There are 3 main types of skin cancers:

• Basal Cell Carcinoma:

Raised pearled edges. Slow growing. Rarely metastasize

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• Squamous Cell Carcinoma:

Scaly. Open non-healing ulcers. Elevated growth. Can be fast growing. Can metastasize

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• Melanoma:

Often a dark lesion with asymmetry, irregular borders, irregular colour, diameter >5mm, changing. Requires urgent Melanoma specialist intervention

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Skin cancers are most often caused by repeated and unprotected exposure to the sun’s UV radiation causing mutations in your DNA which leads to abnormal growth in certain cells. Anyone can develop a skin cancer, but those with fair or freckled skin and those in the older population group are more commonly affected.

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Your skin cancer risk can be reduced with a vigilant sun protection routine. This includes covering up, using an SPF 30+ or above sunscreen, wearing a hat, seeking shade and wearing sunglasses. Consider making this part of your usual daily routine, with extra care when you are planning to spend extended time in the outdoors.

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Your GP or referrer will have examined the lesion and determined that it looks suspicious or would have already performed a biopsy to confirm the diagnosis.

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Removal of Skin Cancers require careful consideration of the appropriate surgical margin including depth, the structures surrounding the lesion that may be affected (e.g. nerves, blood vessels) and the cosmetic appearance after excision.

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Smaller lesions may be closed primarily (sutures directly closing the wound).

Larger lesions may require skin grafts (skin taken from nearby and placed on the area) or a flap (tissue borrowed from nearby and brought into the area with its local blood supply). If the lesion is large or invasive, it may require more complex surgery (See Head and Neck Cancer).

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SKIN CANCER SURGERY

Skin cancer surgery involves the removal of the lesion with an appropriate surgical margin and closure of that wound, with either a primary closure (sutures and direct closure of the edges of the wound), skin graft (skin taken from a nearby location and placed on top of the wound) or local flap (tissue brought from nearby into the wound).

The surgery is usually performed a day procedure, either under Local Anaesthetic or a General Anaesthetic.

The lesion is removed and sent for Histopathology to confirm the diagnosis and determine the completely of the excision. Further excision may be required if there is a close or involved margin.

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Your recovery will take 1-2 weeks, depending upon the type of surgery.

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Informed Consent

The main risks of skin cancer surgery are:

• Bleeding

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• Infection

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• Numbness in the wound or over the graft

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• Cosmesis:

There will be a visible scar or an obvious skin graft which is usually paler in colour than the surrounding skin

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• Need for further surgery:

If the histolopathology report confirms a close or involved margin, further excision may be required

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• Dr Tan-Gore will inform you of specific risks based on the location of the lesion, including the facial nerve, major blood vessels or lymphatic draining pathway