Preparing for your Skin Cancer Surgery
At Skin Essentials, where possible, we reserve wednesdays for our skin cancer excisions – this is where, after a skin cancer check, and a biopsy sample of suspicious lesions, we get confirmation that it is a skin cancer that needs removal.
If you opt for Dr Joshi to do your surgery, as opposed to being referred to another doctor, part of the process is discussing what happens next, as shown by this recent reel here
The reel describes how this woman, Catherine, had what appeared to be an age spot that turned out to be a early stage melanoma. Despite excision, she had to go back for a second round of excision/ surgery because the margins were not wide enough. Following recovery, she then needed a third surgery due to some puckering of part of the scar. Catherine ends her reel reminding everyone to get skin cancer checks.
Australia is the skin cancer capital of the world.
We have the highest rates of skin cancer for a number of reasons (please link to our skin cancer information page from the website here), among them our love of the sun.
We recommend annual skin checks at minimum as a young adult, and more often if you’re someone who has had a lot of sun growing up, or works outdoors now.
Equally, if you notice any new skin changes, please get it looked at by your doctor if it’s growing, changing or otherwise worrying you.
What happens at a skin cancer check?
Some key housekeeping issues that we ask you to be mindful of for best results at your skin cancer check:
- please arrive without any makeup or tan/ fake tan on to allow us to see your skin clearly
- please avoid painting fingernails and toenails so we can examine these also
- please wear loose clothing that can be easily removed; unless you prefer not to, we offer a full body examination in your underwear
- if there are any leasions that worry you, especially on your back or a difficult to see area noted by a loved one, we ask that you get them to circle the lesion of concern to avoid confusion especially if you have many moles in that region.
If we do find any lesions that are suspicious, Dr Joshi will talk to you about a biopsy which is taking a sample of the area to send to the pathologist. The pathologist is a doctor who will examine the tissue and either confirm an abnormality or reassure us that there is nothing further to do.
If the lesion is abnormal, you will be called back to another appointment to discuss your options:
- removal of the cancer in clinic at a different date and time
- referral to another doctor to do the same
- referral to another doctor for a second opinion
I’ve chosen to have my skin cancer surgery with Dr Joshi…
We will book this in for you and talk you through the process including fees, time off work, pain relief and any other relevant information.
Dr Joshi will also discuss the removal process and the healing process with you and when you’d come back to have your stitches out.
Rarely, the cancer may have spread further than we can see with the naked eye. When his happens, we refer to it as having “inadequate margins” as with Catherine above.
With inadequate margins, there isn’t enough space between the cancer cells and healthy skin to ensure < 5% chance of the cancer coming back. In these cases, it’s often recommended that we operate again to clear margins. This is rare but something that will be discussed with you, especially in areas such as skin cancer on the face.
Sometimes, depending on where on the body the cancer occurs, it is not possible to go any deeper to get the cancer. In such cases, very rarely, we may recommend you seek an opinion and treatment from a radiation oncologist to kill any remaining cancer cells.
All these and more may be discussed with you as part of the consent process to help you decide.
Lastly, as with all surgery, sometimes the scar may heal in a way that it puckers or pulls on the surrounding skin, as with Catherine above and a corrective surgery may be needed down the track.
Take home message.
As always the take home message we like you to have is that this is a longterm partnership between you and us. We aim to be there for you from day 1 till everything has healed and settled, even if it means occasionally that we may need to refer you to someone else if that’s needed.
The other important message is that sun damage can eventually turn into skin cancer left long enough, and it is never too late to start protecting your skin, even if you’ve had lots of sun up to now.
It’s never too late to begin.