SKIN CANCER SURGERY LONDON

Our experienced London-based surgeons will eliminate your skin cancer without overnight recovery. We use the latest state-of-the-art MOHS technology. Not sure how to check for skin cancer? Book a free consultation now! If we find an abnormality, same-day procedures are available. 

Skin cancer survival rate and demographic

Melanoma and non-melanoma cancers are the two categories of all skin cancers. For all skin cancers, the rate of contraction increases with age. In other words, the peak rate for both cases is in both men and women aged 90+

Contracting melanoma is relatively uncommon when compared with its other forms. In fact, melanoma only consists of around 9.7% of all cases. However, melanoma is the most severe form of skin cancer because of how quickly it can metastasise (spread) to other lymph nodes (organs/other parts of your body).

Despite its aggression, melanoma has an 87% survival rate, which is high compared with other forms of cancer. However, its survival rate can drop significantly in the later stages of melanoma.

Non-melanoma cancers amount to 90.3% of cases. There are two often reoccurring forms of non-melanoma cancers. BCC (Basal Cell Carcinoma) and SCC (Squamous Cell carcinoma). Even with such high case numbers, their survival rate is 99.3% making this disease relatively tame, especially when treated early. Unlike melanoma, both BCC and SCC are the most common in white men.

 What is Melanoma?

There are two types of melanoma skin cancer known as primary and secondary melanoma.

Primary melanoma arises through genetic or environmental means. In comparison, secondary melanoma develops from the spread of primary melanoma.

Primary Melanoma is a type of skin cancer that manifests from the pigmented cells known as melanocytes. Melanocytes produce the skin’s pigment through melanin production.

One of the most common causes of melanoma is exposure to too many ultraviolet rays through sunlight. Ultraviolet rays are also produced from sun-beds, increasing the risk of contracting melanoma.

Melanoma development

One of the earliest signs of developing melanoma is the change in colour of one of your existing moles or the formation of a new mole or lesion which has a contrasting colour with the rest of your skin. New melanoma moles typically appear brown or black. However, a new mole may emerge with a loss of pigmentation, leading to a pale or red colour. 

Melanoma severity is classified using a staging system. This staging system is split into four parts, from stage one to stage four. In stages one and two, the melanoma is relatively mild, having a difference in size and thickness, but remains relatively small and, more importantly, has yet to spread to other parts of your skin.  

In stages three and four, cancer has spread to deeper layers of the skin known as lymph nodes. You can find lymph nodes in the body’s lymphatic system, which is part of our body’s immune system. The new development of skin cancers (in the lymph nodes) is secondary melanoma. 

The depth and progression of secondary melanoma allow doctors to distinguish between stage three and four melanoma. 

You may discover a later case of skin cancer manifesting in lymph nodes after an apparent lump emerges from underneath the skin layer. Its size may differ between patients with stage three and stage four melanoma.

Occasionally, a primary melanoma is detected purely due to someone developing enlarged lymph nodes with no history of a skin lesion. This form of melanoma is known as a primary occult.

You could also be diagnosed with a later stage of melanoma if you discover melanoma deposits in the skin surrounding the pre-existing primary melanoma (micro-satellites).

What does skin cancer look like?

Melanoma, BCC, and SCC are the three main types of skin cancer, and all three have distinct differences in their appearance.

Melanoma usually appears as a newly formed mole and is often referred to as a skin cancer mole. It can also spawn from a disfigured mole already present. This mole can become irritant and may even bleed if picked at.

BCC skin cancer, otherwise known as Basal cell carcinoma, may appear as an apparent shiny lump on the skin. These are harmless and often left unattended for long periods as they are commonly mistaken for scabs.

SCC skin cancer, also known as Squamous cell carcinoma, will often appear as a dry red lump. They can also be quite painful if touched, commonly emerging due to overexposure to UV from the sun.

What is Micrographic surgery for skin cancer?

Micrographic (MOHS) surgery is a precise skin cancer treatment used to remove non-melanoma cancers surgically.

During MOHS surgery, thin layers of cancer-containing skin are progressively removed and examined until only cancer-free tissue remains.

MOHS is a specialised type of surgery that aims to keep as much non-cancer-affected skin intact. 

