Skin Cancer – Excision and Reconstruction

We Australians love our sun, surf and outdoors lifestyle.  However, we are also have the highest rate of skin cancer in the developed world.

Skin cancer is the uncontrolled growth of abnormal skin cells. It is the most common of all cancers.  Due to our love of the sun and outdoors, Australians have the highest incidence of skin cancer in the world.  More than two-thirds (66%) of the Australian population will develop a skin cancer of some kind during their lives, however, exact incidence will be unknown because cancer registries do not report non-melanoma skin cancers.

Solar radiation, including tanning booths and sunlamps is the major environmental cause of non-melanoma skin cancer

Skin cancer needs to be treated promptly.  The danger of some skin cancers is that it can spread (metastasise) to other parts of the body if treatment is not undertaken.

Anyone can get a skin cancer regardless of skin type, race or age. Most skin cancers occur on the neck, face and head and once the skin cancer lesion is removed, and depending on the extent of the excision, it may be necessary to perform reconstructive surgery. In conjunction with a dermatologist and once skin cancer has been diagnosed, Dr Vlad, who is a highly qualified Plastic and Cosmetic surgeon, will discuss in depth with you, all available treatments and reconstructive surgery options.

Types of Skin Cancer

Actinic Keratosis

This type of skin cancer usually occurs in areas that are most exposed to the sun. They are usually detected by touch as they crusty and scaly.

Basal Cell Carcinoma

This is one of the most common skin cancers and is caused by frequent and long-term exposure to the sun. These are quite difficult to detect as often they can resemble non-cancerous skin conditions such as eczema or psoriasis.

Basal Cell Carcinoma (BCC) is by far the most common type of skin cancer.  Fortunately, it’s also the least dangerous of the skin cancer types. However, this does not mean that a BCC should be ignored.  75% of Australians who have skin cancer have BCC.  It tends to grow slowly, and rarely spreads beyond its original site. However, if left untreated, it can grow deep beneath the skin and into the underlying tissue and bone, causing serious damage, particularly if it is located near the eye.

BCCs are easily treated in their early stages. The larger the tumour has grown, however, the more extensive the treatment needed. Although this skin cancer seldom spreads, or metastasises, to vital organs, it can damage surrounding tissue, sometimes causing considerable destruction and disfigurement — and some BCCs are more aggressive than others.

Squamous Cell Carcinoma

This type of skin cancer typically presents as scaly, rough patches that can bleed and can often be mistaken for warts. There also may be changes to the skin around the cancer site which is a good indication of this type of skin cancer. Squamous Cell Carcinoma is the second most commonly diagnosed skin cancer after the basal cell carcinoma.

Squamous Cell Carcinomas (SCC) are faster growing than BCC’s.  Of those Australians with skin cancer, about 2 in 10 have a SCC.

An SCC frequently appears on the head, neck, hands and forearms, which typically receive more sunlight.  SCC is more dangerous than BCC because it can spread to other parts of the body if not treated promptly.

SCCs can become life threatening if left untreated for a prolonged period. An SCC looks like a red scaly spot or lump and is usually thickened. It can bleed easily and may ulcerate. It is usually tender to the touch.

Melanoma

Although melanoma is usually highly malignant, it occurs in only about 5% of people with skin cancer. Melanoma can usually be treated successfully if diagnosed early. If it’s not treated quickly, however, malignant melanoma may spread throughout the body and is often deadly.

Malignant melanoma can occur on any part of the body, including areas that have not been exposed to the sun. In women, it is more common in the arms and legs, and in men on the face, back and chest. About half of all cases of melanoma develop from moles. The other half develop on previously normal skin as a new lesion.

For a suspected melanoma, Dr Vlad may remove all or part of the lesion.   It is then sent to a laboratory so a pathologist can examine it under a microscope.

Depending on the pathologist’s report, a wider excision (that is, taking more skin more deeply) may be recommended. In which case, a skin graft or a skin flap may be required to repair a large area of skin.  This is called skin cancer reconstruction, and a Specialist Plastic Surgeon like Dr Vlad is trained and qualified to perform this type of surgery. If the cancer is large or if it has spread to the lymph glands or elsewhere in the body, major surgery may be required and a multi-disciplinary team approach with a number of specialities is mandatory.  Dr Vlad will organise this team for you to ensure that you receive best practice treatment and care.

A pre and post surgery information pack, as well as written estimate of surgical fees, is provided following your initial consultation with Dr Vlad, which will include a discussion of treatment options.