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Skin Cancer Diagnosis and Treatment

Monday, May 14, 2012

Avenue Plastic Surgery, as part of its service, provides a skin cancer clinic in Melbourne Australia. Following referral from your General Practitioner or Dermatologist, it is usually possible to treat the skin cancer immediately following your consultation. The skin cancer is removed by surgery in our fully Accredited operating theatre suite often under local anaesthetic. This means that you can return home to recover immediately following your surgery. Usually you will be checked the next day and stitches are then removed after 7 or 14 days.  Depending on the location of the skin cancer and the type of surgery required, you may need to take some time off work. The following skin cancers are commonly treated:

Basal Cell Carcinoma

Basal Cell Carcionoma (or BCC) is the most common cancer diagnosed in humans.  In fact, 75% of skin cancers are BCC’s.  Because of the high levels of sunlight in Australia and the large number of people with pale skin, Basal Cell Carcinoma is very common.

BCC

Diagnosis of Basal Cell Carcinoma

Any new skin growth that fails to heal, enlarges and sometimes bleeds easily, may be a Basal Cell Carcinoma. A lesion may appear as a firm plaque with a pearly edge when the skin is stretched, or as a pearly white nodule. You may have a history of heavy exposure to sunlight. The risks are higher if you have light coloured skin and blond or red hair. It is very rare for a BCC to spread to other parts of the body (metastasize). However, if left untreated, over a long period of time it will grow into surrounding tissues and even into underlying bone.

Treatment of Basal Cell Carcinoma

The treatment is to excise the lesion in its entirety and then reconstruct the resulting defect. Often a simple stitching of the wound is all that is required. Sometimes moving skin from another area in the form of a skin flap or a skin graft is required if the area to close is large.

Other treatments such as 5-fluorouracil, Aldara (Imiquimod) or PDT (photo dynamic therapy) may also be appropriate in certain situations.

Squamous Cell Carcinoma (SCC)

Squamous Cell Carcinoma is the second commonest form of skin cancer – after Basal Cell Carcinoma.  Most squamous cell carcinomas occur on the face and the back of the hands – that is the skin that is most regularly exposed to sunlight

SCC

Squamous Cell Carcinoma has a gradual progression from a keratosis (a pre cancerous skin lesion) through to an early Squamous Cell Carcinoma (Bowen’s disease – or Squamous Cell Carcinoma insitu) through to invasive Squamous Cell Carcinoma.

Diagnosing Squamous Cell Carcinoma

Squamous Cell Carcinoma usually occurs on the face, ears, back of hands and arms.  It may however occur in other areas.  Usually you will notice a rough scaly patch that may become reddish and fail to heal.  Occasionally it may bleed.  Remember that any sore that does not heal may be a sign of early Squamous Cell Carcinoma.

Treatment of SCC

The treatment will depend on the size and the location of the skin cancer.  Although in its early stage the SCC is confined to the local area, eventually some SCC can spread to the lymph nodes and to other parts of the body.  This makes their treatment much more difficult.

Treatment is usually surgical and involves removing the entire lesion and then reconstructing the defect. This may be by suturing the skin edges together or, occasionally, for larger defects a skin graft or skin flap may be required.

Non surgical treatments using creams such as Imiquimod (Aldara) or 5-fluorouracil may also be used for superficial Squamous Cell Carcinoma.  Photo dynamic therapy (PDT) may also be used to treat superficial Squamous Cell Carcinoma.

It is important to remember that some Squamous Cell Carcinomas can spread faster than Basal Cell Carcinomas and may spread to other parts of the body. For example, an ulcerating non healing lesion on the lower lip may well be a SCC and may spread quite early to the lymph glands in the neck.

Melanoma

Melanoma is more common in Australia than in countries such as the UK because of our high level of sun exposure

Diagnosing Melanoma

If you have a brown or black spot that is itchy, enlarging or bleeding it should be checked by a doctor

Treatment of Melanoma

In its early stage, melanoma can be cured by surgical removal-usually under local anaesthetic. More advanced melanoma requires more extensive excision and possible treatment of the lymph nodes and other sites of spread.

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