Specialised Services

Skin cancer clinic

In Queensland, 2 out of every 3 people will be diagnosed with Skin cancer before the age of 70, with Melanoma the second most common life threatening cancer diagnosed in men (behind prostate cancer), and third most common in women (behind breast and colorectal cancer). Fortunately with early detection the majority of skin cancers can be successfully treated before causing significant harm.

All Doctors at Alice Street Medical Centre have access to DermDoc digital dermoscopy system, with the only dedicated skin cancer screening clinic on the southern Tablelands.

Digital dermoscopy provides an accurate system to document your moles, and allows real time comparison of previously photographed moles to highlight changes that may not be apparent with standard dermoscopy alone. This system allows your doctor to make a more accurate assessment on whether a mole needs to be removed or not, both decreasing unnecessary excisions and identifying those moles that are slowly changing which need removal. A well equipped dedicated procedure room allows your doctor to provide advanced skin cancer excisions including skin grafting and skin flaps if required, decreasing the need to refer to specialist surgeons.

The doctors regularly review clinical cases and collate data from each of their clinics, optimising patient care. They continue to review and present this data at clinical education sessions for trainee doctors, local practices, and national medical conferences.

Obstetrics and antenatal care

While pregnancy itself is not a medical condition, at times complications may arise that require input from a doctor.

Dr Caines currently provides the only private obstetric service on the Tablelands, and strongly believes in advocating for womens’ choice while maintaining evidence based best practice.

He enjoys all aspects of obstetric care from preconception counselling, antenatal care, care at the time of birth (including both emergency and elective caesarean), to the care of your newborn baby. He maintains private admitting rights at the Atherton Hospital where he also works as a part time Senior Medial Officer in Obstetrics.

He is able to provide obstetric ultrasound on site (dating ultrasound, growth and wellbeing ultrasound), and has a strong interest in managing diabetes in pregnancy. He finds the most enjoyable aspect of his practice the continuity of care that he is able to provide to families, and continuing to provide general practice care as children grow.

He works closely with a network of clinicians including midwives, paediatricians and specialist obstetricians and maintains the following memberships:

• Advanced Diploma from the Royal Australian College of Obstetrics and Gynaecology
• Australian Diabetes in Pregnancy Society (ADIPS) Member
• Society of Obstetric Medicine of Australia and New Zealand (SOMANZ) Member.

Dr Caines is happy to provide care to women who usually do not attend the practice. No referral is required

Vasectomy

Vasectomy remains the most common form of permanent contraception for a man. The procedure involves disrupting the tube (vas deferens) that caries sperm from the testes to the penis. Sperm only make up a small volume of semen so most men will not notice a significant change in the volume of their ejaculate after the procedure. The vast majority of Vasectomies are performed under local anaesthetic however men will require general anaestethetic to perform the procedure (either by choice or recommended by your doctor). Generally under local anaesthetic, the vas deferens is identified in the scrotum. A small puncture or incision (generally <10mm) is made in the scrotal skin. The vas deferens is lifted from the scrotum and a section is cut out. The cut ends of the vas are either tied, cauterised or both and replaced in the scrotum. The procedure is repeated on the second side. The skin incision can either be sutured with an absorbable suture or left to heal on their own if small enough. The procedure itself takes approximately 45mins to complete. Most men will experience some pain, bruising and discomfort in the few days after a procedure but should return to “normal” within approximately 7 days. While complications are rare they can occur and this should be discussed with your doctor prior to performing the procedure.

There continues to be some misconceptions regarding vasectomy

Misconception #1. Vasectomy is 100% effective
While vasectomy is classed as an effective form of contraception, no contraceptive is 100% effective.

20% of men will continue to have some sperm in their semen analysis at 3months post procedure, and the late failure rate (pregnancy after a negative sperm count) is documented between 1:300 – 1:500 cases. The failure rate remains similar for women undergoing tubal ligation (varies between type of female sterilisation), but is higher than some long acting reversible contraceptives available to women (Implanon ® or Progesterone containing intrauterine device eg Mirena ® or subcutaneous implant eg Implanon ® ).

Other forms of contraception must continue until at least 3 months after the procedure when a semen analysis will be performed confirming sterility.

Misconception #2. Vasectomy increases the risk of prostate or testicular cancer

There have been multiple studies that have not shown an increase risk in any form of Cancer)

Misconception #3. Vasectomy increases the risk of sexual dysfunction
Unless complications arise (such as damage to testes or other structures), vasectomy should have no hormonal effects on sexual function.