Skin cancers are some of the most common conditions dealt with by GPs, dermatologists, and plastic surgeons, with the latter group bearing the brunt of complex skin cancers that require complex reconstructive surgery. GPs are often the first point of contact regarding skin cancer detection, treatment, and surveillance.
Risk factors for the common skin cancers are sun-exposure, fair-skin, and certain conditions that reduce skin UV tolerance. Having a family history of skin cancer or being relatively young (below 60 years old) when first diagnosed with a skin cancer are potential indications that one may be at risk of developing future skin cancers.
The vast majority of skin cancers are highly curable if treated promptly. Minor ones can be easily treated with excision, radiotherapy or, for the very thin surface disease, with measures such as freezing with liquid nitrogen or skin cancer cream.
In addition to looking after general skin cancers, Dr Quan Ngo has subspecialty interests in managing advanced complex cutaneous cancers in the head and neck region as well as melanomas.
Skin cancers in the head and neck region are particularly challenging for many reasons. This region is frequently exposed to sunlight, hence the majority of skin cancers are found here. Secondly, there are many critical structures e.g. eyelids, nose, lips that may be involved. Surgery can therefore impair facial function and have a major impact on one’s self-image and confidence. Being able to completely remove the cancer while maintaining anatomical structure and integrity for the patient is a challenge for the treating surgeon. Dr Quan Ngo spent the greater part of a year doing complex head and neck cancer and reconstructions with the renowned plastic surgeon Professor Hung-Chi Chen in Taiwan in 2011. A significant part of his work since that time has revolved around oncology and reconstruction of the head and neck region. He is part of the Head & Neck Multidisciplinary Team at Liverpool Hospital and Skull Base Multidisciplinary Team at Macquarie University Hospital, where complex cancer and reconstructive cases are discussed and management consensus obtained within a diverse group of experts including surgeons, oncologists, dieticians, and therapists.
Melanomas, on the other hand, form a particularly important subset of skin cancers in Australia that has a high mortality rate. Australia leads the world both in incidence of melanomas and ground-breaking research in the area. The standard of care for melanomas often involves multidisciplinary collaboration between surgeons, medical and radiation oncologists. In recent years, there are new immunotherapy options that have altered the approach to melanoma both in terms of disease prognosis and recommended treatment pathways. Dr Quan Ngo is part of the Melanoma Multidisciplinary Team at Liverpool Hospital and regularly attends meetings to discuss complex cases.
The field of skin cancer can therefore involve a wide range of conditions from minor skin cancers amenable to simple office-based treatments to aggressive and lethal cancers that require complex management with input from several medical specialties. Some warning signs such as a sudden change in colour, size, shape, or thickness of long-standing moles, rapidly growing lesions, development of nodules in nearby skin or lymph node basins should trigger a patient to seek prompt medical attention.