Skin cancer
QVH is the largest specialist plastic surgery unit in the country, with 18 plastic surgery consultants as well as five maxillofacial and three ophthalmic surgeons, supported by over 30 junior surgeons. We are the largest provider of skin surgery services in the south east, caring for patients with lumps and bumps, moles, sun damage and skin cancers. Our team has the highest levels of experience and expertise, treating over 3,000 patients every year.
Our internationally-known Melanoma and Skin Cancer Unit (MASCU) is the only unit in the region providing the complete range of specialist skin cancer services including medical treatments with immunotherapy, cryotherapy, curettage, simple excisions, skin grafting, local flaps, CO2 laser treatment and the complex management of metastatic disease. It is the designated tertiary referral centre for all skin cancers across the region and is recognised by the Kent, Sussex and Surrey Cancer Networks.
Our Macmillan Skin Cancer Nurse Specialists, Maggie Curtis and Julie Anthony, act as a point of contact for patients, relatives, carers and other healthcare professionals and coordinate care and psychological support for patients receiving skin cancer treatment at QVH.
The surgeons listed to the right are those with skin cancer as their main area of expertise. Other QVH plastic surgeons also treat skin cancer patients where appropriate. We also have a team of supporting professionals including pathologists, psychological therapists, multi-disciplinary team coordinators and dedicated MASCU secretaries.
The team can be contacted on 01342 306660.
Recent survey results
Clinical effectiveness
Complete excision rates in basal cell carcinoma (BCC)
BCC is the most common cancer in Europe, Australia and the USA. Management usually involves surgical excision, photodynamic therapy (PDT), curettage or immuno-modulators or a combination. Surgical excision is highly effective with a recurrence rate at 2%. Complete surgical excision is important to reduce recurrence rates. Sometimes this is not possible because of the size or position of the tumour. Sometimes the incomplete excision will only become evident with histological examination of the excised tissue. The high rate of complete excision for QVH is particularly pleasing as 40% of our referrals are from dermatologists who refer more complex cases.
| Measurement: |
Audit of two months activity (286 BCC cases) |
| QVH target: |
100% |
| Benchmark: |
88.9-95.3% (published literature) |
| 2017/18: |
93.5% |
| 2016/17: |
90.2% |
| 2015/16: |
96.8% |
| 2014/15: |
94.1% |
| 2013/14: |
92.5% |
Complete excision rates in malignant melanoma
Melanomas are excised with margins of healthy tissue around them, depending on the type, size and spread of tumour. These margins are set by national and local guidelines and each case is discussed in a multidisciplinary team (MDT). Sometimes total excision is not possible because of the health of the patient, or the size, position or spread of the tumour, and the MDT may recommend incomplete excision.
| Measurement: |
Audit of two months activity (42 Melanoma cases) |
| QVH target: |
100% |
| Benchmark: |
75% (NICE guidance) |
| 2017/18: |
94.6% |
| 2016/17: |
94.4% |
| 2015/16: |
97% |
| 2014/15: |
96.1% |
| 2013/14: |
96.5% |
Full details of our patient safety, patient experience and clinical effectiveness measures are published in our annual Quality Report. You can find the latest version here.
Miss Alexandra Molina
Consultant Plastic Surgeon
Specialist interests: Microsurgery, breast reconstruction, perineal reconstruction, general plastic surgery.
Miss Alexandra Molina is a UK trained Consultant Plastic Surgeon and is on the GMC Specialist Register for Plastic Surgery.
She graduated from Cambridge University with Distinction and started her Plastic Surgery training in 2008. During her registrar post in London she completed a Postgraduate Certificate in Biomedical Education at St George’s, University of London. In 2015 she was awarded the Intercollegiate Fellowship in Plastic Surgery or FRCS(Plast). For her outstanding performance in these final examinations she was awarded the McGregor ‘Gold’ Medal.
