Skin Cancer Surgery

Common types of skin cancer

There are three types of skin cancer we see most often:

Basal cell carcinoma. The most common of all skin cancers, basal cell carcinoma typically grows slowly and usually develops on areas of the body frequently exposed to the sun, such as the face, neck, and head. A cancer spot usually appears as a shiny bump or nodule, a pink growth, or a flat lesion that is brown or flesh-toned.

Squamous cell carcinoma. This type of cancer also grows slowly, but it can grow deep into the skin. It frequently develops on sun-exposed skin, including the face, ears, lips, and hands. A squamous cell spot can appear as a scaly patch, a red bump that’s firm to the touch, or an open sore.

Melanoma. Melanoma spreads quickly and is the most serious form of skin cancer. It can develop within a mole that you already have on your skin, or it can appear suddenly as a dark spot or lesion that looks different from the rest of the marks on your skin. Melanoma can also appear as a black, blue, white, or red/pink lesion or mole with a jagged or irregular border.

How will I know if I have skin cancer?

It’s important to self-examine your skin once a month for any new or changing moles, birthmarks, or lesions. You will want to pay attention to characteristics such as:

• Asymmetry: Is one side of the mole or lesion different from the other?
• Border: Are the edges of the area irregular, scalloped, or poorly defined?
• Color: Is the spot brown, black, red, white, or blue, and has it changed colors since the first time you noticed it?
• Diameter: Is the suspicious area larger than 6 millimeters (about the size of a pencil eraser)? If so, it could be melanoma.
• Texture: Is the spot scaly, crusty, dry, or oozing, or itchy?

If you notice any of these changes, you should make an appointment with a dermatologist. He or she can take a look and if they suspect skin cancer, may biopsy the area. It’s also critical to schedule an annual appointment with a Forefront dermatologist, as it’s easy to miss suspicious lesions during a self-exam. Anyone who has previously had skin cancer, or even a precancerous lesion, should be monitored very closely for skin cancers.

Skin cancer treatment techniques

Cryotherapy. For cases of precancerous lesions or skin cancer that is isolated to a small area, we can spray liquid nitrogen onto the skin to freeze and destroy tissue. After about 14 days, the tissue forms a scab and falls off, taking cancerous cells with it.

Shaving. For low risk basal cell and squamous cell cancers, we use a small surgical blade to shave off the cancerous layers of skin. We then apply ointment or cauterise the wound to stop the bleeding.

Excision. For a smaller spot that has not penetrated additional skin layers, we simply excise the cancerous tissue and then stitch the skin back together. For some melanoma, basal cell and squamous cell cases, we may also remove surrounding healthy tissue to ensure that we don’t miss any cancer cells.

Curettage and electrocautery. Some moles can be scraped away, then cauterized with an electric needle to destroy any remaining cancer cells.

Photodynamic therapy. During this procedure, a combination of laser light and special chemicals is used to kill cancer cells.

Superficial radiation therapy (SRT).
This non-surgical method uses radiation to deliver electromagnetic energy to target and destroy cancerous cells. It only penetrates the surface of your skin, minimizing scarring and preserving surrounding healthy skin tissue.

Mohs surgery. Also known as Mohs micrographic surgery, this is typically the most effective treatment for:

• High-risk, nonmelanoma skin cancers
• Skin cancer that returns after receiving previous treatment
• Skin cancers that have uneven edges, are large, aggressive, or growing rapidly
• Appear on a part of the body where it’s important to preserve healthy tissue, such as your scalp, nose, eyes, lips, ears, toes, fingers, or genitals.

Mohs surgery is performed in stages during a single office visit. It begins with removing visible tumors on the skin’s surface, then removing additional layers one at a time and examining them under a microscope to detect remaining cancer cells. This process continues until all traces of cancer have been eliminated from the area being treated. Once all cancerous tissue has been removed, we reconstruct that area. This team approach with the dermatologist and plastic surgeon optimizes the ultimate outcome from both cancer and aesthetic perspective, and has been found to be 99% effective in permanently removing cancer cells.