Skin Cancer
Prevention
Exposure to ultraviolet (UV) radiation is the primary preventable risk factor for developing skin cancer. UV radiation causes inflammation and DNA damage in skin. Fairer skin types are more susceptible to these effects. Every day, UV levels rise to a peak at midday before decreasing to zero after sunset. During the summer months, the peak UV is over 4 times higher than in winter. The daily UV level can be tracked by using various weather Apps including Sunsmart. By avoiding prolonged sun exposure when the UV level is above 3, you can minimise your chance causing inflammation and damaging the DNA in your skin.When you are exposed to UV levels of 3 and above, you can follow the Slip, Slop, Slap, Seek Shade advice. Keeping to shaded areas and wearing adequate clothing and sunscreen as needed will help minimise UV damage to your skin. For some individuals with a history of multiple skin cancers or pre-cancerous sun spots, vitamin B3 (niacinamide/nicotinamide) supplementation may be helpful. This is not suitable for everyone and should be discussed with your doctor. Detection
Self check
Being aware of the skin changes which occur with skin cancer can help to detect any new suspicious spots. Keeping an eye on your own skin and being observant of anything unusual on your friends and family can aid in early detection of skin cancer. Full Skin Checks
Regular full body skin checks will help to identify small and subtle skin cancers, as well as those which are in locations which are difficult or impossible for you to inspect yourself.Most patients who have regular skin checks attend annually. In some circumstances, we may advise patients to attend more or less regularly, based on their level of risk.We only book 30 minute full body skin cancer checks, to allow time for examination of the entire body including soles of feet, scalp and oral cavity; education around sun safety and biopsies if needed during the consultation. The skin check is performed with patients wearing underwear and lying on the examination bed. A draw- sheet is available if patients wish to only expose part of their body at any one time. A friend or relative is welcome to join each patient during the skin check, if this helps patients to feel comfortable. The comfort of our patients is our number one priority. We use magnification with polarised light to optimise visualisation of skin structures with a dermatoscope. Biopsies
A biopsy is the removal of a small piece of skin for the sole purpose of confirming diagnosis. This involves the injection of a small amount (<1ml) of local anaesthetic into the skin, before removing a superficial piece of skin. Most biopsies at our clinic are shave biopsies and do not require stitches. A small dressing is place over the wound and remains in place for at least 3-4 days. Some suspicious skin lesions require excision of the full thickness of the skin to confirm diagnosis and in these circumstances stitches are sited to close the wound. Stitches are usually removed after between 5 and 14 days, depending on the body site.Serial imaging
Serial digital dermatoscopic imaging is the process of comparing magnified digital photographs of a skin spot over consecutive consultations. This can be helpful in the detection of early melanoma and can help to avoid unnecessary biopsies. Treatment
Topical treatments
Pre-cancerous changes in the skin and some superficial skin cancers can be treated with cryotherapy (freezing with nitrogen gas), and prescribed topical creams/gels.Excision
Thicker cancers and melanomas of any description are generally treated with surgical excision (‘cutting it out of the skin’). This allows the piece of skin which has been removed to be examined under a microscope to ensure that all of the cancer has been adequately removed.When smaller cancers are excised from most locations on the body, the wound can be closed simply by side-to-side closure with stitches.For larger cancers and those on certain parts of the face, scalp, lower legs, hands and feet, a surgical flap or skin graft may be required to close the wound.At Helios, we will make every effort to ensure that any discomfort associated with skin treatments is minimised and that any surgical wounds are given the best chance to heal in a cosmetically pleasing way, without compromising on the quality of treatment. These efforts include adjusting the local anaesthetic mix to minimise stinging, the routine use of buried dissolving sutures to minimise superficial skin tension and routine taping of wounds to minimise scar stretch. We can advise on topical products such as medical grade silicone to optimise the appearance of scars. Radiation therapy
For treating certain subtypes of skin cancer and some skin cancers in difficult surgical locations, radiation therapy can be a safe and effective alternative to surgery. Radiation is prescribed and administered by radiation oncologists. Systemic therapies
Chemotherapy and immunotherapy are systemic therapies which are prescribed and administered by Medical Oncologists for skin cancers which have spread beyond the skin, to lymph nodes or distant sites in the body. Collaboration
From the moment a skin cancer is suspected, throughout every stage of diagnosis, management and follow-up, staff at Helios Skin Cancer Clinic will strive to collaborate with other relevant health professionals wherever this may be helpful. We enjoy positive working relationships with local General Practitioners, Dermatologists, General/Plastic Surgeons, Pathologists, Radiologists and Medical/Radiation Oncologists. You are the most important person to consider while we manage your skin. When skills and services are required that are not available at our clinic, or if for any reason you wish to discuss management with another doctor, we will happily refer you. With your permission, we will endeavour to forward copies of your pathology reports to you General Practitioner so they are aware of any diagnoses we make at Helios.