Every day we take care of patients with skin cancers or benign skin lesions. Skin cancer is the most common form of cancer. Most often, skin cancers are present in sun exposed areas such as the head and neck.
There are three main types of skin cancers: basal cell cancer, squamous cell cancer and malignant melanoma.
Basal cell cancers are generally the most favorable, while malignant melanomas are the least favorable. The outlook for a patient is dependent on the type of skin cancer, the depth of the cancer and at what stage it was diagnosed. In general, the earlier the diagnosis, the more favorable the prognosis. If a patient has a history of skin cancer, he or she is more likely to develop additional skin cancers. We have these patients return regularly for checkups because prevention and early diagnosis are key.
Avoiding excessive sun exposure with clothes and sun block is essential. The ultraviolet (UV) radiation in sunlight and tanning booths causes breaks in the cell DNA (mutation) which can trigger transformation into a cancer cell. The more UV rays a person is exposed to leads to more mutations, and consequently, a higher chance of cancer. Sunblock and clothes basically block the amount of UV radiation the cells are exposed to. The Sun Protection Factor (SPF) of a product indicates the relative efficiency in blocking the rays. Unfortunately, the system is misleading because an SPF of 50 is only slightly more of a barrier than an SPF of 25. It is more effective to reapply a lesser SPF than to count on a higher SPF to last the whole day. Early diagnosis is important. Bleeding, itching, ulceration, varying color and increase in size make lesions more suspicious.
Early diagnosis is important. Bleeding, itching, ulceration, varying color and increase in size make lesions more suspicious.
We either remove or biopsy (remove a small portion) suspicious growths. If the biopsy proves that the growth is a cancer or we did not completely excise it, we would have you return for complete removal. We use long-acting local anesthetics to numb the area. The lesion is removed with the incision in natural skin tension lines. The orientation of the lesion is marked with a suture and the specimen is carried to the pathology lab at Bellin Hospital or St. Vincent Hospital. There the specimen is frozen so it can be sliced thinly. It is placed on a slide, stained and examined by a board-certified pathologist.
Most importantly the margins are checked to make sure that the lesion is completely excised. This process is very similar to Mohs surgery carried out by dermatologists. If a margin is involved, the area is re-resected. This process takes approximately 30 minutes. Once the margins are known to be clear of tumor the wound is closed. Large defects in critical areas may require shifting of tissue (flap surgery) or a skin graft. The patient returns later for suture removal and to make sure scarring is minimized. We use scar tape, massage and steroid injections to minimize scarring in patients genetically predisposed to thick scars and keloids. We follow patients with skin cancer to diagnose new cancers at an early stage and treat pre-cancers with topical chemotherapy or cautery.
Visit the American Cancer Society website to view photos of common cancers and benign lesions. Please make an appointment to see us if you have a lesion you are worried about, or if you have a lesion you wish to have excised. We also remove many lesions for cosmetic reasons, which are not covered by insurance.