A new micrographic surgery for the treatment of skin cancer is proving to have an almost 100% cure rate. Dr Johann de Wet, dermatologist and skin cancer specialist, aims to make this surgery a reality for more South Africans with skin cancer.
Dr Johann de Wet was born in Delareyville, the peanut- and maize-farming district in the North West province of South Africa. He qualified as a medical doctor at the University of the Free State and then worked in the United Kingdom and Canada, where he specialised in Family Medicine. He also worked as a lecturer at the University of Calgary. He originally intended to spend only three years abroad, but as these things go, it turned into nine.
Studying the body’s largest organ: the skin
“It was while working in Canada that I became intrigued by the skin and dermatological disease. As the body’s largest organ, the skin can act as a window and an external system that communicates directly with the internal organ environment,” Dr De Wet says. “Skin cancer screening and treatment also became a large focus of my practice, and I think this is what made me decide to specialise in dermatology.”
When he is not expanding his knowledge in skin science, Dr De Wet enjoys cycling, skiing and travelling with his wife and two sons.
He graduated with a diploma in dermatology from the University of Cardiff in Wales and an MMed in skin cancer from the University of Queensland in Australia before returning to South Africa in 2015.
He specialised in dermatology at Cape Town’s Tygerberg Academic Hospital. He obtained his MMed degree in dermatology cum laude from the University of Stellenbosch and his fellowship from the College of Dermatologists with distinction.
Taking a much closer look at skin cancers
Dr De Wet’s area of special interest and passion lies in skin cancer diagnosis and treatment, specifically in Mohs micrographic surgery. This is a procedure where individual layers of cancer tissue are removed and examined under a microscope one by one until all cancer tissue has been removed.
“The wonderful thing about this form of skin cancer surgery is that cure rates close to 100% are achieved with minimal tissue removal,” he says. “In addition, it is cost-effective and associated with the best cosmetic outcomes when treating skin cancer.”
International guidelines on skin cancer treatment recommend Mohs micrographic surgery as a first-line treatment and gold standard for locally aggressive tumours, for tumours in places where it’s necessary to spare tissue, such as the face, and for patients at highest risk for the cancer spreading. Skin cancer is completely curable in most cases, if detected and treated early.
“My research goals are to improve the treatment of skin cancers with this medically advanced surgical technique and to help to firmly establish this treatment in South Africa,” he adds.
There is a worldwide epidemic of skin cancers, he says, and South Africa is no exception.
A research dream for Dr De Wet
Dr De Wet’s research on the surgical treatment of melanoma in situ – cancer cells in the top layer of the skin – will contribute towards a master’s degree in pathology. He received a Discovery Foundation Academic Fellowship Award to fund this game-changing research. In 2020, he also completed a one-year fellowship in Mohs micrographic surgery through the American Society of Dermatological Surgery. Dr Pieter du Plessis, a pioneer of the procedure in South Africa, mentored him.
He laughs when asked how he felt when he heard he had received the award.
“Initially I thought my application had been unsuccessful, as I heard of others who had received emails from Discovery. I hadn’t, but knew the competition was stiff. The next day I looked in my spam folder – and there was the mail. I was overwhelmed with joy. For the first time, it felt as though many years of study and sacrifice had paid off.”
“I hope to share my knowledge and experience with other healthcare professionals and to help create awareness of this highly curable, but often devastating disease,” he concludes.
This article was created for the 2020 Discovery Foundation Awards and has been edited for the Discovery Magazine.
About the Discovery Foundation
Since 2006, the Discovery Foundation has invested over R256 million in grants to support academic medicine through research, development and training medical specialists in South Africa.
The Discovery Foundation is an independent trust with a clear focus – to strengthen the healthcare system – by making sure that more people have access to specialised healthcare services. Each year, the Discovery Foundation gives five different awards to outstanding individual and institutional awardees in the public healthcare sector.
Despite a challenging year marked by the global COVID-19 pandemic, the Discovery Foundation continues to support cutting-edge clinical research and medical training in South Africa’s public and academic medicine sector.
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