I was lucky enough to score some leave over Christmas & spent time catching up with my extended family on the Gold Coast .
I have 2 younger brothers & although we don’t see each other often ,it’s always great to catch up .
After our initial greetings my youngest brother pulled out his iphone & showed me photos of his recent plastic surgery involving the removal of a large chunk of skin on the tip of his nose because of Basal Cell Cancer –the monstrous defect was closed with a flap of skin from his L cheek & rotated across to fill the gap .The wound was healing well…!!!
He then proceeded to show me a new collection of Basal Cell & Squamous cell cancers( SCC) that had appeared since his “nose job”. More surgery booked …
Confronting…!!
My middle brother then lifted his shirt & showed me his latest scar from a recent ( his second) melanoma operation . I quickly scanned his back at his request & found 3 Basal Cell Cancers(BCC) needing removal & then as he turned noticed a nasty invasive BCC on his L ear overlying the cartilage just below the upper helical margin of his ear . Wow…!!
Then I got to thinking- my own skin cancer Doctor had left town 2 yrs earlier & I haven’t had a proper skin check since …Hmmmm.
I did some looking on line , found a reputable clinic nearby & made a booking .
Several days later I walked out of the clinic with the diagnosis of 3 definite BCCs including one on the nostril (ouch ) ,a likely superficial SCC & several indeterminate lesions needing biopsy .
Take home lessons are simple .
1. Don’t neglect your skin –especially as you get older & especially if you are fair skinned & have spent a lot of time outdoors .
2. Skin Cancer in our community is VERY Common , mostly curable , relatively easy to diagnose & is best managed early .
1 in 2 of us will develop a BCC in our lifetime , 1 in 6 of us an SCC & 1 in 14 will develop melanoma . It’s the latter that can be fatal .
Melanoma prognosis is excellent if it is diagnosed & excised prior to the tumour reaching a depth of 0.76 mm. Yes that’s correct –NOT VERY DEEP.Beyond this depth the 5 year survival rates/disease free intervals decline .
3. Sunscreen has an established role in reducing the development of new actinic keratoses /reducing the risk of these lesions progressing to cancer .
4. Nicotinamine , a vitamin B 3 derivative has a potentially important role in protecting the skin against the development of actinic keratoses ( sun spots ) & may also prevent progression of these spots into skin cancer .
5. A relatively new cream ( Aldara) can be very useful in managing early superficial cancers without the need for surgery .
6. Photodynamic therapy is showing promise in patients with age related sun damage /actinic keratoses & can be as simple as applying a cleanser,followed by sunscreen ,followed by the active treatment cream ,followed by a couple of hours in the sun …The sun damaged skin /skin lesions then redden ,crust & in ~ 10 days fall off with new skin replacing the old damaged bits .
At McLeod St Medical, we have an interest in the diagnosis & treatment of skin cancer so don’t leave it too late & please book in for a review if you find anything that doesn’t look right .
We have an operating microscope that doubles as an excellent extra pair of eyes with hard to diagnose skin lesions , along with the latest polarized light dermatoscopes.
Happy 2019 –stay Sun Safe … SLIP, SLOP, SLAP.
Dr Cam McLeod
