What GPs need to know about skin cancer
Australia has the highest rate of skin cancer in the world. We ask Dr Laniewski, leading Lakeview Private Hospital plastic surgeon, what GPs need to know.
What advice should GPs be giving their patients?
GPs should encourage patients to avoid excessive sun exposure during peak periods and to wear at least a 30+ sunscreen every day on areas of skin that are exposed. Limiting UV exposure not only aids in the prevention of skin cancers but also helps avoid premature ageing.
Who is at risk of developing skin cancer?
Patients considered to be at risk are those with high rates of recreational and/or occupational sun exposure; Fitzpatrick Type 1 and 2 skin (fair skin and eyes, freckles, of Celtic ancestry); and a family history of skin cancer or melanoma.
What should GPs look for when diagnosing skin cancer?
GPs should look for recent changes in pigmentation of lesions (areas of darkening asymmetry or raised edges), and any crusting, bleeding and ulceration of lesions.
What should GPs do if they suspect a melanoma?
If you suspect melanoma look for: (A) asymmetry and irregularity in shape; (B) borders that are irregular and difficult to define; (C) uneven distribution of colour or lesions with multiple colours ranging from blue, black to brown or tan; (D) size – the diameter of a melanoma lesion is usually greater than 6mm; (E) ask the patient about the lesion and how it has changed or evolved.
When is a biopsy necessary?
If in doubt, always take a punch biopsy rather than a shave biopsy of the area as this provides additional histopathological information.
If you suspect a melanoma it is important to refer to a plastic surgeon so that the patient may be considered for a sentinel node biopsy to stage the melanoma.
When should a GP refer to a plastic surgeon?
When non-surgical methods such as cryotherapy, topical chemotherapy or photo-dynamic therapy are not effective; if the lesion is on the face; if the patient is concerned about the best aesthetic result; when there is a need for complex flap reconstruction and/or when you suspect melanoma.
Referrals can be made to Dr Laniewski at Suite A3 24-32 Lexington Drive Bella Vista phone 02 8824 8481.
Article featured in Lakeview Private Hospital News – Autumn 2016
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