Micrographic surgery is only valid for people who have non-melanoma cancers, such as BCC and SCC.

Patients who have previously had failed surgeries or treatments like radiotherapy typically undergo Micrographic surgery.

What happens during Micrographic surgery?

 The surgeon will begin by drawing around the cancer cells with a marker.

A local anaesthetic will be applied so you will remain awake but will not feel pain. 

The surgeon will then remove all the cancer cells and a minor amount of healthy cells known as a healthy margin.

The surgeon will then send the cancer-affected cells to a laboratory technician to confirm if all of the cancer was removed (during excision) from your skin. After which, The surgeon will inform you if you can leave. 

If there are more cancer cells, the surgeon will repeat the procedure until they remove all cancer cells. 

The doctor will then dress your wound if it is small enough. If your wound is more extensive, you may qualify for stitching or plastic surgery to repair it. 

You may experience some bruising and bleeding. In some rare cases, your wound may become infected. Fortunately, aftercare is included in your treatment package, meaning follow-up appointments are typical to track your progression. Our surgeons can treat any immediate complications with no additional charge. In other words, lesion surgery is simply the most reliable treatment if you are looking for a permanent solution. 

What is cryotherapy for skin cancer?

Cryotherapy is a treatment which typically uses liquid nitrogen to remove skin lesions like cancer by freezing them. 

Cryotherapy is commonly used to treat relatively benign and low-grade forms of skin cancer. For example, simple forms of BCC.

What happens during cryotherapy treatment?

Usually applied using a spray gun, liquid nitrogen is administered to your lesioned skin, freezing it. After one to two minutes, your affected skin should return from a pale white colour to its normal pigmentation as it thaws out. Your surgeon may repeat this process if the lesion is large enough.

In the next few days, a scab will form. This scab should take one to two weeks to fall off, leaving the treated area looking relatively normal. A full recovery is common after some time. However, it is possible for some minor scarring or discolouration to appear. Depending on the nature of the lesion, more than one cryotherapy treatment may be necessary until the surgeon removes all skin cancer from your skin.

Your doctor will provide advice on how to care for your wound while it is healing and may suggest using vaseline, patting the wound dry if it becomes wet and advising you to refrain from picking the scab, all to reduce the chances of any scarring.

What is excision for skin cancer?

Excision is a procedure where a surgeon physically removes a skin lesion to stop the spread of skin cancer and reduce the chances of recurrence.

Excision is typically your best chance at completely curing all skin cancers at stages one or two. 

Furthermore, excision surgery can also eliminate the in-transit or satellite lumps of melanoma in the skin near your primary melanoma scar.

If melanoma has spread to internal organs but remains in few deposits, removing them with excision surgery may be possible.

What happens during excision?

The lump or lesion is surgically removed and sent for a histological diagnosis. 

After Which, you will have the option of incorporating a wide local excision or WLE. During this procedure, an estimated margin of 2 cm is taken in addition to your first procedure (despite possibly not being cancerous) to minimise the chances of recurrence of melanoma. Your doctor will discuss how much skin is necessary to extract, as the recommended margin depends on the location and thickness of the melanoma.

The type of scar/s will depend on the location and the type of surgical technique required. After WLE, you may have a similar scar compared with your first procedure. However, it will be more prominent in size. Some scars can be more complicated due to requiring the implementation of skin grafts.

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Skin Cancer FAQs

Are Skin Carcinomas hereditary?

If a family member of yours had contracted a skin carcinoma before, you could be at an increased risk of developing it. However, it is entirely possible to acquire Melanoma, BCC, and SCC exclusively through environmental means.

What is the best sun cream to use to prevent Skin Carcinoma?

The main two types of ultraviolet rays are UVA and UVB. It is paramount you use a sun cream that wards you off both of them. These creams should have at least an SPF of 15.

Can sun-beds cause skin Carcinomas?

Sun-beds do produce ultraviolet rays, which can cause skin cancer.

How can I prevent Skin Carcinoma?

Avoid being sunburnt by wearing clothing and applying sunscreen. Please book a consultation with our clinic at least once a year for a professional skin cancer exam.

