Queensland is the sunshine capital of Australia. We are exposed to high levels of ultraviolet (UV) radiation, and this predisposes us to developing various types of skin cancers.
Like all cancers, skin cancers result from uncontrolled growth of abnormal cells. There are many different types, some of which require additional surgical treatments which cannot be provided in the general practice or skin clinic setting.
The most common types of skin cancer seen are:
Melanoma
Melanoma develops from melanocytes, which are the pigment cell in the deep layer of the skin. When normal melanocytes aggregate together as non-cancerous cells, they form moles (naevi). It is when these melanocytes grow abnormally, they can become a melanoma. It is important to remember that melanomas can rarely develop in locations that get very little sun. This not only includes areas usually under clothes, but also in the retina of the eye, or on the soles of the feet.
One in thirteen (~7%) of Queenslanders will develop a melanoma by the age of 85. An estimated 3100 people are diagnosed here every year. It is the second most common cancer in women and third most common cancer in men in Australia.
Melanoma is less common than other skin cancers but is more serious due to its ability to spread throughout the body (metastasise). It makes up only about 2% of all skin cancers yet is responsible for 75% of skin cancer deaths.
Dr Lancashire was trained by several specialist melanoma surgeons. He performs a sentinel lymph node biopsy for all melanomas that require them.
Indications of sentinel lymph node biopsy include, but are not limited to:
- a depth (Breslow thickness) of > 1mm
- ulceration
- high growth (mitotic) rate
- Clark level IV or V
Dr Lancashire will be able to explain whether you require a sentinel node biopsy, and what a positive or negative result means. You can read a more detailed explanation about sentinel lymph node biopsy here (this resource refers to its use in breast cancer but it applies to melanoma as well).
Basal cell carcinoma
Basal cell carcinoma (BCC) is the most common skin cancer. It makes up about 70% of all skin cancer diagnoses. It is usually a painless, pearly coloured lump that my become ulcerated. BCCs tend to grow slowly, and rarely spread to other parts of the body (metastasise). They are usually easy to treat, especially when they are removed early when they are still small.
Squamous cell carcinoma
Squamous cell carcinoma (SCC) makes up about 30% of skin cancers. It usually develops on areas of skin that are sun exposed. SCC may look scaly or thickened, and sometimes like a small sore that hasn’t healed. They grow more rapidly than BCCs and can metastasise. Fortunately, they are usually easy to remove, and again, more easily when they are smaller.
Surgery for skin cancer
Dr Lancashire has a wide experience in managing all types of skin cancers. He has expertise in the use of sentinel lymph mode biopsy, split-skin grafts and full- thickness skin grafts.
Many skin cancers can be removed under local anaesthetic or with some gentle sedation. Some skin cancers in difficult positions, or those which require a large or deep excision, a skin graft, or a sentinel lymph node biopsy, may require a general anaesthetic to be provided.
Dr Lancashire is happy to perform wider excision for skin cancers that require additional surgery that is more extensive than is possible to be done in community-based clinics.
Dr Lancashire recommends that anyone diagnosed with a skin cancer have yearly skin checks with a skin specialist (Dermatologist) and follow the Cancer Council of Queensland’s Stay SunSmart guidelines.
