With exceptional operating theatres, highly experienced surgical teams, minimal wait times and access to diagnostic technology, Northern Beaches Hospital is the top choice for surgery.

Northern Beaches Hospital provides an extensive range of general and complex surgeries, both elective and life-saving procedures for all private patients, spanning breast, colorectal, endocrine, skin cancer, surgical oncology, upper GI and weight loss.

Post-surgery, patients are cared for by a team of experienced, compassionate nurses whose sole focus is comfort and recovery.

Peninsula Living speaks with two of the hospital’s general surgeons, Dr Penelope De Lacavalerie and Dr David Coker, who reveal the latest in surgical techniques and news for 2024.

 

Dr Penelope De Lacavalerie

Bowel cancer is Australia’s second deadliest cancer, with one 1 in 13 diagnosed during their lifetime. While it claims more lives than breast cancer, prostate cancer, and melanoma, it has a great success rate when caught early.

General and Colorectal Surgeon Dr De Lacavalerie says, “It’s not an old man’s disease only, it’s an ‘all peoples’ disease and it’s getting more frequent in younger people.

“Although the majority of newly diagnosed people occur in age 50 and over, 1 in 9 are under the age of 50 and it’s the number one cancer killer of people aged between 25-34.

“The good news is that it’s 99% treatable if caught early, which is why early detection is so important.”

Dr De Lacavalerie applies her surgical skillset toward General Surgery offering minimally invasive techniques and robotics to deliver optimal outcomes for her patients at Northern Beaches Hospital.

She has expertise in advanced surgical techniques for conditions of the bowel including colorectal cancer, inflammatory bowel disease, bowel endometriosis, diverticular disease, endoscopy (gastroscopy and colonoscopy) and other benign anorectal conditions.

“Northern Beaches Hospital boasts very highly skilled colorectal surgeons and the biggest change I have witnessed in the last few years is robotic surgery,” she explains.

“Robotic surgery is more precise and promotes faster recovery, less pain, lower risk of infection, and reduces the time you need to spend in hospital. It is also used in heart surgery and gynaecology, amongst other specialties.”

Through her work with Bowel Cancer Australia, Venezuela-born Dr De Lacavalerie, is a Bowel Cancer Australia official spokesperson and was heavily involved in pioneering its Never2Young campaign.

“One in nine of those diagnosed with bowel cancer are under 50, with 1, 716 young Aussies developing the disease each year,” she says. “Currently bowel screening starts at age 50, and through our advocacy with Bowel Cancer Australia, we’ve now got the tick of approval from the NHMRC (national Health Medical research committee) for it to be lowered 45 years of age. However, we still need the government to fund it and implement it.

“I’m proud because it’s life-changing, and what’s great about lowering the screening age is that if people on the Northern Beaches and in Australia in general are age between 40 to 45 and also want to be screened before they turn 45, they can now do request their GP specialist for it and not wait until they turn 45.”

 

Dr Penelope De Lacavalerie
Suite 14, Level 6, Northern Beaches Hospital

Tel: 1300 0 BOWEL (26935)

 

Bowel cancer symptoms

Dr De Lacavalerie says for symptoms of bowel cancer, use the word ‘bowel’ as an acronym:

B – blood in stools or on underwear

O – obvious change in bowel habits, this can be a new erratic routine and/or new symptoms that remain, or stay for a few days, disappear but return

W – weight loss and /or changing appetite that can’t be explained

E – extreme tiredness for no reason or an iron deficiency

L –  lump, swelling or bloating in the abdomen that remains and becomes routine.

 

If you recognise any of these symptoms, Dr De Lacavalerie says ask your GP for a referral for a colonoscopy to a colorectal surgeon, general surgeon or gastroenterologist.

“Having a positive test doesn’t mean you have cancer, it may just mean that you may have a polyp, inflammation or haemorrhoids, but it’s important to get checked,” she adds.

“It’s better to prevent bowel cancer than treat, and there are lots of things you can do diet-wise. Eat wholegrains and high-fibre food or fibre capsules, be physically active for at least 30 minutes a day, limit the amount of red and processed meat to 300-500 grams a week, and try to avoid charred meat.

“Limit your alcohol too, as risk increases significantly after 2-3 drinks a day.”

Bowel cancer risk factors include:

  • Being over 50
  • A history of colon polyps or bowel disease
  • A family history of the disease
  • Genetic syndromes like adenomatous polyposis (FAP)
  • Having type 2 diabetes
  • Being obese
  • Smoking and drinking excessively
  • Poor diet

 

Dr David Coker

 

Dr Coker is a General Surgeon and specialises in surgical oncology, melanoma advanced skin cancers, sarcoma and rare tumours. He operates on tumours in many parts of the body, including the abdomen, the retroperitoneum (the complex space behind the abdomen) and lymph node fields in the neck, armpit and groin regions.

About two in three Australians will be diagnosed with some form of skin cancer before the age of 70 and Dr Coker says while there is no screening for skin cancer, early detection is vital.

“Skin cancer is prevalent on the Peninsula where residents enjoy everything the Beaches has to offer in terms of an outdoor lifestyle,” he says. “We encourage people to enjoy the lifestyle but take sensible precautions – sunscreen, covering up, use shade, wear a hat, sunglasses and the usual things like avoiding the midday sun, being the hottest part of the day.”

Patients are usually referred to Dr Coker when a suspicious mole or skin lesion has been removed and is proven to be malignant. His role is then to treat the lesion, which may involve reconstructive surgery, as well as perform further diagnostic and therapeutic procedures, including sentinel node biopsy.

“[The nature of the malignancy] will dictate the management and whether they need an operation where the melanoma is or was. It sometimes involves a flap repair or skin graft, to repair the defect where the cancer was.”

“Depending on the severity, we might need to sample the sentinel lymph nodes with special targeted surgery involving nuclear medicine, which is sent off to the pathologist who does more analysis as to whether the melanoma has spread to lymph nodes and requires further treatment.”

Dr Coker says there have been huge advancements in skin cancer in recent years, including systemic therapies including immunotherapy, but emphasises that early detection and treatment is still of paramount importance.

“A biopsy is the first step, then surgery if needed, and we have the expertise to get other specialists and treatments involved as required.”

“Northern Beaches Hospital is developing a skin cancer unit that can manage these pathologies, which is great for patients living in the region.

“Always check your own skin, and know your own skin. In areas you can’t see, such as your back, have your partner or a friend to look over you. If in doubt, get an appropriate skin check from your GP, a dermatologist or other skin specialist. It’s better to act than not, where early diagnosis and detection leads to better outcomes.”

 

Dr David Coker

Suite 9, Level 6, Northern Beaches Hospital

Tel: 9911 7210

 

When to get a skin check:

  • New moles
  • Moles that increase in size
  • An outline of a mole that becomes notched
  • A spot that changes colour from brown to black or is varied
  • A spot that becomes raised or develops a lump within it
  • The surface of a mole becoming rough, scaly or ulcerated
  • Moles that itch or tingle
  • Moles that bleed or weep
  • Spots that look different from the others