Skin cancer

Skin cancer is a very common type of cancer that can affect anyone – regardless of age, sex or skin colour. As a consultant specialising in plastic, reconstructive and cosmetic surgery, Mr Chris Fenn has extensive experience in surgically treating malignant skin lesions and cancerous moles both in his NHS and private practices in Leeds, West Yorkshire.  

In the NHS Mr Chris Fenn is the plastic surgeon that works within the Leeds based Yorkshire Regional Skin Cancer Service, undertaking a wide range of excisions and reconstructive surgery for skin cancer.

What is skin cancer?

Skin cancer is usually sub-divided into two categories – ‘non-melanoma’ and ‘malignant melanoma’. Non-melanoma is the most common type of skin cancer which tends to develop on the epidermis (the external surface of the skin).  Malignant melanoma is a less common but more aggressive type of skin cancer that develops in the ‘pigmentation system’ – in other words – the layer of skin that tans when exposed to the sun.

What causes skin cancer?

Whilst anyone can develop skin cancer, it is widely accepted that sunburn in childhood, use of sunbeds and long term sun exposure can increase the likelihood of it developing. 

Others at an increased risk include those:

- with fair hair and fair skin

- with a family history of skin cancer 

- who are taking medications that suppress the immune system  

How is skin cancer diagnosed?

Many of the common skin cancers have characteristic features that can allow a clinical diagnosis to be made simply through a physical examination. Sometimes however, a biopsy is required to establish the diagnosis.  Under a local anaesthetic, small lesions tend to be removed in their entirety (excisional biopsy) and larger lesions partly removed (incisional biopsy) and then sent for analysis. A treatment plan is put in place following diagnosis.  

Non-melanoma skin cancer

Basal cell carcinoma and squamous cell carcinoma are the most common types of non-melanoma skin cancer. 

Basal cell carcinoma (BCC)

As the name suggests, basal cell carcinomas develop in the base or the very bottom layer of the skin surface. They develop and grow slowly over months, as a patch, nodule or ulceration that fails to fully heal.

Basal cell carcinoma is the most common type of non-melanoma skin cancer and tends to be more prevalent amongst red or fair haired people whose skin tends to burn easily. Basal cell carcinomas generally develop on parts of the body that are exposed to the sun – such as the face, back and lower legs. Consequently those who spend a lot of time in the sun through work or through choice are at a higher risk of developing this type of cancer than those who don’t.

Squamous cell carcinoma (SCC)

Squamous cell carcinoma is another common form of non-melanoma skin cancer. Similar to basal cell carcinoma, it is also seen more frequently in fair haired and fair skinned people with a history of excessive sun exposure. Squamous cell carcinomas tend to develop more rapidly and can develop into a crusted lump on the skin.

Treatment for non-melanoma skin cancer

In most cases of non-melanoma skin cancer, treatment involves surgical removal of the lesion. Other non surgical options such as radiotherapy or topical treatments can be used for certain situations.

Surgery often involves excision of the skin cancer with a margin of surrounding healthy tissue. If small enough, the cut can be closed leaving a line scar. In many cases, depending on the size and position of the defect following excision, the cut needs to be closed with a flap of skin or skin graft. It is relatively minor surgery which can often be performed under local anaesthetic without the need to stay in hospital.

Malignant melanoma

Malignant melanoma is a serious form of skin cancer which, if diagnosed early, can often be treated successfully. Due to its aggressive nature however, if malignant melanoma is diagnosed at a more advanced stage, it becomes much more difficult to treat – particularly if the cancer has spread into the body.

What does malignant melanoma look like?

Existing moles can develop into malignant melanoma. Typical signs of malignant melanoma include noticeable changes in the colour, shape and/or size of the mole. Likewise an itchy mole or one that bleeds can also be an indicator of melanoma.

In addition, malignant melanoma can appear as a new lesion. This usually presents itself as a dark, irregular shaped mole that grows quickly.

How is malignant melanoma treated? 

Initially, the suspicious pigmented lesion is removed as a simple excision. This enables the doctors to make a diagnosis and assess the lesion properly. An individual treatment plan is put into place based on these findings.  

Depending on the stage of the cancer (cancers are usually graded in severity from stage 1-4 with 4 being the most advanced), treatment may be managed purely by a consultant plastic surgeon or in more advanced cases, by a multidisciplinary team of specialists comprising a plastic surgeon, dermatologist, oncologist and specialist nurse.

Surgery tends to be the main treatment for melanoma and may involve:

Wide surgical excision

This involves removing the lesion under a local or general anaesthetic, along with an area of normal skin surrounding the lesion to ensure any cancerous cells which have grown nearby have been removed.

If the lesion is large, the surgery may be performed in conjunction with a skin graft or flap. This can often be done under a local anaesthetic without the need to stay in hospital.

Block dissection

If the cancer has spread to the lymph nodes, surgery requires removal of all the affected lymph nodes. This procedure is often referred to as ‘block dissection’ or ‘lymph node dissection’ and is generally performed at specialist melanoma centres and plastic surgery units.

Sentinel Lymph Node Biopsy

This is a special test to isolate and examine the lymph node most likely to contain cancer cells if the disease has started to spread. This is undertaken following review by the Multidisciplinary team, and performed through the Specialist Melanoma Centre.


What should I do if I suspect I may have skin cancer?

If you have a mole that has changed in appearance or if you have noticed a new lesion, then you should visit your GP as soon as possible.

Following examination, if your doctor feels the lesion may be suspicious, he will refer you to see a consultant plastic surgeon or a consultant dermatologist.

Can I be referred to see Mr Fenn at a private hospital?

Yes you can choose to be referred to see a consultant, including Mr Fenn, at a private hospital.

Treatment for skin cancer is usually covered by most private medical insurance providers – however, you will need to contact your own insurer to check for any exclusions.

(see page http://www.cosmeticsurgeryleeds.com/services/prices/insured-selfpay ).

If you don’t have private medical insurance, you can choose to self fund your treatment. Most private hospitals, including Spire Leeds Hospital, offer a fixed price payment scheme where you are given a comprehensive price for your surgery which includes the hospital, surgeon and anaesthetist (when necessary) fees. 

(See page http://www.cosmeticsurgeryleeds.com/services/prices/cosmetic for more details)

How much does skin cancer treatment cost?

The price of skin cancer treatment varies depending on the individual treatment plan and will be confirmed following your initial consultation with Mr Fenn. If you would like a guide price on some of the procedures performed by Mr Fenn, contact his secretary, Claire Herbert on 0113 218 5971, email claire.herbert@spirehealthcare.com or complete an online enquiry form.

How do I find out more about skin cancer treatment?

If you have any suspicious-looking lesions, it is important that you visit your GP as soon as you are able. If you would like to find out more about the specific treatments offered by Mr Chris Fenn, call his secretary Claire Herbert 0113 218 5971,  email claire.herbert@spirehealthcare.com or complete an online enquiry form.

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