Skin cancer is the most common form of cancer in our country, accounting for nearly half of all cancers in the US and affecting more people than breast, colon, prostate and lung cancer combined. Melanoma is the most dangerous type of skin cancer and it is deadly unless caught in the early stages. Fortunately some of the other forms of skin cancer do not spread to other parts of the body, and all are responsive to early treatment.
Sun exposure is known to be the single, most important risk factor for developing skin cancer; however, trauma, infection and X-ray exposure can also increase risk. People diagnosed with skin cancer should take special precautions to protect themselves from the sun by using sun block every day, wearing sun-protective clothing and avoiding midday sun.
The two most common types of skin cancer are basal cell carcinoma and squamous cell carcinoma.Basal cell carcinomas grow slowly and, if left untreated, can become large and disfiguring. Only rarely does basal cell carcinoma spread throughout the body.
Squamous cell carcinomas are more aggressive and have the potential to spread to other areas of the body.
Melanoma, the most dangerous skin cancer, can begin as a small mole or discoloration that can be virtually anywhere on your body, including your eyes (though this is rare). It can be cured if caught early so annual skin exams by a dermatologist are recommended.
Use the “ABCDE” to evaluate whether you should have a dermatologist examine any spots on your skin:
- Asymmetry: One half of the abnormal area is different from the other half.
- Borders: The edges of the growth are irregular.
- Color: Color changes from one area to another, with shades of tan, brown, or black, and sometimes white, red, or blue. A mixture of colors may appear within one sore.
- Diameter: The spot is usually (but not always) larger than 6 mm in diameter -- about the size of a pencil eraser.
- Evolution: The mole keeps changing appearance
There are many options available for managing skin cancer. Usually, the type of cancer, its location and size, and your prior history will help determine which procedure is best. Your age and general health are also considered.
Treatment methods include:
- Curettage and electrodessication (removing the damaged tissue by scraping and burning with an electric needle)
- Cryosurgery (freezing the tumor, usually with liquid nitrogen)
- Excision (cutting out the tumor and suturing the wound, or closing the wound with a graft or flap from another area of the body)
- Radiation therapy (using X-ray or other radiation)
- Topical chemotherapy (applying creams that attack the cancer cells or stimulate the immune system)
- Mohs micrographic surgery (microscopically controlled excision, described below)
Traditionally offered only at large, academic institutions, Mohs surgery is the most thorough and effective treatment for the most common forms of skin cancer. This extremely precise method allows us to remove a very thin layer of tissue and examine the removed tissue under a microscope during surgery—not after—so just the right amount of tissue is removed. We make sure to remove all the damaged tissue, but we don’t remove any healthy tissue unnecessarily. That allows for not only the lowest likelihood of recurrence but also the best cosmetic outcome.
We have a Mohs fellowship-trained dermatologist right here and we are happy to make this advanced technique available here in our community, so Carilion patients don’t have to travel long distances to receive the best treatments.