Skin Cancer Diagnosis & Treatment


Diagnosis

A full skin check involves undressing down to underwear (often people feel more comfortable wearing togs/bikini) and Dr Simpson will then examine you from head to toe using a combination of bright illumination and surface microscopy – both computerised and hand-held top of the range dermatoscopes.

Although you are not expected to remove underwear it is important to say if there are any lesions you are concerned about.

If Dr Simpson finds a suspicious lesion at your skin check he will usually take a biopsy and send it to the pathology lab for testing. A biopsy involves taking a small plug of skin and having it examined under a microscope.

Once the results are back you will be expected to come to discuss the most appropriate treatment.

Dr Simpson uses a combination of the highest quality German dermatoscopes made by HEINE Optotechnik and a linked computerised dermatology package.

http://www.scanyourskin.org/

(Skin Cancer College site for skin check info)

 

 

Treatment

Surgical

If a skin cancer is diagnosed it is often treated by excising the lesion because this offers the best chance of complete cure and also provides a specimen for the pathologist to fully examine to confirm complete removal.

In most cases a simple elliptical excision is used but lesions in difficult sites such as the nose, ears or lower legs often need a more complicated procedure to achieve the best result. This may be a skin flap or a skin graft.

Dr Simpson has performed these procedures for many years and received advanced surgical training with the Skin Cancer College of Australasia and so you can have these operations performed in the dedicated operating rooms at Peregian Springs Doctors.

If you would prefer to have the procedure done by a plastic surgeon a referral and advice on local specialists will be provided.

Non-Surgical

Early, thin, non-aggressive skin cancers can be treated using creams or light therapy.

The biopsy you had at diagnosis will allow Dr Simpson to advise if your skin cancer fits the recommended criteria to be suitable for a non-surgical therapy.

The main treatments are Photodynamic Therapy or a skin cancer cream such as Efudix or Imiquimod (Aldara).

Photodynamic Therapy (PDT) can be used to treat Actinic Keratoses as prevention against future skin cancer development as well as being used for sBCC’s and IEC’s.

Treatment involves preparing the skin with skin smoothing creams for 2-4 weeks prior to treatment and then having a cream applied to the area or lesion which is then covered for up to 3 hours before returning to the clinic to be exposed to a strong light source.

This causes an intense reaction in the skin leading to the destruction of the cancerous cells whilst leaving the healthy skin undamaged.

For biopsy-proven BCC’s a second treatment is scheduled a week or so later.

PDT has been shown to reduce the likelihood of future skin cancers and is particularly useful if you have a lot of sun damage or have already had skin cancer.

Ref: British Journal of Dermatology 2010 Jan; 162(1): 171-175

Efudix and Imiquimod can be effective for superficial BCC’s (sBCC) and Intraepidermal SCC’s (IEC) and are usually applied for 4-6 weeks during which time the skin will be inflamed, crusty and possibly tender. It’s important to stay out of the sun whilst using Efudix and Winter is often the best time of year to have this treatment.

All these non-surgical treatments can lead to smoother, more even coloured skin and avoid the need for surgery with cure rates of approximately 80-87%.