Skin Cancer Surgery in Campbelltown: When to See a General Surgeon
General information only: This article provides general educational information about skin cancer and skin lesion surgery. It does not replace assessment or personalised advice from your GP, dermatologist or surgeon. Any new, changing or suspicious skin lesion should be assessed by a doctor promptly. Do not delay seeking medical review on the basis of information in this article. |
Skin Cancer in Australia — Why Campbelltown Patients Need to Know
Australia has one of the highest rates of skin cancer in the world. Two in three Australians will be diagnosed with some form of skin cancer by the age of 70. In New South Wales — including Campbelltown and the Macarthur region — skin cancer remains one of the most common reasons people attend their GP and are subsequently referred for surgical excision.
The good news is that most skin cancers, when identified and treated early, are highly manageable. Surgery — either a simple excision performed in a GP’s rooms or a wider excision performed by a specialist surgeon — is the most common treatment for skin cancer in Australia. Knowing when a skin lesion needs a specialist surgical opinion, and what that process involves, helps patients in Campbelltown navigate their care with confidence.
Dr Devesh Kaushal is a specialist general surgeon at 4 Hyde Parade, Campbelltown, who performs skin lesion excision, wide local excision for skin cancer, and assessment of soft tissue lumps and skin lesions across South Western Sydney.
Skin Lesion Excision and Surgical Assessment — Campbelltown Contact the rooms to discuss current availability | (02) 7906 8312 | drdeveshkaushal.com.au |
Types of Skin Cancer — What You Need to Know
Not all skin cancers behave the same way. The three main types differ significantly in their behaviour, risk of spread, and required treatment margin. Understanding the type of skin cancer identified on biopsy is important for planning appropriate surgical management.
Type | Description | Risk Level |
Basal Cell Carcinoma (BCC) | The most common skin cancer in Australia. Arises from the basal cells of the epidermis. Grows slowly and very rarely spreads (metastasises) to other parts of the body. Most commonly found on sun-exposed areas — face, scalp, neck, ears, back and arms. Can cause significant local tissue destruction if left untreated. | Low — rarely spreads |
Squamous Cell Carcinoma (SCC) | The second most common skin cancer. Arises from squamous cells in the outer layers of the skin. Has a higher risk of spread than BCC — particularly to regional lymph nodes. More common on chronically sun-exposed skin. Can arise from precancerous lesions (actinic keratoses). Immunocompromised patients and those on long-term immunosuppression are at higher risk. | Moderate — can spread to lymph nodes |
Melanoma | The most serious form of skin cancer. Arises from melanocytes (pigment-producing cells). Has significant potential to metastasise to lymph nodes and distant organs if not treated early. Identified by changing moles or new pigmented lesions. Early detection dramatically changes outcomes. Requires wide local excision with defined margins and sentinel lymph node biopsy in selected cases. | High — can spread widely |
Other skin lesions: In addition to skin cancers, a general surgeon may assess and excise benign skin lesions including sebaceous and epidermoid cysts, lipomas (fatty lumps), dermatofibromas, and other soft tissue masses. Not every skin lump is a cancer — but every new, changing or suspicious lesion should be assessed by a doctor rather than monitored at home indefinitely. |
Warning Signs — When to See Your GP About a Skin Lesion
The ABCDE criteria are a widely used guide for identifying skin lesions that warrant medical assessment. Any lesion meeting one or more of these criteria should be reviewed by a GP without delay:
| Feature | What to Look For |
A | Asymmetry | One half of the lesion does not match the other half in shape. |
B | Border | The edges are irregular, ragged, notched, blurred or poorly defined. |
C | Colour | Variation in colour within the same lesion — multiple shades of brown, black, red, white or blue. |
D | Diameter | Larger than 6mm (approximately the size of a pencil eraser) — though melanomas can be smaller. |
E | Evolution | Any change in size, shape, colour or character over weeks to months — or a new lesion appearing where one was not before. |
In addition to the ABCDE criteria, the following features in any skin lesion warrant prompt GP assessment:
- A sore or ulcer that does not heal within 4 to 6 weeks
- A lesion that bleeds spontaneously or with minimal trauma
- A pearly, waxy or translucent nodule — particularly on the face or ears (classic BCC appearance)
- A red, scaly or crusted patch that persists, enlarges or bleeds
- Any lesion that is growing noticeably over a period of weeks to months
- A new lump under the skin — particularly if firm, fixed, or growing
🔴 See your GP urgently if a skin lesion: • Is growing rapidly over days to weeks • Is associated with a painless firm lump in the armpit, groin or neck — which may indicate spread to a lymph node • Is ulcerating, bleeding or breaking down and not healing • Is on the face, eyelid, lip, ear, nose or scalp — where tissue margins are limited and early treatment matters most |
How Is Skin Cancer Diagnosed?