What are the leading causes of Melanoma?

The sun's ultraviolet rays are the most common cause of skin cancer.

How is Skin Carcinoma diagnosed?

You can get diagnosed with a biopsy carried out by one of our licensed professionals.

If cured, can Cancerous Skin come back?

Skin carcinomas can come back. However, the chances depend on your type and what treatment you decide to undergo. The chances of it coming back using MOHS are incredibly deficient.

Can Skin Cancer kill you?

Skin carcinomas can kill you. However, it is rarely life-threatening when treating it early enough.

How long until I recover from MOHS surgery?

You typically are released on the day of your surgery. However, your wounds will usually not heal until four-six weeks have passed.

Can Cancer come back after MOHS surgery?

The chances are meagre. However, skin cancer can return after MOHS.

Is MOHS surgery serious?

MOHS is a minor surgery. But, there are some minor risks from the surgery. These are Haematoma, pain, and infections.

Is MOHS surgery Painful?

Your surgeon will use a local anaesthetic, meaning the procedure will not be painful. However, the local anaesthetic injection and the resulting wound after the surgery may cause discomfort.

What are some of the early signs of melanoma?

Early signs of skin cancer are skin lesions; either cancerous moles, or for non-melanoma cancers, clear shiny lumps or red lumps on your skin.

Where are the most common spots for Skin Lesions?

Skin carcinomas will primarily appear on sun-exposed skin. Subsequently, it is prevalent to develop skin cancer anywhere on the head, arms and legs.

What are the most common Skin Cancer early symptoms?

For melanoma cancers, the symptoms may be an itching or burning sensation around the area of the cancer-affect skin.

What are the limitations of MOHS?

MOHS is ineffective for some types of lesions, like high-risk BCC lesions. Surgeons consider lesions high-risk when preserving the tumour-free surrounding tissue is essential for maintaining physiology, function, or physical appearance. These include the face, hands, nails, feet or genitalia.

Active cancers, which may be significant in size, are re-occurring, have undefined margins, sub-facial extension, bone invasion, pathological features and patients with notably weaker immune systems are also cases that MOHS can not effectively treat,

What are the side effects of MOHS?

All surgical procedures carry some risk. In the case of MOHS, the main risks are infection, bleeding/bruising and nerve damage.

Infection - Since MOHS is an invasive surgery, your wound may get infected after surgery. However, the chances of infection are minimal and typically easily treatable. If you are susceptible to infections or have a weakened immune system, you may be prescribed antibiotics before your procedure.

Bleeding/bruising - Though you should expect bleeding during the procedure, bleeding may occur after the procedure if your wound were to reopen. If you are on blood-thinning medication or have a medical condition that causes your blood to be thin, you should inform your physician before your surgery, as you may require additional care. Bruising is common following MOHS surgery but will often pass after your first few weeks.

Nerve damage: Small nerves may be cut during the surgery while your physician extracts your cancer. Cut nerves can cause numbness that may fade after a few weeks or months. In rare cases, a nerve responsible for the muscle's movement may be compromised, causing weakness or paralysis of that muscle.

Scarring - Scarring is common in any surgical procedure. Though there are measures to avoid or minimise scarring during and after your surgery, some scarring is unavoidable for MOHS surgery. In addition, the amount of scarring will depend on the skill of your surgeon. Thankfully, our expert surgeons' focal point is to keep scarring to a minimum.

Anaesthetic reaction - Reactions are certainly the most dangerous of all immediate side effects with surgical procedures in general. The symptoms following a reaction vary between patients but include a rash, hives, severe itchiness, swelling, drop in blood pressure, shortness of breath, coughing, etc. Fortunately, reacting to anaesthesia is extremely rare and largely preventable.

Our Experts

Why choose PLC for Skin cancer treatment

Entrance of Marylebone clinic PLC Cosmetic
  • High cure rate, meaning there is a high chance of eliminating all cancer-affected cells.
  • Cancer recurrence is very low, allowing treatment to be relatively cost-effective compared to other clinics. 
  • Minimal scarring is our priority for any treatment given.
  • You will not need a general anaesthetic; therefore, you will remain awake with a local anaesthetic throughout the procedure.