Skin Cancer

The frequency of skin cancer is increasing. This is largely thought to be due to people having more sun exposure and travelling more extensively to hotter climates than in the past. Skin cancer can appear as lumps, spots, crusts, dark spots or moles that do not disappear but continue to increase in size.

There are three main types of skin cancer: basal cell carcinoma, squamous cell carcinoma and melanoma. The first two (basal cell carcinoma and squamous cell carcinoma) tend to occur on more exposed sites in patients who have had a significant amount of sun and can be cured if caught early. They usually look like flesh coloured lumps that increase in size and can eventually bleed or form ulcers.

Melanomas are the most dangerous form of skin cancer and can occur on any site of the body (most commonly on the back in men and legs in women) and usually look like a changing mole. The problem with melanoma is that, if not treated early, it can spread to other parts of the body. Melanomas need to be removed completely, and the earlier and thinner they are when removed the greater the chance of a cure. This can usually be done using a local anaesthetic.

Basal cell carcinomas and squamous cell carcinomas can usually be cured if caught early. When they have grown to be raised lumps, the best treatment is usually to remove them surgically, in a small minor operation, using a local anaesthetic. When basal cell carcinomas are flat, or if there are pre-cancerous skin changes, alternative treatment options include freezing with liquid nitrogen, certain anti-cancer creams used over several weeks or a form of light treatment called photodynamic therapy.

Photodynamic therapy involves applying a cream (methylaminolaevulinic acid/Metvix^®) to the cancer or pre-cancerous skin which is taken up by the abnormal skin. Three hours later red light is applied to the skin and the cream that has been taken up by the abnormal skin is then activated to destroy the cancerous and pre-cancerous skin cells. The area treated needs to be protected from the sunlight for 48 hours afterwards. The advantage of this light treatment is that it usually gives a very good cosmetic result in thin, non-melanoma skin cancers and avoids the need for scarring.

If you are concerned about any skin blemish which is changing in size, colour, shape, outline or is bleeding, itching or crusting you should seek advice about it from a dermatologist or your general practitioner who can refer you to a dermatologist if he/she feels it is appropriate.

As a consultant dermatologist, Dr Farrell has been involved in the diagnosis and treatment of skin cancer for many years and attends regular conferences in the UK and overseas to ensure the most up-to-date treatment is provided. She also works in collaboration with other consultant plastic surgeons, pathologists and Mohs micrographic surgeons to offer a comprehensive service for skin cancer.