Big C charity helps patients at NNUH save face

New state-of-the-art equipment funded by the Big C cancer charity to the tune of £32,000 is helping to revolutionise the treatment of certain types of skin cancer at the Norfolk and Norwich University Hospital.

The Mohs surgery technique has the highest reported cure rate of all the available treatments for skin cancer. It involves the removal and examination of skin, layer by layer, until all trace of the tumour has been removed. Skin samples are prepared and analysed in the hospital laboratory while the patient is waiting, to ensure that the surrounding tissue is clear of cancer before the wound is repaired.

Janice Hancock thought nothing of a blemish on her nose until her son Gavin, a doctor in Accident and Emergency, suggested she get it checked out by her GP. “The blemish went away for a while but when it came back it started crusting and bleeding and my son said I should see my GP,” she recalled.

Mrs Hancock was referred to Dr Jennifer Garioch, a consultant dermatologist at the NNUH, who took a biopsy and diagnosed a basal skin carcinoma, one of the most common forms of skin cancer.

After the tumour was removed using the Mohs method, plastic surgeon Mr Marc Moncrieff stepped in to repair the wound. This involved transplanting a flap of skin from the forehead and cartilage from behind the ear to create a new rim for the top of the nostril. The skin from the forehead was carefully “implanted” and allowed to grow in situ for two weeks before being restored to its original position.

“The grafting technique was originally developed in India around 1,000 years ago when a doctor rebuilt the noses of women who had been punished for adultery by having their noses cut off,” explained Mr Moncrieff. “The wound would be 'stitched' by allowing biting ants to latch on with their pincers and then removing their heads – I am pleased to say that is one aspect of the technique that has been improved over the years!”

Dr Garioch commented: “We would not have been able to offer this technique without the generous support of the Big C charity. The Mohs method is especially suited to tumours on the face where the treatment and repair of the skin is especially delicate. It relies on close co-operation between laboratory staff and clinicians to achieve the best possible outcome for the patient in the shortest possible time. I must say the teams have responded brilliantly to the challenge.”

Mrs Hancock is delighted with the results and says the service she received at the NNUH was “excellent”. I was warned to stay indoors during the cold weather when the skin graft was bedding in, but that was fine with me,” she said.

“Everyone was very friendly and approachable and the whole process was explained to me very well at every stage. I am just glad I had the blemish checked out – it’s a great relief to know that the cancer has been completely removed,” she commented.

This week Janice Hancock returned to the hospital to thank the clinicians and laboratory staff who were involved in her diagnosis and treatment. Consultant histopathologist Dr Laszlo Igali commented: “We do not normally get a chance to see the patients who benefit from our work so it has been a real pleasure to meet Mrs Hancock and see that she is doing so well.”