Skin cancer is the most common form of cancer in Australia, accounting for 80% of all newly diagnosed cancers. Skin cancers can vary widely in appearance, and are best detected and treated early. Most skin cancers start as small skin changes, lumps, discolouration or sores that get bigger over time, or have a history of coming and going. Any unusual areas of your skin should be assessed first by your GP and referred to a plastic surgeon if complex surgical treatment is necessary.
In skin cancer, the body’s skin cells are affected and is mainly caused by Ultraviolet Radiation from the Sun. Australia has the highest rate of skin cancer in the world, with approximately 2 out of 3 Australians diagnosed with skin cancer by the age of 70.
A specialist plastic surgeon is used to treat skin cancers when treatments are complex or they occur in cosmetically sensitive areas such as the face.
Meet your Surgeon
Dr. Steve Merten
Meet your Surgeon
Education and Training:
- Bachelor of Medicine, Bachelor of Surgery from Sydney University in 1991
- Fellow of the Royal Australasian College of Surgeons (FRACS) in 2001
- Fellowships in Aesthetic (Cosmetic) Surgery at the Melbourne Institute of Plastic Surgery and Monash University
- Fellowship in Breast Reconstruction at the University of British Columbia, Canada
- Clinical Senior Lecturer in Cosmetic Plastic Surgery and Plastic Surgery Fellowship Program Director at Macquarie University, Sydney
- Consultant Plastic Surgeon Concord Hospital, Sydney
- Supervisor of Plastic Surgery Training, Concord Hospital
- Consultant Plastic Surgeon at numerous top Sydney private hospitals, including:
- Macquarie University Hospital
- Hunters Hill Private Hospital
- North Shore Specialist Day Hospital
- Plastic Surgery Representative NSW Members Advisory Committee Avant Mutual
- Fellow, Royal Australasian College of Surgeons (RACS)
- Member, Australian Society of Plastic Surgeons (ASPS)
- Member, Australian Society of Aesthetic Plastic Surgeons (ASAPS)
- Member, Australian Medical Association
- Member, ANZPATH (Australia and New Zealand Professional Association for Transgender Health)
- Member, WPATH (World Professional Association for Transgender Health)
What are the different types of skin cancer?
There are three main types of skin cancer:
- Basal Cell Carcinoma
BCC is extremely common in Australia, and is the most common type of skin cancer. It occurs mostly in areas of long-term sun exposure, particularly on the face, head, neck and trunk regions, but can occur anywhere on the body. BCCs tend to grow slowly, over months to years, and rarely spread. They can usually be cured with surgery, leaving excellent cosmetic results. They most commonly present as a firm red or red-greyish lump, which may bleed from time to time.
- Squamous Cell Carcinoma
SCC is the next most common form of skin cancer, and typically grows faster than BCC and are more often seen in older people. They are more serious, and have the potential to spread elsewhere in the body. SCCs usually present as a scaly, quickly growing pink lump, which may also break down, bleed and ulcerate. They mostly occur in sun-exposed areas, such as the face and backs of the hands.
- Malignant Melanoma
Australia has the misfortune to have the highest rate of melanoma in the world. Excluding non-melanoma skin cancer, melanoma is the fourth most common cancer in both women and men in Australia. Although it is the least common skin cancer, it is the most dangerous. Melanoma mostly occurs on sun exposed skin, but can occur on skin that is generally covered, and rarely in areas that have never been sun exposed. Melanoma may develop from an existing mole or appear as a new brown, red or black spot which changes and grows in size. Fortunately, if diagnosed early, most melanomas can be cured with surgical treatment alone. The five-year relative survival rate for melanoma is 90% for Australian men and 95% for Australian women.
I have been advised I have pre cancerous skin growths? What is this?
There are also a number of pre-cancerous skin growths, such as solar keratosis, which require treatment before they develop into skin cancers.
Solar keratoses, also referred to as actinic keratoses or “sunspots,” occurs from excess sun exposure, causing the skin to develop red, crusty patches. This condition commonly occurs on the face, neck, hands, forearms and ears. To prevent solar keratoses from becoming worse, it is recommend to stay out of the sun as much as possible, always wear sunscreen when going outside, and try to wear clothing that can protect your skin from harmful sun rays.
What are the risk factors for skin cancer?
There is increased risk for developing skin cancer in those that:
- have been exposed to significant sun exposure with tanning and sunburn in their younger years, or ongoing regular sun exposure through work or leisure activities
- Severe sunburn episodes
- Are fair in complexion, freckled and/or don’t tan
- have a individual or family history of skin cancers
- have a large number of moles on their face and body
- are immunocompromised
It is important to note that anyone can develop skin cancer, even if you are tanned or your skin does not burn.
How can I detect skin cancer?
If you think you may have symptoms of skin cancer, it is important to seek medical attention immediately to avoid any future health risks. Some of the symptoms he says to look out for are:
- Persistent red, pale, or pearly areas / lumps on the skin
- Change in size, shape, or color of moles
- A spot which periodically bleeds and then heals
- New moles or freckles that change in appearance over time or bleed
- Crusty, scaly, non-healing sores
If you experience any of these symptoms, your doctor can perform a biopsy on the area to determine the issue at hand.
How can skin cancers be treated?
Skin cancers can be treated via a number of methods depending on the type of cancer, its stage of growth and location on your body. Methods include skin cancer creams, for early or shallow lesions, “scraping” techniques, or full surgical removal that may require a reconstructive procedure.
Most significant skin cancers are best removed surgically. Some of the surgical options may entail relocating the surrounding skin of the cancer after it has been removed (skin “flap”) or using skin from other body areas to cover the treated area (skin “graft”). Even complex skin cancers such as those that appear on the face can be successfully removed with very subtle scarring, leaving the best possible cosmetic result.
The procedure: What to expect?
If the cancer is small, simple excision (surgical removal, with stitches) is usually a relatively minor procedure, and can often done quickly and easily in our practice rooms, using local anesthesia. This usually leaves a thin, barely visible scar, that fades over time. The specimen will be sent for checking by a pathologist to ensure it has been completely removed. Risks of the surgery are low.
What happens after skin cancer removal?
In simple cases, skin cancer removal is relatively simple and in most cases you can return to normal activities the same day. It may be recommended to avoid strenuous exercise for the first few days. If non-dissolvable stitches were used, you will be required to have these removed post-procedure. Instructions on how to minimise scarring should be adhered to. You will also be advised of your pathology results.
Do you have any more questions?
Please feel free to contact us with any additional questions that you might have about this procedure. Our team will be happy to address any concerns that you may have.