Skin cancer can take several forms, most commonly basal cell, squamous cell or malignant melanoma. Each requires bespoke surgical management strategies. Skin cancer is most commonly caused by sun damage especially sunburn, but this may have occurred many years ago and have been forgotten. Some cancers grow slowly over many years, whilst others change very quickly and behave more aggressively. High risk areas include parts of the face which are regularly exposed to the sun. These skin cancers are more difficult to manage. This is because the lack of spare tissue makes their removal more challenging and there are cosmetic demands on scar placement to take into consideration.
Cryotherapy (freeze treatment) can occasionally be used for surface skin cancers. Usually, removal of the skin cancer with closure of the normal skin either side to leave a scar, allows complete treatment with minimal risk of recurrence. Occasionally, skin grafts or local flap reconstructions are necessary. In order to increase the chances of successful removal, particularly when ill-defined or in cosmetically sensitive areas, Chris works with a MOHs dermatological surgeon to provide the best chance of cure. (MOHs is a type of surgery that allows a sample to be analysed under a microscope on the day of surgery to ensure complete removal.) In the case of malignant melanoma, once the original sample has been analysed by a biopsy, further surgery is often advised to the area.
The results usually last for life, although having one instance of skin cancer increases your risk of another skin cancer developing in a different site. Depending on exactly what type of skin cancer it is, follow on care and screening may be advised. There are nationally agreed guidelines on management, but as new research comes out, the treatments on offer will change. Each patient’s case will be reviewed in line with best current evidence.
The trade off is always the scar, which should be actively managed during the first year or two of maturation. This is usually of good quality, whereby the scar is thin and pale, making it especially easy to camouflage, but ethnicity and genetic factors can affect the appearance significantly. A small risk of recurrence is always sited before the operation. Chris will explain the exact implications of the lesion, once the specimen has been examined in the laboratory. Infection, bruising, bleeding and swelling are risks of any surgery.
The success rate for complete removal of skin cancer in a first surgery is over 90%. Chris always sends the tissue samples off for analysis to ensure complete removal and if further surgery is required, will offer it free of charge. MOHs surgery increases the chances to 99% and is used in high risk areas or areas where there isn’t much tissue available (i.e the nose or eyelids) and there needs to be careful management to ensure the removal of the right amount.
The indicative prices below include the surgical fee, any anaesthetic used and the associated fees from the consultant administering this, in addition to the hospital fee and all tests and follow up. An accurate breakdown and a detailed quote will be given following the initial consultation.
The costs depend on exactly what type and how big the skin cancer is, how many there are and whether a general anaesthetic is required. It also depends on how best to close the resultant hole following removal.
From £1,200 for removal under local anaesthetic
From £1600 for removal and reconstruction under local anaesthetic.
Following skin cancer surgery, if possible, it is advised to keep the area elevated above the level of the heart for a few days to allow swelling to subside. Keeping the area dry for at least 72 hours aids healing. If possible, the dressing should be kept intact until the first follow up appointment. Skin grafts take a little longer to heal in addition to the healing at the donor site.
- Surgery duration: 30 minutes - 1 hour
- Type of anaesthesia: Usually local anaesthetic, occasionally general anaesthetic
- Time in hospital: Day case
- Time off work: 0 days
- Recovery time: 1 week
- First follow up appointment: 1 week if sutures need removing or skin grafts need checking
- Total number of follow up appointments: 2-3
- Pain management: Simple pain relief (paracetamol and/or ibuprofen)
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