Diagnosis of skin cancer involves a combination of clinical assessment and histopathological examination — that is, examination of a tissue sample under a microscope. No skin lesion can be definitively diagnosed as cancer or definitively excluded as benign by appearance alone.
Dermoscopy:
Dermoscopy is a non-invasive technique using a handheld illuminated magnifying instrument that allows the examining doctor to see subsurface structures of the skin not visible to the naked eye. It is widely used by GPs and dermatologists to assess pigmented and non-pigmented skin lesions and guide the decision about whether biopsy or excision is required.
Biopsy or excision biopsy:
The definitive diagnosis of skin cancer requires tissue examination. A biopsy — either a shave, punch or incisional biopsy — removes a sample of the lesion for histopathological analysis. An excision biopsy removes the entire lesion with a small margin of surrounding normal tissue, providing both diagnosis and initial treatment simultaneously. The histopathology report confirms the diagnosis, cancer type, degree of differentiation (aggressiveness), and whether the excision margins are clear.
What the histopathology report tells you:
- Diagnosis: The specific type of skin cancer or benign lesion identified.
- Differentiation: For SCC — whether the cancer is well, moderately or poorly differentiated. Poorly differentiated SCCs carry a higher risk of spread.
- Margin status: Whether the lesion was completely excised with clear margins of normal tissue surrounding it. Involved or close margins may require further surgery.
- Depth of invasion: For melanoma — the Breslow thickness (depth of invasion in millimetres) is the most important prognostic factor and determines the required excision margin and whether sentinel node biopsy is indicated.
When Does Skin Cancer Require a Specialist Surgeon?
Many skin cancers — particularly small, well-defined BCCs and thin SCCs on straightforward anatomical sites — are appropriately excised by a GP with experience in skin cancer surgery. However, referral to a specialist general surgeon is appropriate in a number of specific circumstances:
Situation | Why Specialist Referral Is Appropriate |
Wide local excision required | Melanoma and high-risk SCCs require excision with wider margins (1–2cm or more) than a GP excision typically provides. Wide local excision under general or local anaesthesia in a theatre setting provides adequate margins and appropriate closure. |
Incomplete excision by GP or dermatologist | If the histopathology report shows involved or close margins after an initial GP excision, further surgery (re-excision) is required to achieve clear margins. A surgeon assesses what further tissue needs to be removed. |
Large or complex lesion | Larger lesions — or those in anatomically complex locations — may require planned flap or graft reconstruction after excision to achieve satisfactory cosmetic and functional closure. |
Sentinel lymph node biopsy (melanoma) | For melanomas of 1mm Breslow thickness or greater, or thinner melanomas with high-risk features, sentinel lymph node biopsy is recommended. This procedure identifies whether melanoma has spread to the first draining lymph node and guides further management. |
Suspected lymph node involvement | A palpable lymph node in the drainage region of a skin cancer — armpit, groin or neck — requires assessment and may require lymph node biopsy or dissection. |
Lesion on a surgically complex site | Skin cancers on the eyelid, lip, ear, nose, scalp, or over vital structures may require specialist planning, reconstruction, or multidisciplinary input. |
High-risk SCC features | SCCs that are large, poorly differentiated, deeply invasive, perineural, arising in a scar or chronic wound, or in an immunocompromised patient carry higher risk and benefit from specialist assessment. |
Recurrent skin cancer | A skin cancer recurring at a previously treated site typically requires wider excision and careful margin assessment. |
What Does Skin Cancer Surgery Involve?
