Skin Cancer Surgery - Northern Beaches - Manly

Who Gets Skin Cancer and Why?

Anyone can develop skin cancer, regardless of skin type, race, or age. However, certain factors can increase the risk:

Excessive Sun Exposure: The primary cause of skin cancer is ultraviolet radiation from the sun, which is abundant in Australia, especially in beachside communities.
Fair Skin: Individuals with fair skin that freckles easily, light-coloured hair, and light eyes have less melanin and are more susceptible to UV damage.
Multiple or Atypical Moles: A large number of moles or unusual-sized or shaped moles can increase risk.
Family History: Genetics can play a significant role in susceptibility to skin cancer.
Outdoor Lifestyle: Spending a lot of time outdoors without adequate sun protection heightens exposure.
Previous Radiation Treatments: Therapeutic radiation treatments, such as those for adolescent acne, can increase risk.

Prevention is key when it comes to reducing the risk of skin cancer with regular skin examinations essential. Getting to know your skin and examining it regularly so you can identify any unusual changes early, and for anything suspicious it’s important to consult a plastic surgeon or dermatologist promptly. Additionally, adopting sun protection measures can significantly lower your risk, this includes using broad-spectrum sunscreen, wearing protective clothing, and seeking shade during peak sun hours to minimize exposure to harmful ultraviolet rays.

Types of Skin Lesions

Skin lesions can be categorized into benign, pre-cancerous, and cancerous lesions, each requiring different levels of attention and treatment.

Benign lesions: Non-cancerous growths that have no potential to develop into cancer. These may include moles—common skin growths that are usually harmless—skin tags, which are small, soft pieces of skin that protrude on a thin stem, and lumps like cysts or other non-cancerous lumps beneath the skin. While they are generally harmless, these lesions may be removed for cosmetic reasons or if they cause discomfort.

Pre-cancerous lesions: Exhibit early changes that could potentially develop into malignant skin cancers if left untreated. Examples of these include actinic keratoses, which are rough, scaly patches caused by sun damage, and squamous cell carcinoma in situ (Bowen’s Disease), an early form of SCC confined to the top layer of the skin. Early intervention is crucial for pre-cancerous lesions, and treatments may involve topical medications, cryotherapy, or surgical removal to prevent progression to cancer.

Cancerous lesions: Malignant growths that require prompt treatment due to their potential to spread and cause serious harm. The three main types of skin cancer in Australia are basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. Each of these cancers has distinct characteristics and varying degrees of aggressiveness, but all necessitate immediate medical attention to ensure the best possible outcome.

Types of Skin Cancers

While there a numerous types of skin cancers that occur all over the body, the three main types of skin cancers Dr Turner treats regularly are:

01.

Basal Cell Carcinoma (BCC)

By far the most common type of skin cancer is basal cell carcinoma, which fortuitously has the best cure rate with surgery. They are slow growing lesions, and rarely spreads to other areas of the body. If left untreated however it can grow beneath the skin and erode underlying tissues, including bone causing serious damage and requirement for extensive surgery to both treat the cancer and reconstruct the defect.

Characteristics:

Pearly or waxy bumps, often flesh-coloured or pink.
May have visible blood vessels or central ulceration.
Commonly appears on sun-exposed areas like the face, ears, neck, and hands.
May bleed easily and not heal properly.

02.

Squamous Cell Carcinoma (SCC)

Squamous cell cancers are more aggressive than BCC; they grow faster and occur in older people. It presents as a scaly, quickly growing pink lump, which may also bleed and ulcerate. They occur mostly in sun-exposed areas, such as the face and backs of the hands. It sometimes spreads to distant sites, including lymph nodes and internal organs. Surgical treatment will usually be curative if diagnosed in its early stages, if left untreated can be life threatening.

Characteristics:

Firm, red nodules or flat lesions with a scaly, crusted surface.
Often develops on sun-exposed areas such as the face, ears, neck, lips, and backs of the hands.
May develop from pre-cancerous lesions like actinic keratoses.

03.

Melanoma

Australia has the highest rate of melanoma in the world. While melanoma it is the least common of the three skin cancers, it is the deadliest. Melanoma mostly occurs on sun exposed skin but can occur anywhere. It may develop from an existing mole or appear as a new brown, red or black spot which changes and grows. Fortunately, if diagnosed early, most melanomas can be cured with surgical treatment. Treatment usually requires wider excision of the lesion and the possibly of have lymph nodes sampled as well.

Characteristics:

May develop from an existing mole or appear as a new spot.
Features asymmetry, irregular borders, multiple colours, and larger diameter.
Can occur anywhere on the body, not just sun-exposed areas.
Follows the ABCDE rule: Asymmetry, Border irregularity, Colour variation, Diameter over 6mm, Evolving shape or size.

Surgical Treatment Options

Skin cancers can be treated by a number of methods, depending on the type of cancer and its location on your body. These range from simple creams through to surgical excision and reconstructive procedures. However most skin cancers are best removed surgically, as the cancer will be sent to the pathologist to ensure it has been completely removed.

Treatments of complex skin cancers, or those that occur in cosmetically sensitive areas, such as the face require considerable expertise to ensure the best outcome is achieved. Specialist Plastic Surgeons like Dr Turner are regarded as the best at performing these procedures as they have extensive training to provide the best functional and cosmetic outcome.

