Skin Cancer Treatment

Benign tumours

The majority of skin moles and growths are harmless, hence being mainly of cosmetic concern. Nevertheless, the public awareness campaign about skin cancer risk motivates people to have many such moles removed for peace of mind.

Thin or early growths may be removed by laser without causing a scar. Larger, more advanced growths may need to be surgically excised, consequently leaving a fine scar.

APSA uses the Sciton (Erbium YAG) laser for ablation of benign (and selected superficial skin cancers). The Sciton is an extremely accurate ablative laser, that produces very little collateral tissue injury, hence minimizing complications such as scarring and hyper or hypo-pigmentation.

We do not use chemical or electrical cautery, as these procedures give less control to the operator; consequently they have a higher complication risk profile. 

Malignant Tumors

Australians have one of the highest rates of skin cancer in the world. This is due to our warm climate and the fact that many of us have fair skin, which is not suited to Australian conditions. Adding to this is our love of the great outdoors, where many of our activities are based. Ultraviolet radiation causes skin cancer by not only damaging cells in the skin, but also by depressing our immune system so that it is less able to destroy cancerous cells. We accumulate damage to our cells throughout our lifetime. It is never too late to start protecting our skin with a 30+ broad spectrum sunscreen, protective clothing and hats. Most skin cancers are curable, however early detection is important.

Basal cell carcinomas (BCCs) are the most common skin cancer. They usually occur on sun-exposed areas and grow slowly over time. They almost never spread elsewhere, but left untreated they will continue to grow, potentially making treatment more difficult.

Squamous cell carcinomas (SCCs) are also very common in Australia. They can grow quickly and need to be detected early as they can occasionally spread if treated too late.

Melanomas are another form of skin cancer that arise from our pigment producing cells (melanocytes). They are not as common as BCCs or SCCs, however they are potentially fatal and early detection is crucial. They can arise from moles, but often develop on normal skin. Melanomas, unlike BCCs and SCCs, occur not infrequently in younger people. The risk factors for developing melanomas include a family history of melanoma, excessive sun exposure, sunburn (particularly when young) and having many moles. Change in a mole is an important clue as is an irregular outline or colour.

It is important for Australians to have regular skin checks to improve the chances of detecting early skin cancers. At Adelaide Plastic Surgery Associates we have doctors that offer full skin examinations for skin cancers and are experienced in treating them. Depending on the type of skin cancer, we offer topical treatments (creams), photodynamic (cream followed by intense red light), laser therapy and surgery.

We also have treatments for other sun-induced skin problems, such as sun spots, increased pigmentation, prominent capillaries and wrinkles.

Photodynamic Therapy
(A new treatment modality)

The treatment of skin cancer and pre-malignant skin lesions has traditionally relied on surgical excision. This remains the mainstay of treatment. The benefits are that the lesion is completely excised and there is histological confirmation of that fact.

The benefits of a non-surgical solution are obvious, avoiding surgery, scarring and possible disfigurement. However one must always remember that when you are dealing with a malignancy these goals must always be secondary to the primary aim of cure.

There are many non-surgical options for the treatment of skin cancer and pre-malignant skin lesions. These include

• Cryotherapy
• Laser ablation
• Topical 5-fluorouracil
• Imiqamod
• Intralesional interferon

Photodynamic therapy has a number of advantages in the treatment of skin cancer and pre-malignant skin lesions. It is a one-stage treatment with proven efficacy and may be used to treat a large area in a single setting. The process is as follows.

• Aminolevulinic acid (an anti-neoplastic agent) is applied to the lesion. This is absorbed by the neoplastic (cancerous) cells.
• The aminolevelinic acid cream is covered and left in contact with the lesion for 2-4 hours.
• The lesion is then uncovered and excess cream wiped away.
• Red light is then applied to the lesion for 20 minutes.
• This results in cell damage that specifically targets the neoplastic cells, leaving the normal healthy cells unharmed.

The treatment period when the light is applied may be uncomfortable. Following the treatment there will be redness, inflammation, and crusting of the area for 1-2 weeks.

Photodynamic therapy is only appropriate for selected skin cancer and pre-malignant skin lesions. Your APSA doctor will advise you whether Photodynamic therapy (or any other non-surgical option) is the right choice for you.