Skin Cancer and Melanoma

 

Hearing a diagnosis of “cancer” can be very difficult to accept. Understanding that treating your skin cancer may result in scars or disfigurement can also be troubling. Dr Moko understands your concerns and will guide you through treatment and explain the resulting effect on your health and appearance.

Quick facts about skin cancer treatment:

  • Treatment of skin cancer, much like any form of cancer, may require surgery to remove cancerous growths
  • Dr Moko can surgically remove cancerous and other skin lesions using specialised techniques to preserve your health and your appearance
  • Although no surgery is without scars, Dr Moko will make every effort to treat your skin cancer without dramatically changing your appearance
  • For some people, reconstruction may require more than one procedure to achieve the best results

Australia has one of the highest rates of skin cancer in the world. The most common forms of skin cancer are:

  • Basal cell carcinoma 
  • Squamous cell carcinoma 
  • Melanoma

Dr Moko has extensive experience in the treatment of skin cancer. She offers surgical techniques that give the best chance of cure, with the least amount of scarring.

Basal Cell Carcinoma (BCC)

BCC is the most common form of skin cancer. It can occur in young adults, but is more common in the elderly. It can present as a small pearly nodule, ulcer or plaque-like lesion. BCC can usually be diagnosed by examination alone, but sometimes a biopsy is required.

Treatment

Small BCCs are usually removed under local anaesthetic, but a general anaesthetic may be more comfortable for larger BCCs.

The tumour is excised and sent to the pathologist to be tested. Occasionally the pathologist is present at surgery to test the margins. This is called ‘frozen section’ and can help ensure the tumour is completely excised when it has indistinct margins, or is in a critical area.

After removal, Dr Moko will accurately stitch the wound edges and a straight line scar will result. For larger defects, a skin graft or flap may be required.

In the early stages, some BCCs can be treated by freezing the skin with liquid nitrogen. Radiotherapy is occasionally used if you are unsuitable for surgery.

Recovery

You can usually go home on the day of surgery and return to work the next day. Strenuous activity should be avoided for 3 weeks. More extensive surgery will slow your return to normal.

Squamous Cell Carcinoma (SCC)

This is the second most common form of skin cancer. It can present as an ulcer or crusting skin lesion. Treatment is similar to BCC.

Generally, SCC can be cured by prompt surgical treatment, but occasionally the cancer can spread to lymph nodes in the neck, armpit or groin. Surgery to remove the nodes is required and radiotherapy may also be necessary.

Melanoma

Melanoma is a cancer of the pigment cells of the skin. Normally these cells give us our skin colour, or clump together to form moles.

Most moles are benign, but features suspicious for melanoma include:

  • Change in size
  • Change in shape
  • Change in colour
  • Bleeding or itching

A biopsy needs to be taken to make a diagnosis of melanoma.

The outlook for melanoma depends on how advanced the disease is at diagnosis. The main indicator is its thickness. When it is less than 1 mm thick, the chances of cure is high. As the thickness progresses, however, the prognosis is poorer.

Melanoma can spread to lymph nodes in the neck, armpit or groin. For thicker melanomas, chest xray, CT, MRI or PET scan are requested to check for spread.

Treatment

The first treatment for melanoma is to remove a larger piece of tissue from around the biopsy site to remove any microscopic deposits. In many cases, a simple straight scar will be left, but sometimes a skin graft or flap is required.

When the melanoma is thicker than 1 mm, a ‘sentinel node biopsy’ may be performed. This technique uses a combination of radiation and dye to locate the first lymph node that drains the area of the melanoma. This node is examined to determine if there is early spread to the lymph nodes. Further surgery may be required to remove all the glands in that area.

Despite extensive research into the treatment of melanoma, surgery remains the principal treatment. When required, Dr Moko will refer you to a medical cancer specialist (oncologist) to discuss other options.