Surgical treatments of skin cancer
Removing a skin cancer by ‘cutting it out’ is the most definitive way of dealing with it. As skin cancers grow in a random fashion, a margin of normal skin is always removed around the cancer to ensure no roots of the cancer are left behind. The removed skin cancer is always sent to the laboratory for assessment of complete removal. Skin cancer surgery at Auckland Dermatology is always performed under a local anaesthetic. Long term cure rates in our practice exceed 99%.
Mohs micrographic surgery is an advanced, highly specialised technique regarded as the ‘gold standard’ treatment for high risk cancers primarily on the face. Even if you have had unsuccessful treatment for skin cancer on your face before, Mohs surgery provides you with the best chance of cure. Mohs surgery is a highly demanding, specialised surgical technique. All our doctors using this technique have completed the American College of Mohs Surgery’s accredited 1 or 2 year post graduate fellowship programme. Furthermore, Dr Paul Salmon is an accredited trainer of Mohs surgeons. Your surgeon will remove the skin cancer in a unique way which allows a map of the skin cancer to be created under a microscope. This entire map is then meticulously reviewed and analysed by the surgeon under the microscope to ensure no roots of the skin cancer remain. If roots of the skin cancer are still present, the surgeon is able to identify precisely where the cancer remains and only remove the amount of tissue that is required to get rid of the skin cancer. Patients should therefore be reassured that the size of the wound after their Mohs surgery was the smallest wound that was needed to ensure full removal of the skin cancer. Long term cure rates 99%.
Non-surgical treatments of skin cancer
Efudix cream is licensed for treating solar keratoses (sun spots). Efudix poisons the pre-cancerous cells: a three week course is usually necessary to produce the redness and crusting which is the end point of the treatment. Despite this, once healed the results are usually excellent and importantly there is no scarring. It is usually prescribed between April and September as the cream can increase your risk of sunburn if applied during the summer months. This is not a treatment for cancers and may delay treatment of a cancer when used inappropriately.
Also known as cyrotherapy, liquid nitrogen is a well established treatment for solar keratoses (sun spots), early pre-cancerous skin changes as well as certain types of basal cell skin cancer, depending on its location. This treatment essentially works by inducing a ‘cold burn’ at the applied site. When used for skin cancer treatment is severe and can take up to six weeks to heal. During the healing phase the area becomes red, often blisters and then scabs over eventually resulting in a pale white scar. Long term cure rates are over 95%.
Photodynamic therapy is a treatment where natural sunlight is used to trigger a medication applied to the skin to peel off pre-cancerous areas such as solar keratoses.
Picato is a treatment needing only three applications to treat areas of solar keratoses. This treatment is usually applied in the office on three consecutive days. This is not a treatment for skin cancer.
This cream needs daily application for 3 months and is an at home treatment. This treatment has poor long term cure rates which are variable between patients and therefore this treatment is not often used in our office.