Skin cancer surgery performed by a specialist general surgeon in Campbelltown is typically carried out under local anaesthesia in the consulting rooms or procedure room, or under general anaesthesia in a hospital theatre for larger or more complex excisions. The procedure and setting depend on the size and location of the lesion, the required excision margin, and whether reconstruction is needed.
Local anaesthesia excision (minor procedure):
For smaller lesions in accessible locations, the skin around the lesion is injected with local anaesthetic to numb the area. The lesion is then excised with an appropriate margin of surrounding normal tissue, the specimen is sent to pathology, and the wound is closed with sutures. The procedure takes 20 to 45 minutes. You are awake throughout but feel no pain. You can go home immediately after.
Wide local excision under general anaesthesia:
For larger lesions, melanomas requiring defined wide margins, lesions in difficult anatomical locations, or cases requiring skin flap or graft reconstruction, surgery is performed in a hospital theatre under general anaesthesia. Dr Kaushal performs these procedures at Campbelltown Private Hospital, Sydney Southwest Private Hospital Liverpool, and The George Hospital.
Reconstruction after excision:
When the excision of a large or complex skin cancer leaves a defect that cannot be closed directly with a simple suture line, reconstruction is required. Options include:
- Primary closure: Direct suture closure of the wound edges. Appropriate for smaller defects with adequate surrounding tissue.
- Local flap: Nearby skin is rotated or advanced to fill the defect. Provides good colour and texture match.
- Skin graft: A thin piece of skin taken from another area of the body (donor site) is used to cover the defect. Used when a flap is not possible or the defect is large.
Recovery after skin cancer excision:
Timeframe | What to Expect |
Day of procedure | Local anaesthesia excisions — go home immediately. General anaesthetic — discharged same day or next morning. Keep wound dry and covered as instructed. |
Days 1–7 | Some discomfort, swelling and bruising around the wound — expected and settles. Keep wound dry. Avoid heavy lifting or vigorous activity. Report increasing redness, swelling, fever or discharge promptly. |
Days 7–14 | Wound check and suture removal if non-dissolvable sutures were used. Wound healing progressing well in most cases. |
Weeks 2–6 | Scar continues to heal and fade. Sun protection of the scar is important for at least 12 months — UV exposure causes permanent darkening. |
Pathology review | Dr Kaushal reviews the histopathology report at or before your post-operative appointment. Results are discussed and further management (if any) is planned at this visit. |
Skin Cancer Prevention and Ongoing Surveillance
Surgical treatment of a skin cancer does not reduce the risk of developing further skin cancers. Patients who have had one skin cancer have a significantly increased risk of developing additional skin cancers over their lifetime — making ongoing skin surveillance an important part of post-treatment care.
Prevention — Slip, Slop, Slap, Seek, Slide:
- Slip on sun-protective clothing — long sleeves, collars
- Slop on SPF 50+ broad-spectrum sunscreen — reapply every 2 hours when outdoors
- Slap on a broad-brimmed hat
- Seek shade — particularly between 10am and 3pm when UV is strongest
- Slide on UV-protective wraparound sunglasses
Ongoing surveillance after skin cancer treatment:
Patients who have had a skin cancer should arrange regular skin checks with their GP or a skin cancer clinic. The recommended frequency of surveillance skin checks depends on the type and number of skin cancers previously treated, personal risk factors, and GP or specialist recommendation. Following treatment of a melanoma, surveillance is typically more structured and involves regular clinical review.
