While everyone is encouraged to regularly check their skin, the process of identifying which lesions require attention can be detailed and nuanced. Understanding the signs of skin cancer, and knowing when surgical intervention may be necessary, is crucial for long-term skin health.
What are the common symptoms of skin cancer?
Skin cancer, which can be addressed through skin cancer surgery, manifests differently depending on its type. Basal cell carcinoma typically presents as small, pearly bumps, red patches, or slightly elevated growths that may occasionally crust over or bleed. In contrast, squamous cell carcinoma often appears as persistent, scaly, red patches or wart-like growths that might sometimes bleed. Melanoma, which is less common but more serious, typically presents as a mole or spot that changes in colour, size, or shape over time.
It’s important that any lesion which shows asymmetry, irregular borders, multiple colours, or a diameter larger than six millimetres is monitored closely. Rapid changes, such as new growths or sudden darkening of an existing spot, should always be assessed. Persistent itching, tenderness, or bleeding can also be warning signs that the lesion requires further evaluation.
When should you consider seeing a doctor?
Any new or changing lesion should be evaluated without delay. This is especially true if a spot continues to grow, develops crusting, or becomes painful. While some changes may be harmless, distinguishing between benign and potentially malignant lesions requires a clinical assessment and sometimes diagnostic tools such as dermoscopy or a biopsy.
A medical professional can examine the lesion, take a detailed history, and, if necessary, perform a biopsy to confirm whether it is cancerous. Early identification is important because treatment options, particularly surgical ones, can be more straightforward when skin cancer is caught in its early stages.
When is surgical excision considered?
Surgical excision is often recommended when a lesion has been confirmed as malignant or has suspicious features that make malignancy likely. This procedure involves removing the lesion along with a margin of healthy tissue around it to ensure complete excision. The size of the margin depends on the type and location of the cancer, as well as its depth.
The procedure is precise and requires careful planning. For instance, the skin’s elasticity and how it will be closed after removal are considered to minimise tension and optimise healing. The goal is to remove all cancerous tissue while preserving as much healthy tissue as possible, especially in areas where skin is thinner or more delicate.
How is surgical excision performed?
Before the procedure, the area is marked to outline the lesion and the margins. Local anaesthetic is typically administered, allowing the procedure to be performed without general anaesthesia in many cases. The lesion is then carefully excised using a scalpel, and the depth is adjusted based on the type of skin cancer. In some instances, underlying tissue may also be removed if there is concern about deeper invasion.
Once the lesion and surrounding tissue are excised, the wound is usually closed with sutures. Depending on the location and size of the excision, the surgeon may use layered sutures to support deeper tissue while bringing the skin edges together. Occasionally, small flaps or grafts are used if direct closure is not possible.
What follow-up is required after surgical excision?
Follow-up care is an essential part of the process. The excised tissue is sent to pathology for examination to ensure that the margins are clear of cancer cells. If the margins are positive, further excision may be required. Regular skin checks after surgery are recommended, as a history of skin cancer can increase the likelihood of developing new lesions.
The frequency of follow-up appointments varies depending on the individual’s risk factors and the type of skin cancer removed. Some patients may require ongoing annual skin assessments, while others may be advised to return more frequently in the first year after excision.
What are the risks and considerations of surgical excision?
As with any surgical procedure, there are considerations that need to be accounted for. Risks include infection, bleeding, delayed healing, and scarring, all of which can vary depending on the location and size of the excision. Occasionally, further treatment may be required if the margins are not clear, or if the lesion is particularly aggressive.
Selecting the right approach and timing the procedure appropriately are important to reduce complications. A well-planned excision allows the surrounding tissue to support closure, and careful post-operative care helps to minimise adverse effects on healing.
A/Prof Bish Soliman: Skin Cancer Removal Procedures in Sydney
A/Prof Bish Soliman is a FRACS qualified Specialist Plastic Surgeon with experience in skin cancer removal surgery.
If you need surgical excision, having a consultation with an experienced plastic surgeon will provide you with essential information about the process.
To book a consultation in Sydney or North Shore, please get in touch with our team.
