> Services

Skin Cancer Clinic

The Wakefield Skin Cancer Centre is a new multi-disciplinary unit aimed at a comprehensive treatment of skin cancer, primarily facial tumours. Essential to this unit is the resection of tumours using a technique referred to as Mohs surgery. The reconstruction is performed by specialist Otolaryngologists and Ophthalmologists with specific interests in facial-plastic, oculoplastic and head and neck surgery.

The Mohs Procedure

The Mohs like resection is a procedure in which skin cancers are excised at a 45 degree angle with identification of any remaining tumour using light microscopy. By using this method it is possible to provide almost total histological control of surgical margins thereby providing the lowest recurrence rates with maximal tissue preservation. Non Moh’s surgical techniques sample approximately 1% of the tumour. Therefore the risk of a positive margin and recurrence is considerably higher.

Mohs micrographic surgery is a very labour intensive procedure, primarily because of the need for multiple specimens which are all individually read. To provide optimum treatment for each patient the resection at our unit will be performed by dermatologist Dr Bruce Taylor and Surgeon Mr Simon Robinson. The preparation and reading of the specimens will be performed by Aotea Pathologists.

Indications

There are several specific indications for Mohs micrographic surgery. Principally this technique is for facial skin cancers because of the need for tissue preservation though occasionally other regions may be included. These indications include:

Primary BCC or SCC with indistinct borders;
Recurrent or incompletely excised BCC or SCC;
Lesions in high-risk areas i.e eyelids, nose nasolabial folds, vermilion border, columella, periorbital, temples, preauricular and postauricular areas, close proximity to ear canal and scalp;
Tumours with aggressive clinical behaviour (i.e rapidly growing and/or >2cm in diameter);
Tumours with aggressive histological subtypes (i.e morpheaform BCC, basosquamous, perineural or perivascular invasion, and infiltrating or multicentric tumours);
Tumours arising in sites of previous radiotherapy;
Basal cell nevus syndrome;
Tumours arising in immunosuppressed patients.

Reconstruction

Following the resection of the tumours, reconstruction will be undertaken according to the site and complexity of the defect. Most of the facial defects will be reconstructed by Simon Robinson, the periocular and eyelid defects by Neil Aburn and for lesions with metastasis into the surrounding structures by Francis Hall. It is anticipated that this multi-disciplinary approach will provide optimal management with regards to preservation of function and cosmesis to the appropriate tumour site.

Referral to the unit

All patients will be assessed by Bruce Taylor and Simon Robinson at a combined clinic prior to the Mohs resection and reconstruction being performed.

Referrals should be made to Wakefield Skin Cancer Centre.

Faculty

Mr Simon Robinson
Dr Bruce Taylor
Mr Francis Hall
Mr Neil Aburn
Aotea Pathology