Do not ignore new or changing lesions: Between scheduled skin checks, any new lesion, or any existing lesion that begins to change in size, shape, colour or character, should be assessed by a doctor without waiting for the next scheduled review. Early detection remains the most important factor in skin cancer management. |
Frequently Asked Questions
My GP removed a lesion and said the margins were not clear — what does this mean?
Clear margins means that when the pathologist examined the excised specimen, normal tissue surrounded the cancer on all sides — indicating the entire cancer was removed. Involved margins means cancer cells were found at or very close to the edge of the excised specimen, suggesting some cancer may have been left behind. Close margins indicates normal tissue was present but very narrow. Both involved and close margins typically require re-excision — removal of further tissue around the scar — to ensure the cancer is completely cleared. Dr Kaushal assesses these cases and plans re-excision at consultation.
How do I know if I need a general surgeon or a dermatologist for my skin cancer?
Dermatologists and general surgeons have overlapping roles in skin cancer management. Dermatologists assess and diagnose skin lesions and may excise smaller or more straightforward cancers. General surgeons perform excision — particularly for larger lesions, wide local excision, lesions requiring reconstruction, melanoma requiring sentinel node biopsy, and lymph node assessment. Your GP will advise on the most appropriate referral based on the type and complexity of your skin cancer. For melanoma and complex or high-risk skin cancers, referral to a general surgeon is generally appropriate.
Will I have a visible scar after skin cancer surgery?
All skin excisions leave a scar. The appearance of the scar depends on the size and location of the excision, the technique used for closure, individual healing characteristics, and post-operative scar care. Most surgical scars fade significantly over 6 to 12 months. Sun protection of healing scars is important. Silicone scar products and scar massage are useful adjuncts once the wound is fully healed. For complex excisions on cosmetically sensitive areas such as the face, Dr Kaushal discusses the reconstruction plan and expected cosmetic outcome at the pre-operative consultation.
I had a melanoma removed — what follow-up do I need?
Follow-up after melanoma excision depends on the Breslow thickness and stage of the melanoma. Thin melanomas (less than 1mm) with clear margins and no high-risk features typically require regular clinical skin checks and monitoring for recurrence. Thicker melanomas may require sentinel lymph node biopsy, imaging, and more intensive surveillance. Dr Kaushal discusses the specific follow-up plan appropriate for your melanoma at your post-operative appointment. Long-term follow-up for melanoma is coordinated between the treating surgeon, GP, and where indicated, a medical oncologist.
Does Medicare cover skin cancer surgery?
Medicare rebates apply to skin cancer excision procedures when performed by an eligible provider with a valid referral and appropriate clinical indication. The amount of the rebate depends on the MBS item number applicable to the specific procedure. Private health insurance generally covers theatre and hospital costs for procedures performed under general anaesthesia in a private hospital. Contact the rooms and your insurer for specific information about your expected out-of-pocket costs before proceeding.
Skin Cancer Surgery Assessment — Campbelltown
If you have been referred by your GP for assessment of a skin lesion or skin cancer — or have received a histopathology report requiring further management — Dr Kaushal provides surgical assessment and skin lesion excision at 4 Hyde Parade, Campbelltown. A GP referral is recommended and required for Medicare rebates.
Specialist General Surgeon | Upper GI and Bariatric Surgery 4 Hyde Parade, Campbelltown NSW 2560 Phone: (02) 7906 8312 Email: [email protected] | drdeveshkaushal.com.au Office Hours: Monday – Friday, 9:00 AM – 5:00 PM Current hospital appointments and accreditations include: Sydney Southwest Private Hospital Liverpool | Campbelltown Public Hospital | Campbelltown Private Hospital | The George Hospital Medicare rebates and private health insurance benefits may apply depending on the service, referral and individual policy. Please contact the rooms and your insurer regarding fees and potential out-of-pocket costs. |
General information only: This article provides general educational information about skin cancer and skin lesion surgery. It does not replace assessment or personalised advice from your GP, dermatologist or surgeon. Any new, changing or suspicious skin lesion should be assessed by a doctor promptly.
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