Skin Cancer Clinics -back-up

• Regular checks give you a good chance of spotting the signs of sun damage before they become serious
• Regular checks will help you get to know your own skin and gain a greater understanding of what is normal on your skin and what is not, which will help you in identifying any new or changing areas of your skin
• Extremely important for those with a higher risk of getting skin cancer (people with reduced immunity, people who have had skin cancer before, and people with a strong family history of skin cancer) to be checked regularly to avoid any cancerous spots
• Cancer can appear on parts of the body which are not exposed to the sun, so checking these regularly is also very important

• Detecting sun spots early means potentially avoiding cancer
• Sun spots and skin cancers that are identified and treated early have a better outcome than most other types of cancer

• New moles
• Moles that increase in size
• An outline of a mole that becomes notched
• Change in colour on a spot from brown to black or is varied
• A spot that develops a lump within it or becomes raised
• Rough, scaly or ulcerated surfaces begin to develop
• Moles that itch or tingle
• Moles that bleed or weep
• Spots that look different from your other spots

• Melanoma
• Nodular melanoma
• • Basal cell carcinoma (BCC)
  • Nodular and nodular-ulcerative BCC
  • Pigmented BCC
  • Superficial BCC
  • Morphoeic BCC

• Slip, slop, slap, seek, slide
• Slip on sun protective clothing that covers as much skin as possible
• Wear a shirt with a collar rather than a singlet top, when swimming, wear a wetsuit or rash vest
• Slop on sunscreen
• SPF30+ sunscreens filter out 97% of UV radiation
• Sunscreen will only filter out sun if enough sunscreen is used and it is used properly
• Sunscreen should be applied over all areas of exposed skin 20 minutes before sun exposure and reapplied every two hours (sooner if you’ve been swimming or sweating)
• Try to use water resistant sunscreen
• Apply sunscreen liberally to each limb, the front and back of the body and the face, neck, ears, hands and feet
• Slap on a hat
• Wear a wide-brimmed hat to protect your face, back of the neck, eyes and ears
• Seek shade
• 11am-3pm is when the sun’s UV rays are their harshest, try your best to seek shade especially during these hours
• Slide on some sunglasses
• Long term exposure to UV radiation can cause cataracts and skin cancers of various tissues in the eye
• Using sunglasses which wrap around the face and are close fitting will provide the maximum protection
• There is an Australian Standard for sunglasses

To help get the most out of your skin check, consider checking your own skin first, so you can point out the skin spots you are concerned about. It is not routine for the doctor to examine your genitals, however skin cancers sometimes do occur in these areas. We encourage you to check your genitals prior to your full body skin check, and the doctor will check any skin spots that you have noticed. We have both male and female doctors available to carry out Full Body Skin Checks.

Please visit the following independent websites on skin self-examination: Cancer Council nsw ,Knowyourownskin and Scanyourskin.

On the day of your skin check it is essential that your skin is not covered by foundation, makeup or nail polish. Any makeup will need to be removed at the practice and if required re-applied after your consultation.

A skin check generally starts with an assessment of your skin cancer risk and a review of your general medical history including any medication. The latter is not only for consideration of your risk of skin cancer, but also for any biopsies or procedures that may be required in the future.

Each doctor has their own routine of executing a skin check, but in general will cover all skin and the use of a hand help skin microscope called a dermatoscope. As above your genitals and breast will not routinely be examined, but let us know if you are concerned about any lesion or if you want any additional skin area examined.

You may wish to have only one spot examined and we will certainly not force you to undergo a full skin examination. We would, however, advise a full skin check as most cancers we find are not detected by the patient.

In the unfortunate case a suspicious lesion is identified, we may carry out a biopsy of this lesion.

It is possible that you have a skin cancer that is undetectable at the time of your skin check. Although most skin cancers take several years to develop or become invasive, some aggressive types can develop in several months. Therefor it is important to keep an eye out for changing lesions in between your skin check and not to become complacent.

Skin Biopsies

Some skin cancers are clinically obvious, but others may be more inconclusive, so when needed, skin biopsies (including shave biopsies, punch biopsies, and excisional biopsies) will be performed to provide further information from pathology analysis. These procedures can often be performed at the time of your initial clinic appointment.

Mole Removal

Moles that are suspicious for melanoma as well as moles which need to be removed for other reasons can be removed surgically. This procedure is typically performed at the clinic, but due to space and time constraints, may be scheduled for a future date.

