Either on the NHS, as a private paying patient or health insured patient - the treatment is the same but the time to treatment is generally different

Introduction

Non-melanoma skin cancer is a prevalent form of cancer that primarily affects the upper layers of the skin. In contrast to melanoma, non-melanoma skin cancer refers to a group of more common skin cancers that develop slowly. Discover the types, symptoms, and available treatments for non-melanoma skin cancer.

The management of your skin cancer includes surgical excision with a small clinical margin of normal looking skin and subsequent reconstruction of the area. This is to account for growth at a cellular level that is occurring below the skin surface that we cannot see. 

This is most often carried out under a local anaesthetic with several small injections to anaesthetise the area before hand. Sometimes, if the cancer has grown unusually or demonstrates unusual histopathological features under the microscope, I may need to remove more tissue as a further operation at a later date, or offer additional creams or rarely treatment such as radiotherapy.

The reconstruction will be decided on the day of surgery, and would either utilise surrounding tissue mobilised into the area - termed a local flap - or by taking some tissue from another site as a skin graft. 

There are typical post operative expectations with this type of operation that include swelling, bleeding, and infection that are minimised by ensuring a relaxed post operative period; in particular avoiding any strenuous activities or any bending down for example whilst gardening, playing golf, bowls, picking up a dog ball, and so on. These issues can lead to problems with the healing process and with the local flap or skin graft that may dictate a more prolonged follow up period.

All medication should be taken as normal apart from blood thinning medication:

• Medication for atrial fibrillation - to be stopped 48 hours before the operation in most cases, but is continued where factors such as diabetes and previous stroke are apparent
• Medication for DVT / PE / heart valve operation - to be continued as normal
• Medication for cardiac stenting - usually to be stopped 5 days before the operation, unless told by the cardiologist to continue this treatment lifelong (some specific stents that were inserted during a particular time scale require this)

Types and Symptoms of Non-Melanoma Skin Cancer

Non-melanoma skin cancer includes two primary types: basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). BCC typically manifests as a shiny pink or pearly-white lump with a translucent or waxy appearance, while SCC appears as a firm pink lump with a rough or crusted surface. Both types may undergo changes, such as bleeding, ulceration, or becoming crusty. Other signs include the presence of red, scaly patches known as Bowen's disease or actinic keratoses.

Diagnosis and Medical Advice

If you notice any unusual skin abnormalities, such as a persistent lump, ulcer, lesion, or skin discoloration that doesn't heal after four weeks, it's advisable to consult a general practitioner (GP). They can examine your skin and, if necessary, refer you to a specialist dermatologist or surgeon for further evaluation. An urgent referral is typically required for suspected squamous cell skin cancer.

Treatment Options for Non-Melanoma Skin Cancer

Surgery is the primary treatment for non-melanoma skin cancer. It involves removing the cancerous tumour along with some surrounding skin. Other treatment methods include cryotherapy (freezing), anti-cancer creams, radiotherapy, and photodynamic therapy (PDT). The choice of treatment depends on factors such as cancer type, size, and location. Fortunately, non-melanoma skin cancer has a lower risk of spreading to other parts of the body compared to other types of cancer.

Prevention and Regular Skin Checks

While non-melanoma skin cancer may not always be preventable, you can reduce your risk by minimising exposure to ultraviolet (UV) light. This includes avoiding sunburn through the use of high-factor sunscreen, appropriate clothing, and limiting sun exposure during peak hours. It's crucial to regularly examine your skin for any new tumours or changes, enabling early detection and increasing the chances of successful treatment.

Complications and Follow-up

For individuals with a history of non-melanoma skin cancer, there's a possibility of the condition recurring. The risk is higher for larger and more severe cancers. In such cases, regular check-ups with healthcare professionals are recommended to monitor your health. Being proactive in examining your skin for new tumours is essential, as non-melanoma skin cancers can often occur multiple times.

Non-melanoma skin cancer is a prevalent form of cancer that primarily affects the outer layers of the skin. Understanding its types, recognizing symptoms, and seeking timely medical advice are crucial for early detection and successful treatment. By taking preventive measures and monitoring your skin regularly, you can reduce the risk and increase the chances of favourable outcomes.

Note: The information provided is for general purposes only and should not replace professional medical advice. Please consult with a qualified healthcare professional for personalised guidance regarding your specific condition and treatment options.