Download this fact sheet here
Sometimes patients are concerned regarding whether or not the doctor who excises their skin cancer should be the doctor repairing the skin defect later.
It may surprise many to know that by far the largest skill to acquire in skin cancer management is reconstruction following tumour excision. Estimates of the skills and knowledge required to manage skin cancer are as follows:
- Clinical recognition of skin cancers from benign skin lesions - 10%
- Dermoscopic recognition of skin cancers from benign lesions - 10%
- Dermatology and theory of skin cancers and their behaviour - 10%
- Dermatopathology and histology of skin cancer - 10%
- Non surgical modalities for managing skin cancer - 10%
- Reconstruction of skin defects - 40%
- Other aspects of skin cancer management - 10%
The ACSCM trains and examines all these vital aspects of skin cancer management. Note that by far the largest skill doctors need to acquire is reconstruction skills. For this reason, ACSCM runs extensive training programs in surgical reconstruction of skin defects following tumour excision. Training includes repair of defects in all body locations including all locations on the face. Training also includes scar revision and refashioning that is sometimes required.
There are three main outcomes we try to achieve when managing skin cancer:
- Curing the patient of the tumour
- Restoring any impaired function to the region where the tumour was located
- Optimizing aesthetic outcome having achieved the first two objectives
All three are important and all three are integral parts of the ACSCM training and certification.
College Diplomats have acquired substantial skills in skin defect reconstruction and and will be able to effectively manage the majority of skin cancers they are presented with in their practice, including the surgical repair of such cases. Many diplomats frequently manage skin cancers on the nose, lips, ear and eyelids and other difficult locations.
College Fellows are extensively trained an experienced in surgical reconstruction. They are certified with the skills to manage difficult skin defects including in difficult locations such as the nose, lips, eyelids and ears. All Fellows have certified extensive experience in these difficult locations. They are also experienced at scar revision and refashioning when and where it is needed. A small number of skin cancers will be managed by Fellows in conjunction with other experts such as oculoplastic surgeons, radiation oncologists, plastic surgeons, medical oncologists, head and neck surgeons, etc.
Further, ACSCM trains doctors to recognise locations and circumstances that are beyond them. At all levels of training, doctors are cautioned regarding situations that require added skills. College members are taught to recognise their own limitations and are well placed to know when and who to refer to when tumours require particular added expertise.
Other questions about skin cancer management?