appearance as closely and naturally as possible, the most important factor is that the skin cancer will be removed.
As with any surgery, there are some potential complications and risks. These may include:
- Potential infections that may require treatment with antibiotics
- Loss of skin graft requiring further surgery
- Pain, bruising and swelling
- Other risks related to anaesthesia
- Incomplete removal of the skin cancer and need for further treatment
- Less than ideal wound appearance or function requiring further treatment or surgery
Scars are an inevitable part of any invasive surgery. There are people more prone to hyperpigmentation and hypertrophic scars or keloids. As the scars heal, they will usually flatten and eventually fade, but they will be visible.
Further surgery may be necessary if the skin cancer requires more treatment. This may include surgery to the same area or more rarely another part of the body if the skin cancer has spread.
Further surgery may also be required or desired if the appearance or function of an area can be improved following skin cancer surgery, including quality of the scar.
In general, most patients can start to resume regular activities 2-3 weeks after surgery.
Depending on the type and location of the skin cancer, some alternative treatments include cryotherapy (or freezing), light therapy and occasionally some topical creams. Radiotherapy is also used to treat skin cancers either alone or on some occasions following surgery if the results indicate radiotherapy will be beneficial in helping to treat the skin cancer or reduce the chances of it coming back.
Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. Dr Avery is a member of the two leading professional associations for plastic surgeons in Australia, ASAPS and ASPS. Their websites provide additional information regarding plastic surgery in Australia that you might find useful, please visit ASAPS and ASPS.