Skin cancers are extremely common in Sydney. Most people notice a skin lump or ulcer and go to their General Practitioner (GP) who organises management. The family doctor is knowledgeable about skin lumps and bumps and will be able to determine if a skin lesion is a cancer. They may excise the lesion or biopsy it and send you to a Plastic Surgeon.
Excising the lesion is often straightforward. It is the reconstruction and the scar which can be tricky. This is why you might be referred to a Plastic Surgeon.
Specialist Plastic Surgeon’s are experts in reconstruction.
Are all skin lesions or lumps skin cancer?
No. Some lesions are not cancer. It is best to have your Family Doctor or General Practitioner look at any lesions that concern you. Your Family Doctor maybe able to address these skin lesions or refer you to a Specialist.
Do I need a biopsy?
Your Family Doctor can tell you this. Your GP can do the biopsy or send you to a Specialist. If there is any doubt then it is best to have a biopsy. A biopsy can be done in my office under local anaesthetic most of the time. Ask your General Practitioner for a referral and call my office on 1300 440 441 to make on an appointment.
What are some types of skin cancer?
Some types of skin cancer are basal cell carcinoma, squamous cell carcinoma and melanoma. There are many other types of skin cancers too.
Some skin lesions are pre-cancer. These include Actinic Keratosis which occurs on sun-damaged areas and looks like a red and scaly patch.
How do I prevent skin cancer?
Modifying your behavior can prevent or minimise the risk of developing skin cancer. Most importantly avoid sun exposure and protect your skin by applying a sunscreen, sun glasses, clothes and a hat when exposed to the sun.
The sun is needed for 10-15 minutes a day on arms and legs for vitamin D metabolism. Avoiding the sun between 10am and 5pm is wise.
Perform self examination regularly for changes in skin. Contact your primary GP or family doctor if you have any concerns.
Is the treatment always surgery?
No, surgery is not always needed. However, if you are sent to a Plastic Surgeon by your GP or Dermatologist then you may likely require surgery.
Sometimes topical treatments can be used.
Topical or surface treatments can be used to treat superficial skin cancers. Cryotherapy uses liquid nitrogen to damage the cancer cells. There is no accurate way to control which cells are removed. This is a good treatment for superficial small cancers and if they recur then they can be excised.
Topical medicine or chemotherapy can be used to treat superficial basal cell or squamous cell cancers. The 2 common medications are fluorouracil (5-FU) sold as Efudex and Imiquimod sold as Aldara. These drugs can cause quite severe skin reactions and patients should be monitored by your Plastic Surgeon.
Furthermore laser and photodynamic therapy can be used by Dermatologists to treat some types of skin cancers.
Will I need a general anaesthetic?
Not for most skin lesions. These can be done with local anaesthetic alone in the procedure room in my office or it can be done with sedation and local anaesthetic in a hospital. Some patients will need or ask for a general anaesthetic. We will discuss the pros and cons in your consultation.
Do I need to go to a hospital?
Not all the time. There are many lesions that can be removed in my office procedure room. Most small skin lesions can be removed in the procedure office.
What is the follow-up after surgery or other treatments?
After surgery you will need to be reviewed 5 to 7 days after surgery to have your sutures removed and get the formal result from the histopathology report. Removal of sutures is an easy and straight forward task with minimal discomfort if any at all.
If you are treated with creams or lotions then you will need a review during and after your treatment and occasionally a biopsy of the area involved.
Dr Rizk advocates the National Law and Australian Health Practitioner Regulation Agency (AHPRA) guidelines that any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.