The majority of skin cancer is caused by damage to cells from ultraviolet radiation received from sun exposure. The effect is cumulative over a lifetime and skin cancer becomes much more prevalent in the latter decades particularly in patients with a history of multiple sun burns as a child. Skin cancer is very common in our area as many of our older population did not have access to sun blocking agents during their childhood.
COMMON TYPES OF SKIN CANCER
There are three common skin cancers: basal cell , squamous cell, and melanoma. Basal cell skin cancer does not metastasise (spread to other tissue) except in extremely rare cases and can usually be cured with initial treatment. Squamous cell cancer can spread to other tissues if advanced but is usually diagnosed and treated before this occurs. Melanoma is a dark skin cancer and will spread to other tissues if diagnosis is not done at an early stage and can be difficult to cure with medical therapy and can be fatal . These common skin cancer do have visual characteristics which can be seen on exam and prompt a biopsy.
During your fist visit a comprehensive skin examination will be done in addition to examination of any skin growths (lesions)which are of concern to you. Any growths felt to be suspicious for skin cancer will be biopsied and a follow up appointment will be scheduled to review the biopsy results and discuss a treatment plan.
A punch biopsy will be done on the majority of suspicious lesions. The area of the lesion will be anesthetized with local anesthetic and a 3 - 4 mm circular core will be obtained and sent for evaluation for cancer (histology). A single stitch is usually placed which will be removed at the next visit ,usually in one week. Dark lesions which are suspicious for melanoma will be completely excised so that the entire area can be evaluated since further treatment of melanoma is based on the deepest extension of growth.
Should basal or squamous skin cancer be diagnosed ,the next step is usually surgical excision of the lesion in the office or hospital. Surgical excision will involve removal of at least 5mm of skin on both sides of the lesion to help assure complete removal of all the cancer. This is done using local anesthesia and for larger lesions ,sedation in the hospital out patient setting. Some very superficial cancers can be treated with Aldara or Efudex cream rather than excision.
The chance for developing skin cancer can be significantly lessened by reducing exposure to the sun’s ultraviolet rays by using protective clothing and sun block and limiting total exposure time.