The Western Bay of Plenty Primary Health Organisation is highlighting the Bay of Plenty's significant capability for managing skin lesions with a three-pronged approach to staying sun smart.

Encouraging Kiwis to seek funded skin lesion treatments, as well as promoting the benefits of private treatment centres, and providing advice to help New Zealanders stay sun smart, WBOP PHO is on a mission to limit the damaging effects of skin cancer on the nation.

General Practice referrals

With the aim of lowering the burden on hospitals, the WBOP PHO provides funded Skin Lesion Services to eligible patients in the Bay of Plenty.

Providing essential treatments for patients in a timely and cost-effective manner, the WBOP PHO Skin Lesion Service allows specially trained GPs to perform surgery on patients with skin lesions.

'There is such a huge burden of skin cancer in New Zealand,” says Dr Tracy Dixon, GP at Ōtūmoetai Doctors. 'If all cases had to go through the hospital, there's no way every patient would get seen or treated.

'Allocating these jobs to GPs through the WBOP PHO's Skin Lesion Service is a win-win because less public money is spent, and patients are treated more efficiently.

'Instead of relying on hospital resources, this service sees most patients go through the system within about five weeks.”

Performing skin checks, diagnostics, providing second opinions, and carrying out surgery – these services allow GPs to step up and take care of patients with skin cancer.

'Throughout the process we see the patient and talk them through what we are going to do, before performing surgery and following up to make sure everything is on the right track,” says Tracy.

To access the WBOP PHO Skin Lesion Service, a patient must be referred into the programme by their GP, before their information is graded to assess whether they are eligible for the funded treatment.

'Eligible patients are referred to the Skin Lesion Service by their regular GP and then referrals are triaged and allocated by the service to a specialist skin GP who can carry out the surgery,” Tracy adds.

While there is no public funding for a skin check itself, patients can reach out to their regular GP and book in with a contracted skin specialist, who can conduct checks, walk the patient through their options, and refer them into the programme if eligible.

With six diplomas, a Master of Medicine in Skin Cancer from the University of Queensland, and a range of extracurricular achievements, Tracy loves helping patients through this service.

'The Skin Lesion Service is excellent. I absolutely love what I do and take pride in completing surgery with as little scarring as possible to provide patients with the best experience they could hope for,” Tracy says.

Privately funded treatments

Private clinics offer a great alternative for those who don't qualify for funded services.

With advanced treatments and comprehensive detection techniques available, Skinspots skin cancer clinic, one of a number of clinics operating in the Bay of Plenty, uses revolutionary technology to provide services to anyone who wants a check-up.

'Our team of trained experts carry out complete skin assessments to ensure we treat any lesions of concern,” says Dr Franz Strydom, Chief Medical Officer at Skinspots.

'We use special software that can compare a spot from years ago to a spot now to track changes over the years. Software using artificial intelligence (AI) also helps us compare one spot to another and evaluate the current risk for malignancy. It's a comprehensive process that helps us detect concern quickly and early.”

By offering different options, Skinspots can remove lesions or treat them superficially.

'If you can treat a spot before surgery is required, you can cure 70 to 95 per cent of early cancers before they turn into something nastier,” Franz says.

Skinspots can treat sun damage and pre-cancerous cells over the entire body with the use of ointments, chemotherapy creams, or photo dynamic therapy.

'We've pioneered PDT to treat large areas of the skin such as the whole face or back, whereas normally most clinics only treat an area of about 250 square centimetres.”

As one of only two places in New Zealand that offers this treatment, PDT involves applying a natural substance onto the skin.

'This substance contains a molecule that accumulates in cancerous cells. When you shine a bright light on it, it energises the molecule. When it touches oxygen, it turns into a free radical which kills the cancerous cell from within.”

As an effective way of killing cancer cells, the treatment takes three hours and has high success rates.

'It's very popular, but not funded,” says Franz. 'That's why we have been innovative in our approach and can treat a much larger area at the same price.”

As well as PDT, Skinspots can surgically remove cancers that don't require a general anaesthetic.

'As a day stay unit, we can complete surgery with local anaesthetic without the patient feeling a thing,” Franz adds.

With no referral criteria, patients can call or email Skinspots to book an appointment. Skinspots is easily accessible and has clinics in Ngongotahā, Pyes Pa, Fraser Street, Mount Maunganui, and Papamoa.

General safety advice

While the Bay of Plenty is equipped with advanced skin cancer treatment options, using protection to avoid sun damage is the best course of action.

'Research has proven that the daily application of sunscreen reduces skin cancer excisions by 40 to 50 per cent and helps the skin immune system heal pre-cancers (solar keratoses) by about 50 per cent. This is compared to the intermittent use of sunscreen.

'I give this advice to anyone with evidence of sun-damaged skin, solar keratoses or a history of skin cancer,” Tracy says.

Although many Kiwis understand the basic rule of slipping on protective clothing or slipping into the shade, slopping on and reapplying sunblock, slapping on a hat, and wrapping on a pair of sunglasses, Franz from Skinspots says a lot of people misunderstand how to detect skin abnormalities in the first place.

'Google says that to find skin cancer you need to use the ABCDE algorithm which looks for asymmetry, border, colour, diameter, and evolution in your spots. However, as most melanomas appear as new spots, this algorithm misses them.

'Scanyourskin.org is a good site that promotes a more effective and easier technique to assess whether you need to visit a skin clinic,” Franz says.

The SCAN (Sore, Changing, Abnormal, New) technique tells people to look out for spots that are slow to heal, scaly or sore, changing in size, shape, colour, or texture, abnormal spots that look different to others, and new spots.

'Another sun safety misunderstanding occurs as many Kiwis think they are safe from the sun after applying sunscreen.

'Sunscreen acts as a screen and allows you to stay in the sun for longer, but it doesn't block UV rays completely. If you want to spend a day in the sun, whether working in the garden, fishing, golfing, or doing anything outside, the best way to protect yourself is to get something between you and the sun,” says Franz.

From a hat to a long-sleeved top, light pants, or finding shade, Kiwis are urged to take precautions.

'A lot of damage occurs by just doing daily activities such as walking or driving, especially during peak UV hours between 10am and 3pm.

'The UV ratio in the New Zealand winter is close to the UV ratio in the Northern Hemisphere's summer, so it's important to remember that you aren't protected from damage, even on cloudy days,” Franz adds.