Skin Cancer

Dr Jay Chelladurai offers Skin Checks and Skin Cancer procedures at Central Coast Skin Cancer Clinic, East Gosford

Which of these are Melanoma?

The middle ones are Melanoma. As you can see, 2 moles which may appear very similar can be very different. One can be a deadly melanoma and another can be a harmless condition called Seborrhoeic Keratosis or sometimes even just a freckle.

Who needs skin cancer checks?

• People with a fair skin.
• People who have spent time in the sun.
• People who have many moles.
• People who have lots of freckles.
• People who have previously had a skin cancer.
• People who have a family member who may have had a melanoma or another skin cancer.
• People who have had radiotherapy.
• People who have had an organ transplant.

What Happens at a Skin Check Consultation?

Just as the name suggests. Check your skin. The doctor will greet you. Ask a few questions to better understand your risk of skin cancer. Then it would be the stage of skin examination. You would need to undress, usually down to your underwear. Lie on a bed. The doctor would examine your skin from head to toe/toe to head aided by bright light +/- magnification. Some moles would need to be felt by touching, to see if it is thick or raised. Each suspected mole would further be examined with a special device called dermatoscope (skin microscope). Some times photos of some moles may be taken to be stored to explain to you or for future comparison for interval change.

What if I am not comfortable to undress?

Unfortunately a thorough skin examination would not be possible without undressing. You can bring in your partner/parent/children if that may help. You can ask for a chaperone (usually a nurse) to be with you during the examination. Or you can elect to only have part of your skin examined, in which case, potentially dangerous skin cancers may not be picked. Contrary to some beliefs, a dress penetrating camera is not used.

How often do I need a Skin Check?

It depends on multiple factors. Your skin colour, your sun exposure, your age, number of moles/freckles you have. The higher the risk, the more often you would need. Most people are advised to have a check once a year. Some may need 6 monthly. Some may not need a check for 3-4 years. You will be advised about your next visit during the consultation.

How do I prepare for a Skin Check?

Most often, you do not need any specific preparation. But some of these would be very helpful

• Wearing clothings that can be easily removed and worn back can make the process easy.
• Avoid wearing make up. Some make up materials can be hard to wipe away and can make evaluating some moles very difficult.
• Remove nail polish if possible. Some nail changes from underlying cancers may not be visible if covered by nail polish
• If you had to have fake tan, try to schedule a skin check 3-4 weeks after so the skin can be examined better.
• If you have very dry skin, applying some good moisturisers can be helpful.

What happens if an abnormal mole is found?

We will explain to you about the mole as to what it could be. Then offer management pathways as 

• Asking you to self monitor until your next planned visit.
• Come back for a follow up in an earlier interval eg 3 months instead of the usual 12 months.
• Have pictures of the mole taken to monitor the progress.
• Some moles can be treated with a process called Cryotherapy
• Some moles may need to be further ascertained by a process called Biopsy.
• Some moles may need to be completely removed by a process called Excision

Will I die if I get a skin cancer?

Most skin cancers are slow growing and do not spread until they have become really big. However, there are some skin cancers such as melanoma that can be deadly if not treated. So they are not entirely harmless, if that makes sense.

The commonest skin cancers are squamous cell cancers and basal cell cancers. Then the melanoma. Most common of the melanoma are early stage melanoma or melanoma in-situ. Most early stage melanoma once removed, the never come back. And generally once we find a mole is a melanoma we almost always do a further procedure to take some more skin around it (Wide Local Excisio) to make sure there are no more melanoma cells in the vicinity. 

However, for some cancers, especially advanced melanoma, we would need to refer you for further treatment.