Melanoma skin cancer
Skin cancer is the commonest type of cancer in Australia. Broadly speaking there are two types of skin cancer – melanoma and non-melanoma (basal cell cancer and squamous cell cancer). To read more about non-melanoma skin cancer click here.
Melanoma is a disease where malignant (cancer) cells form in the cells that give your skin colour (melanocytes). While most moles or freckles are safe, some moles may begin to change shape or colour, potentially resulting in melanoma.
The main preventable cause of melanoma is excessive ultraviolet radiation, either from the sun or from artificial sources of ultraviolet radiation (e.g. sunbeds). Factors that can result in you have an increased risk of melanoma include having a fair complexion, having multiple moles, having repeated sunburns, or a family history of melanoma.
As melanoma can grow quickly if left untreated it needs to be removed as early as possible.
Your GP or dermatologist may have already done a sample of the area (skin biopsy) to confirm that the lesion is melanoma.
Once this is confirmed a wider excision of the area is recommended to reduce the risk of melanoma recurring or spreading.
The exact nature of your operation will depend on the type, size, and location of the melanoma.
Smaller melanoma skin cancers may be removed under local anaesthesia (with you awake) and as day surgery, meaning you can go home the same day. The lesion is removed and sent to pathology laboratory for analysis, the incision is closed with sutures, with a dressing applied.
Larger melanoma skin cancers may be removed under local anaesthesia with some sedation, or sometimes under general anaesthesia (with you asleep). The lesion is removed and sent to pathology laboratory for analysis. Depending on the thickness of your melanoma lesion a sample of the lymph nodes (sentinel node biopsy) may be indicated. If the wound is too big to close directly with sutures then it may be reconstructed with a skin graft or flap. If any of these treatments are necessary then Dr Colbert will be discuss them with you before your operation.
Your exact recovery will depend on the size of the lesion and the area it is located, however most people can return to their usual activities the following day.
Patients usually experience only mild discomfort after the operation.
Follow up with Dr Colbert will be arranged to ensure the wound is healing without problems, to discuss any results, and to remove any stitches.
Regular follow up is essential to assess for any recurrence or spread of the melanoma, and also to diagnose any other new melanoma lesions.
While there will be a scar from where the lesion was removed, as a plastic surgeon Dr Colbert will always aim to minimise scarring by using precise surgical techniques and by placing scars where they will be hidden.
Surgical scars usually take several months to settle down – they are often initially lumpy, bumpy, red, then after several months settle to become flat, thin, pale.
Skin cancer surgery is associated with the following risks:
Wound infection: this may present as redness or discomfort or discharge, and may require a course of antibiotics.
Bleeding, bruising, and haematoma: haematoma refers to a collection of blood that needs to be removed in the operating room.
Delayed wound healing: skin grafts may not completely ‘take’, resulting in further dressings being required until they heal.
Scarring: scars are initially lumpy, but settle down over months. Rarely they may be permanently lumpy or thick (hypertrophic or keloid scarring).
Deep vein thrombosis (DVT) and pulmonary embolism (PE): DVT refers to a blood clot that forms in a vein in your limb, which can break off and travel to your lung (PE). This can be serious, but is thankfully very rare, especially in skin surgery.
Incomplete excision: there is a small risk (less than 1 in 20) that the lesion is incompletely excised at the time of surgery, resulting in further surgery being recommended.
Skin cancer surgery is like any surgical procedures in that it carries risks - therefore before having any operation you should always speak to an appropriately qualified health practitioner about these potential risks.
Costs associated with plastic surgery can be confusing. To help make things clearer we have listed the the following fees that make up the final cost.
Surgical fee: Medicare will partly pay for some surgical procedures that are itemised by the government, however depending on the nature of your operation there will be some out of pocket expenses. Dr Colbert will discuss these costs with you during your consultation.
Anaesthetic fee: Medicare covers most of the anaesthetic fee, except in the case of some cosmetic operations.
Hospital fee (this includes operation room fee, bed costs, surgical or medication fees, and any other hospital extras): Medicare does not cover this fee. If you have private health insurance then this may be covered by your insurance fund, but you should check with your fund if there is any out of pocket expenses. If you have no private insurance then you will have to pay this fee on discharge from the hospital.