Skin cancers are by far the most common form of cancer in humans.

As a direct result of the sunny New Zealand climate and the outdoor lifestyle of the average Kiwi, we have one of the highest rates of skin cancer in the world. Fortunately the majority of these cancers can be cured with surgery and are rarely a threat to life.

The key to effective treatment lies in early diagnosis, expert surgical removal to ensure complete eradication of the cancer, and maximizing the aesthetic results of surgery.

Basal Cell Carcinoma (BCC)

BCCs most commonly occur on the face and other areas of the body that have received prolonged sun exposure. They develop as small non-healing red or lumpy lesions on the skin and gradually get bigger over a period of some weeks or months. When treated early, they are almost always curable with minor surgery, usually performed under local anaesthetic. Some forms of BCC may be treatable with the use cryotherapy (liquid nitrogen) or the use of topical ointments such as Aldara prescribed by your GP or specialist.

When surgery is recommended, the exact procedure will be discussed with you in detail. This usually takes the form of a local anaesthetic procedure and the lesion is always sent for histological examination (under the microscope) to check the diagnosis and ensure that it has been completely removed. Very occasionally (less than 1% of cases in my practice), a second procedure will be recommended if the histology examination turns up unexpected findings or more extensive infiltration of the tumour than originally thought.

Once the cancer has been removed, the surgical defect will be repaired using a plastic surgical technique to minimise any potential for deformity or scars. This may involve the use of local flaps or less commonly skin graft.

Squamous Cell Carcinoma (SCC)

SCC of the skin is the second most common form of skin cancer after BCC. It is most commonly related to sun exposure, though there are other causes such as certain drugs or previous radiation therapy.

SCC appears as non-healing scaly, red or lumpy skin lesion which grows slowly over some weeks or months. Occasionally it can grow quite rapidly, such as the subtype referred to as Keratoacanthoma. Most SCCs remain localized and do not tend to spread elsewhere in the body. There are exceptions to this rule though, particularly in the head and neck, when spread to lymph nodes may be anticipated in around 5% of SCCs. This is especially true if they have been neglected for a long period of time.

When treated early, SCCs are almost always curable with minor surgery, usually performed under local anaesthetic. Some forms of SCC may respond to other treatments such as cryotherapy (liquid nitrogen) or topical ointments such as Aldara prescribed by your GP or specialist.

When surgery is recommended, the exact procedure will be discussed with you in detail. This usually takes the form of a local anaesthetic procedure and the lesion is always sent for histological examination (under the microscope) to check the diagnosis and ensure that it has been completely removed. Very occasionally (around 1% of cases in my practice), a second procedure will be recommended if the histology examination turns up unexpected findings or more extensive infiltration of the tumour than originally thought.

Melanoma

It goes without saying that the diagnosis of melanoma can come as devastating shock to you and your family. Unfortunately it is a disease with little regard for the patient's age and can strike at anytime. Whilst the publicity around prevention and diagnosis of melanoma has served to ensure a much higher level of public awareness around this condition, this also raises the level of fear and despair that may be experienced when the diagnosis is made.

Hope is most certainly out there, and the good news is that the majority of melanoma patients are successfully treated. The key to this success is early diagnosis and timely surgical treatment from a team of specialists who deals with this condition on a regular basis.

If you are concerned about a mole or a spot on your body, you should have it checked as soon as possible by your GP. If there is any doubt about the spot, it should be removed in its entirety and submitted to the laboratory for analysis. This is the ONLY way to make an accurate diagnosis. If the diagnosis of melanoma is made, you will be referred to a plastic surgeon for further examination and possibly surgery.

It is difficult to be concise about the range of treatments that may be recommended to you as there are a number of different factors to consider. The most important thing is that you are treated in a timely manner and with reference to best practice guidelines produced in the "Clinical Guidelines on the Management of Melanoma in Australia and New Zealand".