Dr Atul Ingle

Skin Cancer & Melanoma Surgery

Skin cancer is the most common form of cancer, and it arises from the uncontrolled growth of abnormal skin cells. In Australia, skin cancer rates are among the highest in the world due to the high levels of ultraviolet (UV) radiation from the sun.

Melanoma is the most serious type of skin cancer, originating from the pigment-producing melanocytes in the skin. Early detection and treatment are crucial for effective management and improved survival rates.

Overview of Skin Cancer Types

There are three main types of skin cancer: basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. Each type has distinct characteristics, risk factors, and treatment approaches.
Basal Cell Carcinoma (BCC)
  • Description: BCC is the most common but least aggressive form of skin cancer. It originates in the basal cells at the bottom of the epidermis.
  • Appearance: BCC often appears as a pearly or waxy bump, a flat, flesh-coloured or brown scar-like lesion, or a bleeding or scabbing sore that heals and returns.
  • Risk Factors: Chronic sun exposure, fair skin, and a history of sunburns increase the risk of developing BCC.
  • Description: SCC is the second most common type of skin cancer, arising from the squamous cells in the outer layer of the skin. It can be more aggressive than BCC.
  • Appearance: SCC typically manifests as a firm, red nodule, a flat lesion with a scaly, crusted surface, or a sore that doesn’t heal.
  • Risk Factors: Sun exposure, fair skin, a history of sunburns, and immunosuppression are significant risk factors for SCC.
  • Description: Melanoma is the most dangerous form of skin cancer. It develops in the melanocytes, which are responsible for skin pigmentation. Melanoma can spread (metastasise) to other parts of the body if not detected and treated early.
  • Appearance: Melanoma often looks like a new mole or a change in an existing mole, exhibiting asymmetry, irregular borders, multiple colours, diameter larger than 6mm, and evolving shape or colour (ABCDE criteria).
  • Risk Factors: Risk factors include excessive UV exposure, fair skin, a family history of melanoma, and the presence of numerous or atypical moles.

The primary cause of skin cancer and melanoma is exposure to UV radiation from the sun or tanning beds. Other contributing factors include:

  • Genetics: A family history of skin cancer can increase the risk.
  • Fair Skin: Individuals with fair skin, light hair, and light eyes are at higher risk due to lower levels of melanin, which provides some protection against UV radiation.
  • Weakened Immune System: Immunosuppression, whether from medical conditions or treatments, can increase susceptibility to skin cancer.
  • Age: The risk of skin cancer increases with age, although melanoma is also common in younger individuals.
Treatment for skin cancer depends on the type, size, location, and stage of the cancer. Surgical removal is the most common and effective treatment for most skin cancers.

Surgical Treatments

  1. Excisional Surgery:
    • Procedure: The surgeon removes the cancerous tissue along with a margin of healthy tissue to ensure complete removal. The wound is then closed with sutures.
      Indications: Suitable for most BCC, SCC, and early-stage melanoma.
  2. Mohs Surgery:
    • Procedure: A specialised technique where thin layers of skin are removed and examined under a microscope until no cancer cells remain. This method preserves as much healthy tissue as possible.
      Indications: Often used for BCC and SCC, especially in cosmetically sensitive areas like the face.
  3. Wide Local Excision:
    • Procedure: Involves removing the melanoma along with a wider margin of healthy tissue to reduce the risk of recurrence.
    • Indications: Typically used for melanoma to ensure complete removal of cancerous cells.
  4. Sentinel Lymph Node Biopsy:
    • Procedure: Involves removing and examining the first lymph node (or nodes) to which cancer cells are likely to spread from the primary tumour.
    • Indications: Used to determine the spread of melanoma.

Non-Surgical Treatments

  1. Topical Treatments:
    • Description: Creams or gels containing cancer-fighting agents are applied to the skin.
    • Indications: Suitable for superficial BCC and SCC.
  2. Radiation Therapy:
    • Description: High-energy rays are used to target and kill cancer cells.
    • Indications: Used for patients who cannot undergo surgery or for cancers that are difficult to treat surgically.
  3. Cryotherapy:
    • Description: Freezing the cancerous tissue with liquid nitrogen.
    • Indications: Effective for superficial BCC and SCC.
      Targeted Therapy and
  4. Immunotherapy:
    • Description: These treatments use medications to target specific molecules involved in cancer growth or to boost the body’s immune response against cancer cells.
    • Indications: Primarily used for advanced melanoma.

The Skin Cancer and Melanoma Procedure in Australia

In Australia, the high incidence of skin cancer has led to the development of comprehensive and advanced treatment protocols. Plastic surgeons play a crucial role in the management and treatment of skin cancer, particularly when surgery is required to remove the cancer and reconstruct the affected area.

Patients are usually advised to:

  • Avoid certain medications, such as aspirin or anti-inflammatory drugs, which can increase bleeding.
  • Stop smoking, as it can interfere with healing.
  • Protect their skin from further sun damage by using sunscreen and wearing protective clothing.
Surgical procedures are typically performed under local anaesthesia, although general anaesthesia may be used for more extensive surgeries. The duration of the surgery depends on the type and extent of the cancer being removed.
  • Wound Care: Patients will receive instructions on how to care for their surgical wounds to prevent infection and promote healing.
  • Follow-Up Visits: Regular follow-up appointments are necessary to monitor healing and check for any signs of recurrence.

Recovery times vary depending on the type of surgery and the extent of the cancer removed. Most patients can return to normal activities within a few days to weeks. The final results, including the appearance of any scars, will improve over time.

The success of skin cancer surgery largely depends on early detection and treatment. Regular skin checks and monitoring for any changes in the skin are crucial for maintaining long-term health.

Undergoing surgery to remove skin cancer not only addresses the immediate health concern but can also provide significant psychological relief. Patients often feel a sense of reassurance and confidence knowing the cancer has been effectively treated.

Conclusion

Skin cancer and melanoma surgery are vital procedures for effectively managing and treating skin cancer, especially in a country like Australia with high UV exposure. Experienced plastic surgeons perform these procedures with great success, helping patients achieve both medical and aesthetic goals.

Early detection and prompt treatment are key to ensuring the best possible outcomes.

For more information or to schedule a consultation, please contact our clinic. Dr Atul Ingle has significant experience performing both minor and major skin cancer and melanoma surgery, and is dedicated to helping you achieve your surgical goals and enhancing your overall quality of life.

Dr Atul Ingle is a Specialist Plastic and Reconstructive Surgeon based in Townsville.

He has 20+ years of experience in plastic and reconstructive surgery and holds two Master of Surgery Degrees. He is the Head of the Plastic and Reconstructive Surgery Department at Townsville University Hospital.

If you have a question about a condition or treatment, or would like to book an appointment, please contact us and one of our friendly staff members will happily assist you.

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Dr Atul Ingle

(07) 4413 7118

47 Fulham Road
Pimlico, QLD, 4812

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