After removal of a skin cancer a ‘defect’ may be left, as it may not be possible to simply stitch the wound closed. This requires reconstruction by employing many different plastic surgery techniques, the most common techniques including:

Skin Graft

Skin grafts

This involves taking some skin from another location to fill the defect. It relies on new blood vessels to grow into it the graft for it to ‘take’ and needs to be protected during this phase. The final cosmetic result takes much longer than with a skin flap.

Skin flaps

This involves moving some skin around to either fill a defect that is either too large or to achieve a better cosmetic outcome. Because the skin flap is usually moved from an adjacent area, the characteristics of the skin are closely matched and hence give a superior cosmetic outcome.

Importance of Follow-Up and Skin Surveillance

No matter what type of skin cancer you have had, it’s essential to have a follow-up plan for monitoring both the treated area and detecting any new lesions. Regular skin surveillance involves:

Self-Examinations: Regularly checking your skin for any changes or new growths.
Medical Check-Ups: Scheduling routine appointments with your local GP, dermatologist or Dr Turner Specialist Plastic Surgeon.
Lymph Node Monitoring: Notifying your doctor if you notice any lumps in areas like the neck, armpits, or groin.

Early detection of recurrence or new skin cancers significantly improves treatment outcomes.

Your Consultation with Dr Turner

During your consultation, Dr Turner will conduct a thorough examination of your skin and discuss your medical history, including any previous skin cancers or treatments.

Diagnosis and Planning:

Biopsy: If necessary, a biopsy will be performed to determine the type of skin lesion.
Treatment Options: Dr Turner will explain the most suitable surgical options, tailoring the approach to your specific needs.
Questions and Concerns: You’ll have the opportunity to ask questions about the procedure, recovery, and expected outcomes.

Preparing for Surgery:

Pre-operative Instructions: Guidelines on medications, smoking cessation, and sun protection.
Scheduling Surgery: Arrangements will be made for your procedure at a convenient time.

Fee Information for Skin Cancer Surgery

We are committed to providing high-quality health care to our patients. Our practice uses advanced technology, top-quality medical equipment, and meets strict safety standards. Our experienced team ensures that patients receive expert care in a safe and supportive environment.

Our fees reflect the cost of delivering quality care while keeping out-of-pocket expenses as low as possible. Medicare and private health fund rebates may vary depending on several factors. The fees are based on the complexity of the surgery and the skill and experience required to perform it.

Costs for Skin Cancer Consultation with Dr Turner

The initial consultation with Dr Turner at Manly costs $275, with part of the fee covered by Medicare. This consultation fee is payable on the day of your appointment. If additional procedures, such as a punch biopsy, steroid injections, or surgical excisions, are needed during or after the consultation, separate fees may apply. For follow-up consultations, fees may vary depending on the type of follow-up, how much time has passed since your surgery or procedure, and the expiry date of your referral.

Costs for Skin Cancer Surgery in a Private Hospital?

Dr Turner follows the fee recommendations of the Australian Medical Association (AMA). The AMA provides a guide, known as the AMA List of Service and Fees, which reflects the costs of medical services, considering expenses like staff, rent, equipment, and more.

As we offer high-quality care and patient safety, our fees are based on the AMA recommendations. Most health funds do not fully cover these fees, so the difference between what your health fund reimburses, and the AMA rate will be your out-of-pocket cost. You can request a written estimate of the fees when a procedure is scheduled. Fees for procedures typically include follow-up care for the first six weeks.

What does Private Health Insurance Cover?

Private health insurance is used on admission to hospital either as a day case or for longer stays. Each procedure is assigned a code in the Medicare Benefit Schedule. The hospital you are going to will check your eligibility for the procedure according to your level of cover. In many skin cancer cases the entire theatre fee and hospital stay are covered by your health fund.

Dr Turner fees are based on the AMA list of services and fees. Medicare will rebate 75% of MBS fee and your private health insurer will rebate 25% of the MBS fee. The difference from this MBS fee and the recommended AMA fee is the co-payment (or ‘Gap’) for which you are personally responsible.

Why is there such a Large Gap with Private Health Insurance?

When Medicare started in 1985, MBS fees and AMA fees were about the same. Over the years, MBS fee increases haven’t kept up with inflation (CPI) or the average weekly earnings increases (AWEI). The costs of providing medical services have risen faster than both CPI and AWEI (see graph below). As a result, it’s become impossible to ‘bulk bill’ or offer ‘no-gap’ services while still providing high-quality health care.

We won’t compromise the quality of our facilities, services, or patient safety. Therefore, the fees we charge reflect the rising costs of delivering top-quality surgical care.

Cost for Skin Cancer Surgery in our Clinic?

Dr Turner fee is the same as those procedures that are charged in a private hospital setting. However, with skin cancer surgery done in our clinic there are no rebates from your private health insurance and so your co-payment (gap) is often larger. However, this is frequently offset by the no co-payment for the anaesthetist and health insurance excess payments.

Public Hospital Admissions?

Dr Turner only operates in private hospitals in Sydney on Northern Beaches and Eastern Suburbs. He does not hold a public appointment and so only sees skin cancer patients that have private health insurance or are able to self-fund their private hospital admissions.

Northern Beaches, Manly Skin Cancer Surgery

Who Gets Skin Cancer and Why?

Types of Skin Lesions

Types of Skin Cancers

Basal Cell Carcinoma (BCC)

Squamous Cell Carcinoma (SCC)

Melanoma