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  • Staging skin cancer

    Contents

    Staging

    Staging is a way to describe the size of the skin cancer and whether it has spread. BCCs rarely spread and usually only need staging if they are very large. SCCs may require staging as they are able to spread, although this is uncommon.

    Usually a biopsy is the only information a doctor needs to determine the stage of a skin cancer. The doctor may also feel your lymph nodes to check for swelling, which can be a sign that the cancer has spread.

    Prognosis

    Prognosis means the expected outcome of a disease. Your treating doctor is the best person to talk to about your prognosis. Most keratinocytic skin cancers are successfully treated if found early.

    Which health professionals will I see?

    If you have a suspicious spot on your skin, there are a number of health professionals you may see.

    General practitioner (GP)

    Your GP knows your medical history and can examine your skin, including areas that are not exposed to the sun. GPs can treat skin cancers using some types of surgery and by prescribing topical treatments. They may refer you to a dermatologist or surgeon if necessary.

    Dermatologist

    A dermatologist is a specialist doctor who is trained in preventing, diagnosing and treating skin diseases, including skin cancer. You need a referral from a GP to see a dermatologist—without a referral, you will have to pay the full cost of the consultation and will not receive a refund from Medicare.

    When you make the appointment, ask the receptionist about the cost of each procedure and how much will be refunded by Medicare, and check if there is a waiting list. If there is a spot on your skin of particular concern, your treatment should not be delayed. In this situation, your GP can request an earlier appointment.

    Many public hospitals in large cities have dermatology outpatient clinics where care can be provided for free. Your GP can refer you. In areas where there may not be a dermatologist, you may be able to see a visiting dermatologist or a general surgeon.

    Surgeon

    Some skin cancers are treated by a general surgeon, surgical oncologist or plastic surgeon:

    General surgeon—can manage most skin cancers and perform reconstructive techniques, such as skin flaps and grafts.

    Surgical oncologist —can manage complex skin cancers, including those that have spread to the lymph nodes.

    Plastic surgeon—is trained in complex reconstructive techniques for areas that are difficult to treat, such as the nose.

    Skin cancer clinics

    Skin cancer clinics offer a variety of services and fee arrangements. They are usually operated by GPs who have an interest in skin cancer, although some are run by specially trained dermatologists.

    Clinics may not necessarily offer a higher level of skill than your GP. In deciding whether to attend a skin clinic, it is important to find out about the services offered and the expertise of the staff.

    Choosing a skin clinic

    There are four main points to consider when choosing a skin clinic:

    • the qualifications and experience of the medical staff, including whether they are members of a professional association relevant to treating skin cancer 
    • what you will have to pay—some clinics bulk-bill for the initial consultation but require up-front payment for further appointments or surgery (which may not be refundable by Medicare), while others require up-front payment for all appointments
    • the diagnostic and treatment services offered
    • the information and follow-up provided.

    Cancer Council does not operate or recommend any specific skin cancer clinics, and does not recommend specific specialists.

    This website page was last reviewed and updated December 2017.

    Information reviewed by: Prof H Peter Soyer, Chair in Dermatology, Director, Dermatology Research Centre, The University of Queensland School of Medicine, Head, South-West Cluster, Deputy Head, School of Medicine, Director, Dermatology Department, Princess Alexandra Hospital, QLD; Christine Archer, Melanoma and Skin Cancer Specialist Nurse, Canberra Region Cancer Centre, ACT; Irena Brozek, Research and Development Officer, Cancer Programs, Cancer Council NSW; A/Prof T Michael Hughes, Surgical Oncologist, Associate Professor of Surgery, Sydney Adventist Hospital Clinical School, The University of Sydney, NSW; Dr Simon Lee, Head of Surgery, The Skin Hospital, Dermatologist, Sydney Skin, NSW; A/Prof Jonathan Stretch, Plastic Surgeon, Melanoma Institute Australia; Mark Strickland, SunSmart Manager, Cancer Council Western Australia, WA; Dr Tony Tonks, Plastic and Reconstructive Surgeon, Canberra Plastic Surgery, ACT; Leslie Tortora, Cancer Information and Support Service, Cancer Council Victoria, VIC; Dr April Wong, Poche Fellow, Melanoma Institute Australia; Robert Wood, Consumer. Thanks also to Sydney Melanoma Diagnostic Centre for providing the dysplastic naevus photograph, and to Prof H Peter Soyer for providing the other photographs.

     
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