Skin Cancer / Lesions

Dr. Richard Hamilton treats skin cancer and lesions at his Adelaide, Australia practice.

Dr. Hamilton: “Skin cancer is an increasing problem in our community. In Australia, we’ve got sun, we’ve got the outdoor life, we’ve got people of Caucasian or European background with fair skin, and we’ve got an ageing population. We’re seeing more and more skin cancers as the years go by. And occasionally we see it in younger people in their 20s and 30s. Much of these people are referred from general practitioners who know I do this kind of work. And of course, those patients with cancer are sometimes very worried about it and what the implications are. We can remove those lesions, and sometimes it’s just a simple cut and stitch procedure. Sometimes it requires a more advanced procedure if it’s a larger defect after removal of the cancer. In those situations, I need to repair the defect with a skin graft or a skin flap. In most situations, the report that comes back from lab tells me the cancer has been completely removed. Of course, this is a great relief to the patient. But cancer being cancer, they can sometimes come back, so I usually put patients onto a monitoring program of seeing them every 6 to 9 months over a number of years, to be sure the lesion doesn’t come back. Some of these patients will develop a second primer of skin cancer somewhere else in their body, which is quite unrelated to the other. It’s really good work, and it’s interesting work, and it’s very much within the province of a plastic surgeon. Most of the patients, when they come in for the procedure, they come into the operating room, and I’ll talk to them. I’ve already seen them for a consult, but I’ll talk to them again and I’ll explain to them what I’m going to do, marking on the defected part of the body with an indelible pen what I need to remove. I administer a local anesthetic, and when it’s numb, I’m able to proceed and remove the cancer and do whatever repair is appropriate. Patients on the whole are quite comfortable and not in any stress. There are a few patients who are a bit anxious. Those patients can be young, or they can be old, and they can require a bit of intravenous sedation. In such instances, I’ll have on-hand a anesthetist who can administer a sleep drug that helps them relax, so they have no memory of the procedure. That’s what we call twilight sedation. After the operation is done and dressings are applied, we take all patients into the recovery room. We sit them down, make them feel relaxed, and give them a cup of tea or coffee. That gives my nursing staff a chance to talk to them about after-care of the wounds. And then I can come in and have a chat, let them know how their operation went, and where we go from here. In addition to skin cancer, I treat a lot of benign lesions. For instance, if a young woman has an unsightly mole on the face in a visible position, and it might be growing a few hairs, that’s not something she wants. These lesions are very nicely removed in a similar fashion, using very fine sutures so that scarring is almost imperceptible. And patients are very grateful for this treatment. It’s good medicine, and very enjoyable medicine, and it’s very satisfactory for me and the patient.”