SKIN CANCERPORT MACQUARIE CANCER CLINIC

Greenmeadows Health Centre152 Greenmeadows Drive

Port MacquariePh: 02 5525 1122Fax: 02 5525 1111

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The clinic has operated since 1996 and places a high priority on a prompt and comprehensive service. Theprincipal, Dr Robert Clarke has a Bachelor of Surgery (University of Sydney) and a Masters in Skin Cancer(University of Queensland). Once a suspect lesion is identified it can be removed at the time in the Clinic forsmaller lesions and within three weeks for larger lesions. Commonwealth Card holders are bulk billed,

otherwise a $20 gap fee is charged.

FACTS ABOUT SKIN CANCER• Australia has the highest incidence of skin cancer in the world.• Two out of every three Australians develop skin cancer during their lifetime.• Skin cancer includes basal cell, which grows locally, squamous cell, which can spread and melanoma, which

eventually always spreads.• Melanoma is the most common cancer in men aged between 15 and 50 and women aged between 15 and

34. It is the second biggest killer of young adults after motor vehicle accidents. The lifetime risk of gettingmelanoma in Australia is now one in 30.

• In Australia on average, 30 people are diagnosed with melanoma and 3 die of it each day.

• Early melanoma is totally curable. Advanced melanoma is almost always fatal.• Skin cancer manifests in a variety of ways. Almost always there is a progressive change in size, shape or

colour that occurs over a period of months.

ACTINIC OR SOLAR KERATOSIS lE SUN SPOTS• These are a slowly changing minor abnormality.• They are treated mainly because they are a nuisance, an irritation or of an unpleasant appearance.• Only a small number are progressive and become skin cancers (squamous). They become larger, thicker

and often become irritable. These are resistant to freezing. A 'sun spot' that returns or persists afteradequate freezing should be reviewed

TREATMENTS• The treatment of a solid skin cancer is excision. The pathologist can then report on the exact nature and

margin clearance. If it is superficial, other treatments such as curette and cautery (scrape and singe),double freezing or Aldara cream are used.

• There are many treatments for solar keratoses, all with their own advantages and disadvantages. Liquidnitrogen freezing is the most common, but it is not for everyone or every spot. For large areas, Efudix orSolareze are useful.

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INFORMATION ON PROCEDURES

FreezingFreezing (cryotherapy) kills the top abnormal layer of cells and the response of the skin is like a burn with pain,redness, and sometimes blistering. If a blister does form, prick it with a clean needle and drain. For care ofblisters or weeping areas, shower or bathe as usual, dab dry and apply an antiseptic cream I ointment andcover if possible. Repeat this until a firm scab has formed.

ExcisionsAll excisions produce a scar. We use several techniques to minimise-scar formation and the scar will generallvfade and flatten over six months, but never disappears completely. The local anaesthetic used stings for 30seconds and can be painful in sensitive areas such as the nose, ears and lips we add bicarbonate to reduce the

pain.PrecautionsLet the doctor know if you have an artificial heart valve or are on warfarin.Skin Care after Proceduresa. Ordinary excision - avoid activity in the first day which outs tension on the wound as this can causebleeding.Leave the dressing on for three days then soak it off during a shower or bath. Generally leave open but maycover to prevent clothing rubbing on stitches.b. Excision with graft.Leave dressing on the excision site. If the dressing becomes loose, apply more tape. The graft donor site it istreated as in point (a).c. After the stitches are removed a supportive dressing is applied, leave this on for 4 days, then it should besoaked and removed.ComplicationsApproximately 1% of excisions have excessive bleeding (ie.soaks the dressing). I this occurs apply a cold packfor 30 minutes and change dressing. Infection can occur (becomes red and tender, usually day 3-5 after theexcision). Infections occur mainly after an ulcerated or scabby cancer is removed as it is impossible to sterilisethe skin. Excising lesions in different sites is also a risk factor. If either of these complications occur come backfor review and managementSkin wound healingThe thin top layer (epidermis) heals in 3 days. The bottom thick layer (dermis) is only 25% healed when thestitches come out .The dressing supports the join and protects against bumps and stretching. You cananticipate the following time for removal of stitches.Face 5-7 daysNeck 7-10 daysTrunk & arms 10-12 daysLegs 14 days

Dr. R Clarke22nd October 2012

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