Skin Cancer
What are the signs of skin cancer?
A lesion on the skin which grows rapidly, changes in colour, has an irregular border, bleeds, itches or changes rapidly is suspicious and should be looked at by a Plastic Surgeon with an interest in skin cancer.
What does the management of skin cancer involve?
In the vast majority of cases I will be able to make a clinical diagnosis with regard to whether or not the lesion represents a cancer and if so the type of skin cancer it represents. In the event that I am not completely sure of the diagnosis based on the appearance of the lesion a small biopsy is be taken under local anaesthetic to achieve a histological (laboratory) diagnosis before proceeding with treatment.
What are the common types of skin cancer?
The common types of skin cancer are basal cell carcinoma, squamous cell carcinoma and malignant melanoma.
How do these skin cancers differ in their behaviour?
A basal cell carcinoma is normally confined to the area of origin and does not spread to other parts of the body.
A squamous cell carcinoma if allowed to grow unchecked can spread into the lymph nodes and sometimes into the blood stream.
A malignant melanoma can spread by lymph nodes or by the blood stream to the other parts of the body.
What does surgery for skin cancer involve?
Once a diagnosis of a skin cancer has been made I will arrange for the lesion to be removed. This procedure may be carried under local anaesthetic or may require a general anaesthetic depending upon the size of the lesion and the type of reconstruction that is required.
Small lesions can be removed and the skin can be closed directly resulting in a straight line scar. Larger lesions may require repair with either a skin graft from another part of the body or skin flap from an adjacent area.
What does the normal post operative care involve?
In most cases you will be asked to rest the part to allow uneventful healing. A review appointment will be arranged with a specialist plastic surgery nurse for the management of the wound or of a graft or flap five to seven days following surgery. At this time sutures may be removed and steristrips may be applied across the wound to support it for a few days
What does the normal post operative care involve?
There will be bruising and swelling around the area of the operation. You will be given pain killers and antibiotics for the postoperative period if the lesion that has been removed was open or infected prior to surgery. It takes between two to six weeks for grafts and flaps to heal and to become stable before you resume normal activities.
How much time will I require off work?
If the surgery for skin cancer involves a simple excision and direct closure in most cases it is possible to return to work within a few days of the operation.
In the event that a skin flap is performed on the face it is sensible to postpone business meetings or face to face customer contact and not to have such a procedure done just before an important social occasion as the bruising and swelling from surgery may take five to seven days to settle.
If a skin graft is applied it will take between seven to ten days for the graft to become stable and approximately two to three weeks before normal activities including travelling to work can resumed.
What are the postoperative arrangements for follow-up?
Following surgery depending upon the type of skin cancer you maybe requested to go undergo blood tests and may have x-rays or scans of your chest and abdomen. These are usually routine and baseline tests which form the basis for a follow up programme.
Where can I get more information about my skin cancer?
A sensible site to visit is www.cancerbackup.org.uk. This site is written by doctors, nurses and patients and presents the available information on skin cancer in a readable and non-sensationalised format. It will provide you with good background information on why certain treatments or tests are being carried out and what you can expect during the course of your treatment.