Alex has completed two prestigious microsurgery fellowships at St Thomas’ Hospital, London and QVH. She then worked as a locum consultant, performing principally DIEP breast reconstruction, at the Royal Marsden Hospital, before taking up her permanent post at QVH. Her main interest is in microsurgical breast reconstruction, but she also holds honorary contracts at Darent Valley and Maidstone Hospitals, where she is involved in perineal reconstruction after rectal cancer. She runs a peripheral clinic at William Harvey Hospital in Ashford, where she covers general plastic surgery, including skin cancer.
In 2017-18 Alex was awarded the Lady Estelle Wolfson Emerging Leaders Fellowship at the Royal College of Surgeons of England. She maintains her interest in teaching and leadership alongside her clinical commitments. She also has a young son who keeps her busy in her spare time!
Mr Brian Bisase
Consultant Maxillofacial Surgeon
Specialist interests: Head and neck cancer ablation and reconstruction, including micro-vascular surgery and surgical dermatology; maxillofacial trauma surgery; salivary gland disease; and routine oral surgery.
Mr Brian Bisase graduated in dentistry and medicine from the University of London, where he was awarded the Newland Pedley Medal and Scholarship. After completing his surgical training, Mr Bisase undertook higher training in oral and maxillofacial surgery over a five year period, working across the Royal Surrey County Hospital in Guildford, Guys and Kings College Hospitals in London, and here at QVH.
He was awarded the British Association of Oral and Maxillofacial Surgery Gold Medal for coming top in the intercollegiate maxillofacial surgery FRCS exams in 2009. He undertook further specialist training in Toronto, Canada and at the Royal Marsden Hospital where he developed experience in thyroid, anterior skull base and sarcoma surgery, laryngo-pharyngeal reconstruction and advanced reconstruction of the complex defect.
Mr Bisase is an active member of the British Association of Oral and Maxillofacial Surgery and British Association of Head and Neck Oncologists where he has presented clinical research projects and been published in their journals. He is also published in other peer reviewed journals and plays an active part in research at QVH and collaboration with other hospitals. He is a member of the NICE (National Institute for Health and Care Excellence) quality assurance and framework group.
He joined QVH in January 2012. In addition to his clinical work at the Trust, he is the Trust clinical lead for head and neck cancer. He also devotes time to teaching, professional training and steers the clinical outcomes group for head and neck surgery at QVH. He is project lead for the introduction of a number of programmes aimed at improving patient care such as – Tracheostomy Care and the Enhanced Recovery Program for patients undergoing major Head and Neck surgery (ERPHN), sentinel node biopsy and electrochemotherapy. QVH is the only provider of the latter two services in the South East of England.
His major cases are all fully discussed in a multi-disciplinary team, he ensures that they have received sufficient testing for diagnosis, and treatment plans are in line with national standards.
Mr Bisase also runs clinics at Horsham and Maidstone hospitals.
Miss Jennifer O’Neill
Consultant Plastic Surgeon
Specialist interests: Skin cancer, hand surgery, reconstructive surgery
Miss Jennifer O’Neill joined Queen Victoria Hospital (QVH) as a consultant in 2017.
She graduated from Queens’ College, Cambridge with a 1st class BA Hons degree and then completed clinical medical training at New College, Oxford.
Initial surgical training was completed in London, Brighton, Exeter and East Grinstead. Miss O’Neill then visited Melbourne to perform research (MMed) on the subject of the lymphatic system before taking up a further surgical training post on the South-West plastic surgery training programme (Bristol and Exeter).
Miss O’Neill’s specialist fellowships were the hand surgery fellowship at QVH and a microsurgery fellowship performing free tissue transfer to the lower limb in Bristol. She also completed an interface fellowship in reconstructive and cosmetic Surgery (Training Interface Group) based in Guildford in addition to the Bristol aesthetic fellowship.
Miss O’Neill was awarded both the British and the European hand diplomas following the hand fellowship at QVH.
After becoming a consultant in 2015, Miss O’Neill worked as a hand and skin cancer specialist Locum Consultant at Wexham Park Hospital prior to taking up her current role at QVH. Miss O’Neill is the lead plastic surgeon for West Kent Dermatology.
