Non-melanoma skin cancer (BCC, SCC)
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 melanoma click here.
Non-melanoma skin cancer is most commonly either basal cell carcinoma (BCC) or squamous cell carcinoma (SCC). Like most skin cancers these are caused by ultraviolet radiation, most commonly from the sun, but also from sun-lamps and solariums.
Anyone can get skin cancer, however your risk is higher if you have fair skin and freckle easily, have light coloured hair and eyes, or have a history of significant ultraviolet radiation exposure (such as blistering sunburns, working or playing sport outdoors).
Skin cancers are abnormal growths that need to be removed as early as possible.
Basal cell carcinoma (BCC) is the commonest type of skin cancer, and fortunately it cannot spread beyond its original location. Although it often grows slowly it needs to be removed before it grows deep beneath the skin and causes problems with surrounding nerves or vessels or other structures (e.g. the eye).
Squamous cell carcinoma (SCC) is another common type of skin cancer, and often appears in areas of significant sun exposure such as the head, neck, and arms. Rarely it may spread away from its original location, such as lymph nodes or distant organs. It can become life threatening if left untreated.
The exact nature of your operation will depend on the type, size, and location of your skin cancer.
Smaller 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 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. If the wound is too big to close directly with sutures then it may be reconstructed with a skin graft or flap. If 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.
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.