Scar-less skin surgery?
There is no such thing as scar free skin surgery.
The only scar free Surgery is to the unborn fetuses.
Most surgical scar will be barely visible in a few weeks / months. Scars naturally remodel. However it will help, when the wound has been stitched correctly and well looked after post operatively.
Our patients rarely develop pin cushions, trap doors, retracted nostrils, crooked lips or eyelids. In the rare event that you do- we will know how to fix it. Complications rarely happen with proper patient selection and having a good skill set.
Can skin cancer be missed on examination?
There are certain skin cancers that by nature can be here one day and gone the next. That is why is in your own best interest to do regular self skin examinations looking out for any lesion/s that have changed in shape, size, colour, texture etc…
It is not uncommon to book a patient in for surgery, then on the surgery day the cancer is invisible, but sure enough 3 months later the cancer rears its head again.
No clinical examination will be able to pick up all of your skin cancers on 3, 6 or 12 monthly examinations. In fact, in the general community, most skin cancers are picked up by you then presented to the doctor for confirmation.
The vast majority of skin cancers don’t kill or mane. The ones that we see that could do are: merkle cell carcinoma (a cancer that is much more sinister than melanoma) and nodular melanoma or non-pigmented melanoma which by their nature are extremely difficult to pick up in the very early stages. These cancers grow very rapidly become a large bump within a few weeks to months.
How long does a skin cancer examination take?
Less than 3-4 minutes, undressing and re-dressing may take longer. Ideally on the day of your consultation manageable clothing and no make up will make it easier for both Your Doctor and yourself.
Do we do mole checking machine?
No we don’t. We don’t rely on machines to make decision for us.
Such machines are great to doctors who are not yet proficient in skin cancer diagnosis.
Mole checking machines may be of value in high risk melanoma patients with hundreds of moles and numerous dysplastic neavii ( atypical moles ) where numerous routine biopsies would be impractical and hence photographic follow up would be ideal.
Do we take photo of moles ?
From time to time the doctor may do Microphotography of low risk but still suspicious atypical moles for comparison where biopsy is not required, especially if that mole is in keloid prone areas or if the patient is needle phobic.
Results,
You are welcome to phone us for results. You will be given a copy for your record if required. The results will only be given to the Patient or your General Practitioner.
Prioritizing Skin cancer care,
Skin cancer is part of daily life in Australia. The majority of skin cancers we see wont kill you, but do require treatment to reduce big scars and unnecessary pain. Most important is that you have regular skin cancer examinations as part of your overall health screening program.
Skin cancer education
The internet is full of skin cancer information. Bing or Google for basal cell carcinoma, squamous cell carcinoma or melanomas with search phrase ending with mayo, edu, or dermnet and you will have more information than you need without being bombarded by ads trying to get you in for skin checks, sell you cures, and promote expensive treatments.
Do we do Moh’s surgery ?
From time to time the doctors at Marsden skin cancer clinic may use “modified or slow Mohs’ surgery” . This is a very useful technique for subtle cancers that may be difficult to see with rushed pathology examination that are used in the regular Mohs’ surgery. These include certain basal cell carcinoma, dermatofibrosarcoma protuberans, lentigo maligna, acrolentiginous melanoma in situ., sebaceous carcinoma and extramammary Paget’s disease
Slow Mohs is a staged excision. The open wound is left opened then closed at a later date ( up to a week or longer ) when we have the clearance from our pathologist.
We rarely use Moh’s surgery. If a doctor has excellent surgical skill then the issue of tissue sparing or good wound closure is really a non issue in the majority of cases.
Moh’s surgery can be argued that in the majority of cases—unnecessary and simply un-economic for the patient and the healthcare system.