Miss O’Neill is the current surgical tutor for plastic surgery at QVH and is part of the simulation teaching faculty. She has postgraduate qualifications in healthcare leadership and medical education.
Miss O’Neill is a fully qualified plastic, reconstructive and aesthetic surgeon. She has been awarded the intercollegiate fellowship in plastic surgery and is a Fellow of the Royal College of Surgeons of England (FRCS Plast). She is on the GMC’s specialist register for plastic surgery and is a member of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS).
Mr Keith Cullen
Consultant Plastic Surgeon
Specialist interest: Skin cancer
Mr Keith Cullen joined Queen Victoria Hospital as a Consultant Plastic Surgeon in 1991.
Mr Cullen is a General Plastic Surgeon with a special interest in skin cancer. During his time at the Hospital he has also undertaken the role of Deputy Medical Director and was Lead Clinician in Plastic Surgery for five years.
Mr Sam Orkar
Consultant Plastic Surgeon
Specialist interests: Breast surgery including breast reconstruction and breast asymmetry, skin cancers, hand surgery and problem scars.
Kusu Samuel Orkar was appointed Consultant Plastic and Reconstructive Surgeon at Queen Victoria Hospital on 1 July 2009.
Sam qualified at the University of Jos in Nigeria and was the best graduating student in his year. He completed the Nigerian and West African training in General Surgery and Plastic Surgery and worked as a Consultant General and Plastic surgeon in Nigeria. He undertook further training in Plastic Surgery in the UK at the Canniesburn Unit, Glasgow, St Andrews Centre for Plastic Surgery and Burns, Chelmsford, Queen Victoria Hospital and the McIndoe Surgical Centre both in East Grinstead.
Sam has done fellowships in breast/microsurgery, hand surgery and cosmetic surgery to further hone his skills.
Sam’s subspecialty interests are breast surgery including reconstruction, skin cancer, hand surgery and problem scars. Sam runs clinics at QVH and the Medway Maritime Hospital.
Sam is on the GMC specialist register for plastic surgery and is a member of BAPRAS and BAAPS
Qualifications:
- BM BCh University of Jos, Nigeria
- FMCS(Nig) Fellow Medical College of Surgery, Nigeria
- FWACS (plast) Fellow West African College of Surgeons (plastic surgery)
- FRCS Ed Fellow Royal College of Surgeons Edinburgh
- FRCSEd(Plast) Royal College of Surgeons Intercollegiate Fellow(plastic surgery)
Mr Siva Kumar
Consultant Plastic Surgeon
Specialist interest: Skin cancer; microsurgical reconstruction; trauma; breast; general plastic surgery.
Mr Siva Kumar Veeramani is a UK-trained Consultant Plastic, Reconstructive & Aesthetic surgeon appointed at Queen Victoria Hospital in 2016. He has been awarded the intercollegiate fellowship in plastic surgery and is on the General Medical Council specialist register in plastic surgery.
Mr Kumar graduated from the University of Newcastle-upon-Tyne in 2005. He undertook his plastic surgery training at major UK centres in the North of England. He completed his training with three nationally appointed specialist fellowships in skin cancer surgery, trauma surgery and cosmetic surgery. During his skin cancer fellowship at Leeds, he trained in sentinel node biopsy and the surgical management of patients with advanced melanoma. His trauma surgery fellowship at the Queen Elizabeth Hospital in Birmingham involved the management of both civilian and military trauma. Prior to his appointment at Queen Victoria Hospital, Mr Kumar worked as a locum consultant at the Newcastle-upon-Tyne Hospitals Foundations Trust specializing in breast reconstruction. These posts offered him additional experience in cancer management and microsurgical reconstruction.
Mr Kumar is a designated member of the specialist skin cancer multi-disciplinary team at QVH.
Mr Kumar holds clinics at Queen Victoria Hospital and Eastbourne District General Hospital.
Qualifications: MBBS BMed.Sci(Hons) MRCS MBA FRCS(Plast.)
