A pragmatic approach to facial closure in frail patients

This episode of Life by a Thousand Cuts explores a common but challenging scenario in skin cancer practice: managing a large, bleeding facial lesion in an elderly patient where comfort and control matter more than long-term cure.

A/Prof Tony Dicker uses a real case to walk through clinical reasoning around diagnosis, margins and treatment options, before focusing on practical closure planning for a sizeable cheek defect.

The discussion highlights how patient context, tumour behaviour and functional risk all shape surgical decisions, and why there is rarely a single “right” answer.

A useful listen for clinicians looking to sharpen their approach to complex closures, particularly when balancing technical execution with realistic, patient-centred outcomes.

Note: This episode includes discussion of multiple clinical images. A video version is available for those who wish to view them. Watch in video format >

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Prefer a visual format? Watch this podcast on the HealthCert Education YouTube channel.

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Or explore more educational content in Skin Cancer Surgery.

Life by a Thousand Cuts 

This podcast series is designed to help you enhance your clinical decision-making, procedural skills, and confidence in skin cancer management. Focus on real-world cases, surgical techniques and tips, journal article reviews, diagnostic and management insights, and guest interviews with GPs and specialists.

Listen to the previous episode: Mohs surgery and how it fits into everyday skin cancer practice

About A/Prof Tony Dicker

Associate Professor (Skin Cancer) & Course Coordinator MMed (Skin Cancer), The University of Queensland

Tony Dicker has practised full-time Skin Cancer Medicine in Melbourne since 2004, and previously practised in Brisbane. He obtained his PhD from The University of Queensland in molecular biology of skin cancer with Professor Ian Frazer's group at Princess Alexandra Hospital. He then spent three years as a dermatology registrar at the Royal Brisbane and Princess Alexandra Hospitals.

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