Dermatopathology

All skin biopsies and specimens that are performed and sent out will be evaluated by a qualified dermatopathologist – a pathologist who specializes in diagnosing disorders of the skin.KRS usually utilizes DHM Sonic Skin pathology provider .

Skin Cancer Surgery/Treatment

Skin cancers can be removed surgically in the office as our doctors specialise in all techniques for removing skin cancer, including standard surgical excision, electro-dissication and curettage.After skin cancer removal repairs , either with simple closure or even more complicated and large defects reconstruction using Skin flaps or grafts. . When appropriate, non-surgical treatments of skin cancer will also be discussed with you, including radiation, cryotherapy, and topical chemotherapy.

Reconstructive Surgery

After a skin cancer is removed, our staff are well trained to repair the resulting wound. This may include reconstructive surgery when necessary.

Scar Revision

Scar revision can also be performed at our clinics to enhance the appearance of a scar resulting from surgery.

Cryotherapy with Liquid Nitrogen

Cryotherapy or “freezing” with liquid nitrogen is an effective way to treat several skin conditions, including Actinic Keratoseswhich are commonly known as “pre-skin cancers”.

Nonsurgical Treatments

Modern technology is producing several new methods of dealing with skin cancer. Nonsurgical treatments can include topical chemotherapy or immunotherapy. These options are only appropriate for certain tumor subtypes, but can be an excellent treatment option when indicated.

Why photograph your skin?

The Problem

Over 1500 Australians die each year from melanoma. With early detection however, melanoma is nearly always curable. How can we ensure that we survive this preventable form of cancer? We need to monitor our skin for any suspicious changes. This includes change in size, colour or symmetry of existing moles and the appearance of new spots that persist for more than a few weeks on the skin.

The Importance of Change

The single most important distinction between melanomas and normal moles is that melanomas change noticeably in size, shape or colour whereas normal moles are stable. Your skin cancer doctor will ask you if you have noticed any change in spots on your skin to help with early detection of skin cancers. Often, as patients, we are unable to provide useful information about change because of having lots of skin spots or because the spot is in a place that we cannot easily see. With large numbers of moles, monitoring becomes even more difficult and unfortunately the more moles we have, the higher our risk of melanoma.

The Solution

Many melanomas appear as a new spot whilst some begin from a pre-existing mole. Often these changes are too subtle early on for your skin cancer doctor to confidently diagnose melanoma. Comparison with a set of images of the skin during your skin check provides a reliable way to assess whether a change has occurred allowing much earlier detection of a developing melanoma.

Who should have total body photography?

Living under the harsh Australian sun your risk of melanoma is much greater than elsewhere in the world. This is especially true if you have more than 100 moles, have already had a melanoma or have 2 or more close relatives (parents, siblings or children) who have had melanoma. People in these high risk groups should consider the benefits of total body photography for early melanoma detection.

Please remember that the photographs are an aid to medical follow up, not a replacement.

What happens during the photographic Session?

• The photographic session takes 30 to 45 minutes.
• A controlled studio environment is used to take all the body photographs.
• Normal photographic lighting is used and there is no harmful lighting or any X-rays used.
• Skin cancer nurse , Nicole Taylor has had training at the Melanoma Institute of Australia to perform Total body photography and you may talk to your doctor or Nicole if you have any question about this very important monitoring tool.

Will my privacy be respected?

• Maximum client privacy is ensured at all stages.
• You do not need to remove your underwear. To maximize the quality of the photographs, we suggest that underwear is a neutral colour (preferably grey or skin toned) and of a brief style leaving as much skin surface exposed as possible.
• The photographs will be sent to you by registered post within 2 weeks or you can come to collect them in person if that is preferable.

Tell me more about the photographs

• Images will be provided as large, high quality colour photographs (and additionally in CD format or on USB if requested).
• Close-up and dermoscopic images of each individual mole is not required but may be requested either by yourself or your treating doctor.
• The 17 image full body photography system ensures that the images are close enough to detect most changes.
• The photographs will only need to be repeated every 6-8 years.
• It is recommended that you take the photographs to each skin check-up by your doctor.
• You can use the photos to refer to when doing self-checks of your skin, according to your doctor’s instructions.

What is the cost of full body photography?

• Some private health funds provide rebates (a letter can be provided for your health fund if your skin cancer doctor recommends full body photography).
• This service is not claimable on Medicare
• Usually Total body photography cost 110 $ inclusive of the CD or USB and a copy of your images if you wish printed copy as well.

ACCREDITATION