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Skin cancer surgery | Antony Fitton Plastic Surgery

Skin Cancer

Skin Cancer Surgery

The most common skin cancers are Basal Cell Carcinoma, Squamous Cell Carcinoma and Malignant Melanoma.

Incidences of skin cancer in the South West of England are amongst the highest in the UK. Serious skin cancer can be cured if treated promptly.

If you are concerned about the appearance of a skin lesion we would be able to advise however, skin cancer treatment is available on the NHS in the UK and therefore your doctor will be the best person to see in the first instance.

Basal cell carcinoma (BCC) is the most common form of skin cancer. It is the most common of all cancers. Until recently, those most often affected were older people, particularly men who had worked outdoors. However, nowadays more and more young people are getting BCCs.

What to look for in skin cancer

The five most typical characteristics of basal cell carcinoma are:

    • An open sore that bleeds, oozes, or crusts and remains open for three or more weeks. A persistent, non-healing sore is a very common sign of early basal cell carcinoma.
    • A reddish patch or irritated area, frequently occurring on the chest, shoulders, arms, or legs. Sometimes the patch crusts. It may also itch or hurt. At other times, it persists with no noticeable discomfort.
    • A shiny bump or nodule, that is pearly or translucent and is often pink, red, or white. The bump can also be tan, black, or brown, especially in dark-haired people, and can be confused with a mole.
    • A pink growth with a slightly elevated rolled border and a crusted indentation in the centre. As the growth slowly enlarges, tiny blood vessels may develop on the surface.
    • A scar-like area which is white, yellow or waxy, and often has poorly defined borders. The skin itself appears shiny and taut. Although a less frequent sign, it can indicate the presence of an aggressive tumour.

Frequently, two or more features are present in one tumour. Because basal cell carcinoma (BCC) can sometimes resemble non-cancerous skin conditions such as psoriasis or eczema it is always wise to seek a medical opinion if you are concerned about a spot.

The vast majority of BCCs can be cured – unlike other forms of cancer.

BCCs do not spread to lymph glands or other organs. If discovered early treatment has a 95% chance of cure, but the presence of one BCC does increase the chance that you may develop others – so be vigilant and consult your doctor with concerns.

There are several treatment options for:

Basal Cell Carcinoma

    • Curettage: For very small BCCs this is a very effective treatment. Under a local anaesthetic, your doctor can simply scrape the lesion away from your skin. This might leave a small scar.
    • Surgery: Many BCCs can be cut out. The BCC can be tested by a pathologist who will be able to determine whether it has been completely remove. This gives you the confidence in knowing that it has been cured.
    • Radiotherapy: Treating BCCs with a very short and localised course of X-ray treatment has been shown to be effective in curing BCCs. Many patients choose this option as it avoids an operation.

Squamous Cell Carcinoma

SCCs can present as a scaly red patch, ulcer, raised nodule with a central depression, or warts. They may have crust and can bleed.

SCC is mainly caused by sun exposure throughout a lifetime and therefore is generally seen in late life. SCCs are most common in areas where skin is exposed to sunlight such as the rim of the ear, lower lip, face, bald scalp, neck, hands, arms and legs.

Treatment can vary depending on the appearance and location of the lesion. Many can resemble sun-damaged skin and are of a low grade. If small and superficial curettage laser ablation and topical treatment with Efudix or Imiquimod may be effective. Plastic Surgery may be needed for larger more worrying tumours especially if they lie in an awkward site of the body.


Malignant Melanoma

Malignant melanomas start either in normal skin or from a mole. It is most commonly seen in patients who have a history of sun exposure (where the number of sunburn episodes increases risk), in those who have a propensity to sunburn (skin type I and II) and in those who have a close family member with melanoma. It is most common between 40 to 60 years of age.

Those with more than 50 moles and which have an atypical appearance are also at increased risk. Melanomas can arise in patients who have had organ transplants. Rarely it can be seen in a condition known as Xeroderma Pigmentosa.

There are 4 main types of malignant melanoma:

    • Superficial Spreading (most common, 70% of cases)
    • Nodular (10-20% of cases)
    • Acral Lentiginous (5% of cases)
    • Lentigo Maligna Melanoma (5% of cases)

If you think that a mole is getting bigger, changing colour or is irregular you should seek medical advice. Itching, bleeding or redness of the skin around the mole are also cause for concern.

 

Extensive description of further management is beyond the intention of this site. You may find the following useful:

Cancer Help UK

British Association of Plastic, Reconstructive and Aesthetic Surgeons

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What you need to know...

Consultation

Serious skin cancer can be cured if treated promptly and early.

Stay Required

No hospital stay is required.

Time

For most people, the procedure takes less than four hours.

Anaesthetic

The skin is first numbed with a local anaesthetic.

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