Skin Cancer Surgery Port Macquarie


Sunburn and skin cancer port macquarie

Many patients will be aware of the advertising campaign about skin cancer. When normal skin cells are exposed to radiation from the Sun and tanning beds, the cells are damaged and become abnormal or dysplastic. Eventually some of these cells continue to change and develop into skin cancers.

Port Macquarie has a high incidence of skin cancer due to its coastal location and lifestyle of sun and surf.

There are 3 types of sun radiation, UVA, UVB and UVC. Type UVA and UVB causes the damage to skin cells, whilst UVC is stopped from injuring the skin by our atomosphere.

Australia leads the world in the skin cancer rates:

• Compared with all types of cancers, skin cancer accounts for 80% of newly diagnosed cancers

• Skin Cancers are predominantly caused by the sun (95-99% of cases)

• Compared to other western countries, the incidence of Skin cancer in Australia is 2-3 times more than countries such as the UK and North America.

What are the leading types of Skin Cancer:

melanoma – Often lethal if not treated early

basal cell carcinoma (BCC) *

squamous cell carcinoma (SCC) *

*BCC’s and SCC’s are known as non-melanoma skin cancer. SCC’s can be malignant dependant on their location on the body. BCC’s are typically non-malignant, however, their behaviour can be as damaging to tissues as a malignant lesion.

Incidence and mortality of Skin Cancers in Australia

• 2 out 3 Australians diagnosed with skin cancer by 70 years of age

• Between 1982 to 2007 Melanoma diagnosis increased by 50%

• BCC’s and SCC’s are the most common type of skin cancer

• More than 400,000 people are treated for one or more Non-melanoma skin cancer

• 543 people died of non-melanoma skin cancers in 2011

• Melanoma is the 3rd most common cancer in both males and females, and the most common cancer in people aged 15-44 years old

• In 2009 approximately 11,500 people were diagnosed with melanoma

• In 2011 there were 1544 deaths due to melanoma

• The 5 year survival rate for melanoma is 90% for men and 94% for women

• More than 2000 people died from all types of skin cancer in 2011

Symptoms and diagnosis of skin cancers

Early diagnosis is key to prevention and often curative management, with or without surgery. With delay skin cancers often results in significant surgical intervention, potential disfigurement and or in some cases death. It is not unusual for patients to detect their own skin cancers or the changes associated with formation of skin cancer.

What are these changes that you need to look for:

• Sores that appear like pimples, or crust and never seem to heal

• Sometimes application of moisturiser will initially make the sore disappear, it returns months later

• Often the lumps are pimple like, small, red, pale or pearly in colour

• Some lesions form a crater or ulcer

• Abnormal spots or moles will change in shape, size, colour and contour over a period of weeks to months. Many of these lesions will have variegated colour, especially those dark brown to black, red or blue-black in colour.

Visit the cancer council website for more information about early detection of skin cancer by clicking the following link screening and early detection of skin cancer. There is also a section on how to check your skin for signs of skin cancer.

Causes of skin cancer

Skin cancer in the majority of cases is caused by exposure to radiation from the sun. The incidence increases with age.

Sunburn

• 95% of melanomas is caused by sunburning

• On average during the summer months, 14% of adults, 28% of teenagers and 8% of children develop sunburn.

• Sunburn occurs equally when it is sunny and during overcast days.

• Prolonged and repeated exposure to the suns radiation will cause skin cells to become damaged and potentially lead to skin cancer.

Tanning is not healthy

• Many Australians still consider that a tan looks healthy. The risk however, is skin cells are damaged and they develop skin cancer.

• Tanning indicates that the skin has been exposed to excessive UV radiation. Other than skin cancer, the damage to the skin manifests itself in wrinkles due to the loss of skin elasticity, dis-pigmentation of the skin (poikiloderma) and patchy pigmentation, accelerated aging and sagging of the skin.

• Fake tan does not offer adequate sun protection; it is equivalent to applying SPF4. Typically SPF30-50 is recommended for adequate sun protection. UV radiation will damage the DNA of cells and lead to the development of skin cancer.

Solariums

• Solariums work by emitting UVA/UVB radiation close to the skin. Consequently solariums are recognised as causing skin cancers especially deadly melanomas. Solariums are not recommended for tanning; as of December 2014 they will be completely outlawed in NSW.

Skin Protection and Prevention

Protect your skin

• Protection of your skin includes sun cream usually SPF 30 to 50 and re-application of the cream every 2 hours

• Sun cream is not meant to be used as a means of prolonging your time spent in the sun

• Wear protective clothing, hats, and sun glasses

• Midday is when UV exposure is at its worst, so try to avoid exposure during this time of the day

• The weather bureau provides a UV forecast index so check this to determine the need for sun protection (an index of 3 or above is significant)

Management options for skin cancers

Premalignant and superficially forming skin cancers can be treated by a variety of therapies dependant on the type of lesion. This may include cryotherapy (freezing), or curettage and or cautery. Other modalities include various topical creams specifically designed for superficial lesions.

It is not uncommon for a biopsy to be taken of suspicious lesions to determine the depth and type of skin cancer forming in the skin. Biopsies will help determine if a skin cancer requires surgical excision.

The majority of skin cancers will require formal excision. Some can be performed under local anaesthetic in the surgery rooms. However, more advanced skin cancers will require extensive excision of the lesion and surrounding skin, to ensure complete removal of the lesion. Occasionally the repair of the resulting defect or wound may require a skin flap or graft; consequently these lesions may require excision and repair to be performed in an operating theatre.