Skin cancer is a leading cause of death for many men and women. Those afflicted with cancer know of the fears and uncertainty that come with a diagnosis. Heartland Dermatology and Skin Cancer Center specializes in Mohs micrographic surgery, a superior treatment with proven curable results. Review below the various types of skin cancer, as well as the many treatment options available.
Let our highly trained medical staff care for you with early detection and professional treatment.
TYPES OF SKIN CANCER | TREATMENT
Actinic Keratosis |back to top|
(A Precancerous Lesion)
Actinic Keratosis is considered the earliest stage in the development of skin cancer. These common lesions of the outer layer of skin are caused by life-long sun exposure. The typical lesion is a persistent, red, scaly patch most commonly located on the sun-exposed face, ears, neck, arms and scalp. Similar change of the lips is known as Actinic Chelitis. About 25% of patients with Actinic Keratosis will eventually develop Squamous Cell Carcinoma. Treatment of Actinic Keratosis with liquid nitrogen cryotherapy is usually curative, but other treatment options are available and sometimes necessary.
Basal Cell Carcinoma |back to top|
Basal Cell Carcinoma is the most common malignant tumor of the skin. Most Basal Cell Carcinomas present as a flesh colored or “pearly” growth on the sun-exposed skin. Common presentations include a spot that frequently bleeds, continues to grow, or does not heal. Occasionally, Basal Cell Carcinomas may appear on the trunk as red scaly patches. Although Basal Cell Carcinomas do not metastasize (spread throughout the body), they will continue to grow and may cause extensive local damage if not treated adequately. Treatment options include excision, curettage, radiation and Mohs micrographic surgery.
Squamous Cell Carcinoma |back to top|
Squamous cell carcinoma is the second most common skin malignancy. These tumors have a number of different clinical presentations, but are frequently quickly growing palpable lesions with thick Keratosis on the sun-exposed face, neck, arms and hands. With Squamous Cell Carcinoma there is a chance of local and metastatic spread, making its diagnosis and treatment imperative. About 7 cases per 1000 may be fatal. Risk factors include a lifetime of sun exposure, immunosupression (usually from organ transplants), fair skin, and some genetic disorders. Again as with Basal Cell Carcinoma, treatment with excision, curettage, radiation and Mohs micrographic surgery can be discussed with your provider.
Malignant Melanoma |back to top|
The incident of this deadly skin cancer has continued to dramatically rise over the last 40 years. In the US, it is currently estimated that approximately 1 out of 40 will develop melanoma over their lifetime. Most experts consider exposure to sunlight, particularly in childhood, and sunburns to be a significant risk factor. Based on exam of lesion asymmetry, border irregularities, color variations and diameter biopsy, additional treatment may be warranted. Early identification is crucial as malignant melanoma is nearly 100% curable by excision in its earliest stages. Unfortunately, with progression of this disease, melanoma may spread to local lymph nodes and then important internal organs. At that point, surgery, radiation, and chemotherapy may be attempted to slow the disease.
SKIN CANCER TREATMENTS
Mohs Micrographic Surgery |back to top|
Developed in the 1930’s by physician Frederic Mohs, Mohs micrographic surgery has become the treatment of choice for Basal and Squamous Cell Carcinomas. Its superiority over other techniques lies in the precise removal of an invasive tumor that may twist and tunnel under the skin, and remain unnoticed by the normal eye. The procedure involves a layered removal of the tumor with immediate frozen section microscopic evaluation of all edges of the removed tissue. Because each layer is examined microscopically, the Mohs surgeon can identify the exact area of remaining tumor, while limiting removal of normal unaffected skin. Following complete removal of the skin cancer, the wound is repaired to be as functional and cosmetically appealing as possible. Mohs is performed in our office under local anesthetic. The procedure usually takes only a few hours but we ask that our patients bring a friend or family member, and be prepared to spend the day if necessary.
Surgical Excision |back to top|
This standard technique involves removal of a skin cancer with a scalpel taking adequate tissue around the margins of the lesion. The margins are later evaluated by a pathologist to ensure the complete removal of the lesion. While Mohs micrographic surgery is recommended for the face, excisions are generally performed on the trunk and extremities.
Curettage |back to top|
Curettage describes the superficial scraping away of the identified skin cancer. The area around the lesion is numbed with local anesthetic, then a sharp instrument, called a curette, is used for scraping. An electric current from a special machine is used to control bleeding and kill any cancer cells remaining around the edge of the wound. Recurrence is not uncommon and regular check-ups are recommended.
Radiation |back to top|
Some forms of skin cancer respond best to radiation treatments. This is the use of x-rays to destroy the cancer cells. If this is the best treatment for you, you will be referred to the appropriate treatment center. The affected area generally needs to be treated several times over a number of weeks to reach a dose that is effective for the size and stage of your skin cancer.
Cryosurgery |back to top|
Liquid nitrogen cryotherapy is used to “freeze” the premalignant and benign lesions of the skin, most commonly Actinic Keratosis. The treated skin may initially swell and become reddened for a day or two, then peel over the next week leaving healthy new skin. Actinic Keratosis that do not respond to this treatment may need to be biopsied to make certain they have not transformed into skin cancer.
Prevention |back to top|
As with any disease, prevention or early detection of skin cancer is the best medicine. We recommend that all our patients use sunscreen of SPF 15 or higher and practice sun protective behaviors on a daily basis. If you should have any areas of concern that you would like examined, please do not hesitate to call. Any patient may request a full skin examination and we are happy to evaluate any worrisome lesions at any time.
