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NON-MELANOMA SKIN CANCERS IN SYDNEY & CANBERRA

Australia is known for its incredible summers and beautiful natural environment. Unfortunately, one of the unwanted by-products of this bounty is that we have some of the highest rates of skin cancer in the world. While rates of cancer amongst Australians has improved in recent years, it still remains a major concern in our society.

THE SYDNEY AND CANBERRA CLINICS TO TRUST WITH YOUR SKIN CANCER TREATMENT

Among the general public, melanoma receives the bulk of attention. However, melanoma represents less than 2-5% of all cutaneous malignancies. The other 95-98% are the non-melanoma skin cancers and, as a group, these are the most common form of cancer in humans. The extensive incidence of non-melanoma skin cancers is often underrepresented in cancer rankings. Recent estimates demonstrate that more cases of non-melanoma skin cancers have occurred in the past 30 years than all other forms of cancer combined.

Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the most common forms and account for the vast majority of non-melanoma skin cancers. Despite growing public awareness campaigns on the harmful effects of UV exposure, the incidence of non-melanoma skin cancers has been rising by 3-8% per year since 1960. This trend is predicted to continue as populations age worldwide. Despite this increase, the death rate from non-melanoma skin cancers is decreasing due to increased awareness, earlier diagnosis and improved treatment options.

At Panthea Clinics, we specialise in skin cancer treatment to ensure that every one of our patients has the best chance at overcoming this difficult disease. Lead by some of the best medical professionals in the field, we are proud to be a leading skin cancer clinic throughout the country.

WHAT IS A BASAL CELL CARCINOMA?

Basal cell carcinoma (BCC) is a type of skin cancer that begins in the basal cells. They generally grow and spread slowly. Most BCCs are sproadic, with environmental exposures being the major causal factors, with a latency period of anywhere between 20 and 50 years from exposure to the development of BCCs. For this reason, most sporadic BCCs occur in older males (50+ years) with fair complexions as this group has the greatest lifetime exposures to environmental influences.

Intensive, intermittent UV exposure resulting in sunburn and blistering (especially during childhood/adolescence) is a major risk factor for BCC. Fair skin types and individuals in hot sunny climates are at greater risk of incidental intermittent sunburn. In Australia, which experiences the greatest UV solar irradiation per area of any continent, these factors combine to produce the highest incidences of non-melanoma skin cancers and melanoma in the world. Additional environmental factors include tanning bed use, chronic inflammation (burns, scars), ionizing radiation, arsenic and hydrocarbon exposure.

Early-stage superficial BCCs can now be treated successfully with creams. Most other subtypes are easily treated with simple resection. There are, however, subtypes that are prone to widespread infiltration and higher risk of recurrent growth. Most importantly, as with all skin surgery, aesthetically sensitive areas require special attention to reduce the chances of unattractive scarring and to achieve best camouflage of the incisions.

WHAT IS A SQUAMOUS CELL CARCINOMA?

Squamous cell carcinoma (SCC) is the second most common type of skin cancer, characterised by abnormal, accelerated growth of squamous cells.They may arise de novo (anew) or from precursor lesions called actinic keratosis (AK). Their estimated progression rate from AK to SCC is 0.025% – 16% per year. Squamous cell carcinoma in situ (also known as Bowen’s disease) is a very early form of skin cancer that hasn’t yet spread beyond the top layer of the skin. Once the cancer has spread beyond the epidermis (beyond the top layer of the skin), then it becomes an invasive SCC. Although less common than BCCs, SCCs carry a risk of metastasis and death. Despite the rising incidence of SCCs, there is a 20% reduction in mortality due to increased public awareness and more aggressive treatment of highly invasive tumours.

Increasing age and chronic UV exposure, including tanning bed use, are the most significant risk factors for SCC development, with a sharp increase in incidence over the age of 40. SCCs typically arise in sun-exposed sites (e.g. head, neck, ears, dorsal hands, lips and legs). SCCs usually present as a changing solitary lesion developing from a pre-existing AK or Bowen’s disease. Both of these precursor lesions can be confused with eczema or psoriasis, however, they are typically asymptomatic and do not respond to steroids. The development of tenderness, increased size or scale and erosions may represent progression to SCC.

SCCs are generally faster growing than BCCs and may spread to regional nodes or through the bloodstream to more distant sites, causing serious complications. The size, thickness and intrinsic nature of the tumour will determine its capacity for spread and threat. They require closer surgical scrutiny to ensure not only that the tumour is removed but also that there is no evidence of regional or distant disease.

THE PROCESS OF GETTING TREATMENT

If you are concerned about a lesion, you should visit your general practitioner who will then perform an examination of the site under a microscope (histopathology) and/or a punch biopsy. General practitioners, who suspect the lesion may be a type of skin cancer, will then write you a referral.

If you have been referred to us by your general practitioner, and the referral has been faxed to us, the team here at Panthea Clinics will contact you as soon as possible to book you in for an initial consultation to see Dr Farhadieh. At your initial consultation, Dr Farhadieh will review the histopathology results and perform a punch biopsy if one has not yet been done. At this consultation, surgical options will also be discussed, along with possible risks and complications.

Treatment may involve prescription of creams or in many cases, surgery. Depending on the size and scale of the lesion, surgery may be performed either under local or general anaesthesia.

WHAT YOU SHOULD KNOW

Every surgery carries complication risks, no matter how small or trivial here at Panthea Clinics in Sydney and Canberra, we discuss all of these with you at your  consultation.

To ensure the highest quality outcome, we like to see our patients at regular intervals following the initial postoperative consultation. If at any stage you have questions or concerns about your surgery or healing process, we are more than happy to discuss them with you day or night. It’s our belief that the trust between you and your surgeon is the most important factor in the surgical process. Our practice is based on compassion, honesty transparency and patient welfare. We pride ourselves on making sure that our patients feel supported through each stage of the journey.

Before proceeding make sure that you have read all the information sheets and have your questions answered.

Frequently Asked Questions

You will need to obtain a referral, as this will allow us to have a direct line of communication with your general practitioner.

It depends on the extent of the lesion and reconstruction needed. Often skin cancers can be managed under local anaesthetic or with twilight sedation. In some cases general anaesthetic is indicated.

Surgery without scars is impossible but remains the holy grail of plastic surgery. The art of plastic surgery is making sure that surgical incisions are camouflaged and are blended into the normal skin creases. Time and postoperative scar management often help a great deal in hiding the telltales of surgery.

It depends. Most skin cancer surgery recovery is quick, and most people are able to resume normal activities the next day.

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