In Australia every year 1/400 people die from melanoma and 1/450 die of non- melanoma skin cancers. Many of these deaths could be prevented by educating patients on preventive measures including how to identify suspicious lesions so that patients can present early to a doctor.
Dr. Argie has always had an interest in skin and not only has two cosmetic medicine Fellowships (qualifications recognizing specialization in a field of medicine) and a Diploma in Dermatology from Monash University. She is also currently undertaking a Diploma in Skin Cancer Surgery which takes around 2 to 5 years to complete. She has been removing skin cancers since 1996 and not only aims to remove the suspicious lesion completely but also with the best final cosmetic result.
Dr. Argie also has the advantage of using ARGERA’s state-of-the-art Health Department day hospital theatre for her removals.
The first step is to book an appointment with the doctor to check your lesion(s) of concern. During that consultation, she will look with a dermatoscope to enlarge the cellular pattern and aid in diagnosis. During the initial consultation, a biopsy can be performed if indicated. Once the biopsy results are back, a more detailed plan can be made about the necessity of removing the lesion, the type of removal and any risks. Some lesions are obviously cancerous and plans for removal can be made without the need for biopsy. There is small out of pocket fee of $55 when a biopsy is taken, in addition to the consultation fee. Most of the consultation fee is rebated by Medicare.
The cost of the removal will be dependent upon the complexity, size of the lesion, the location of the lesion and its pathology. It will mostly be covered by Medicare with a small out of pocket fee for the cost of materials (around $110 to $220 for more difficult removals).
Removal techniques include -
- Standard elliptical excision - a basic ellipse cut is made around the lesion with a safety margin. It is then sutured for closure. This is the most common type of removal.
- Skin Graft - reserved for where there is a lot of tension in the skin and suture closure is impossible. Skin is taken from a donor site similar in nature to the lesion’s surrounding skin.
- Flaps - technical cuts where the skin is rotated to allow closure of the wound along lines of natural healing to improve the cosmetic result. Flaps are used where elliptical removal is impossible, or where it would result in a poor cosmetic outcome. More cuts and suturing are required, but in time these usually heal with good cosmetic results.
- Wedges - occasionally needed in areas such as the ear lobe.
Where cancerous tumours have penetrated near cartilage and bone, or if an invasive melanoma is involved, referral to a dermatologist or reconstructive plastic surgeon will be needed.
Other treatments for cancerous lesions may include topical creams that target cancerous cells over a number of weeks, or within hours with specialized medical light activation. Our doctor will be able advice on the suitability of these options in each individual case.
So what are the danger signs a patient should look for at home?
It’s as simple as ABCDE
- A is for Asymmetry (one half of the mole doesn’t match the other)
- B is for Border irregularity
- C is for Color that is not uniform
- D is for Diameter greater than 6 mm (about the size of a pencil tip eraser)
- E is for Evolving size, shape or color.
If you notice any CHANGE in size, shape or elevation of a mole, or experience any new symptom such as bleeding, itching or crusting, see your health care professional promptly. Check for suspicious moles once a month and report anything unusual to your health care professional.
Prevention centres around avoidance of excess sun, since nearly all skin cancers can be triggered by exposure in prone skin. It is important to have at least 20 minutes of direct sunlight a day to generate vitamin D for bones and the immune system. On a hot day, this would be obtainable by simply carrying on normal daily activities such as hanging washing on the line. In Winter it may constitute actively seeking sunlight. Prolonged exposure requires the skin to be covered up with clothing, hats sunglasses, and sunscreen. Sunscreen should be broad-spectrum (UVA and UVB) cover. Patients wanting additional protection of their melanin plus anti-aging effects should add medical strength 20% pure vitamin C serum or cream. Our doctor uses a combination of these daily on her face, neck décolletage, and hands. These are the areas that are generally most affected by the sun and the tell-all areas of aging on women.