More than a million new cases of skin cancer are diagnosed every year in the United States, making it the most common of all cancers. Skin cancer can be an even greater concern for those with light skin or eye color and an active outdoor lifestyle.  Prevention and early detection are the best defenses against skin cancers and routine screening is important. We specialize in skin cancer management with advanced treatment options.

In order to detect skin cancer early, you should examine your skin regularly to identify areas of skin changes in size, shape, color or diameter. Protecting your skin from the sun is also important as 90 percent of all basal and squamous cell carcinomas are thought to be caused by overexposure to ultraviolet light.

There are three basic forms of skin cancer. The two most common are basal cell and squamous cell carcinomas which account for 90 percent of all cases. The third kind, and the most dangerous, is malignant melanoma which can spread throughout the body. When detected early and treated properly, the recovery rate for all three types can be very high.

One in five Americans will develop skin cancer at some point in their lives. Skin cancers are generally curable if caught early. However, people who have had skin cancer are at a higher risk of developing a new skin cancer, which is why regular self-examination and doctor visits are imperative.

This is the most common form of skin cancer. Basal cells reside in the deepest layer of the epidermis, along with hair follicles and sweat ducts. When a person is overexposed to UVB radiation, it damages the body’s natural repair system, which causes basal cell carcinomas to grow. These tend to be slow-growing tumors and rarely metastasize (spread). Basal cell carcinomas can present in a number of different ways:

• Raised pink or pearly white bump with a pearly edge and small, visible blood vessels
• Pigmented bumps that look like moles with a pearly edge
• A sore that continuously heals and re-opens
• Flat scaly scar with a waxy appearance and blurred edges

Despite the different appearances of the cancer, they all tend to bleed with little or no cause. Eighty-five percent of basal cell carcinomas occur on the face and neck since these are areas that are most exposed to the sun.

Risk factors for basal cell carcinoma include having fair skin, sun exposure, age (most skin cancers occur after age 50), exposure to ultraviolet radiation (as in tanning beds) and therapeutic radiation given to treat an unrelated health issue.

Diagnosing basal cell carcinoma requires a biopsy — either excisional, where the entire tumor is removed along with some of the surrounding tissue, or incisional, where only a part of the tumor is removed (used primarily for large lesions).

Treatments for basal cell carcinoma include:

• Mohs Micrographic Surgery — The preferred method for optimal management of complex tumors including those on the head and neck, large tumors, or tumors previously treated by other methods where recurrence of the cancer has detected.  Mohs Micrographic Surgery combines removal of cancerous tissue with microscopic review while the surgery takes place. By mapping the diseased tissue layer by layer, less healthy skin is damaged when removing the tumor.
• Cryosurgery — Some basal cell carcinomas respond to cryosurgery, where liquid nitrogen is used to freeze off the tumor.
• Curettage and Desiccation — The preferred method of dermatologists, this treatment involves using a small metal instrument (called a curette) to scrape out the tumor along with an application of an electric current into the tissue to kill off any remaining cancer cells.
• Prescription Medicated Creams — These creams can be applied at home. They stimulate the body’s natural immune system over the course of weeks.
• Radiation Therapy — Radiation therapy is used for difficult-to-treat tumors, either because of their location, severity or persistence.
• Surgical Excision — In this treatment the tumor is surgically removed and stitched up.

Squamous cells are found in the upper layer (the surface) of the epidermis. They look like fish scales under a microscope and present as a crusted or scaly patch of skin with an inflamed, red base. They are often tender to the touch. It is estimated that 250,000 new cases of squamous cell carcinoma are diagnosed annually, and that 2,500 of them result in death.

Squamous cell carcinoma can develop anywhere, including inside the mouth and on the genitalia. It most frequently appears on the scalp, face, ears and back of hands. Squamous cell carcinoma tends to develop among fair-skinned, middle-aged and elderly people who have a history of sun exposure. In some cases, it evolves from actinic keratoses, dry scaly lesions that can be flesh-colored, reddish-brown or yellow black, and which appear on skin that is rough or leathery. Actinic keratoses spots are considered to be precancerous.

Like basal cell carcinoma, squamous cell carcinoma is diagnosed via a biopsy — either excisional, where the entire tumor is removed along with some of the surrounding tissue, or incisional, where only a part of the tumor is removed (used primarily for large lesions).

Treatments for Squamous Cell Carcinoma include:

• Mohs Micrographic Surgery — Because squamous cell carcinomas can be more aggressive than basal cell carcinomas, Mohs surgery is often the best choice for squamous cell carcinoma of the skin, because it is able to give the best cure rate.  Mohs Micrographic Surgery combines removal of cancerous tissue with microscopic review while the surgery takes place. By mapping the diseased tissue layer by layer, less healthy skin is damaged when removing the tumor.
• Surgical Excision — In this treatment the tumor is surgically removed and stitched up.  The tissue is sent in a jar to a pathologist who sections the tissue and makes slides, then reads the slides to determine if the representative margins appear clear.  It takes approximately 5 business days to determine if the margins are clear or if further surgery is warranted.
• Radiation Therapy — Traditional radiation therapy is used for difficult-to-treat tumors, either because of their location, severity or persistence.  Electronic brachytherapy can be utilized in-office to treat relatively early primary tumors with a high cure rate and no surgical scar.