Skin Cancer
Procedure: Skin Cancer removal
Surgery Length: (Depends on type and extent of skin cancer)
Anesthesia: General with local or local with sedation
Where: Outpatient Hospital/Inpatient Hospital
Recovery: Depends on technique
Back to work: Depends on technique
Full activities: Depends on technique
Risks: Scaring, Bleeding
A variety of skin cancers inclusive of basal and squamous cell carcinoma as well as melanoma are treated by plastic surgeons. This is particularly the case when wide excisions are required and other tissue such as skin grafts or flaps are needed for reconstruction. Similarly, extensive dissection using lymph node dissection with the new sentinel lymph node technique would again come under the care of a plastic and reconstructive surgeon.
THE PREVENTION OF MALIGNANT MELANOMA
Skin Cancer is a preventable and a curable disease if found early. You must pay attention to changes in your skin and see your doctor promptly if you have any questions.
Get to know your skin. Spend some time inspecting your skin; learn what it looks like, where birthmarks and moles are located and what they look like. Don't forget the hard-to-see areas, especially the back and scalp. You should ask a relative or friend to help inspect your skin and obtain a full-length mirror for self-examination. You should systematically examine your own skin at least once a month. Begin with your face and scalp, and step-by-step, look carefully at shoulders, back, chest, arms, legs, etc. If any moles have changed (see below), see your doctor right away.
Find a good doctor for your on-going medical follow-up. This doctor should understand the importance of your family history and be willing to biopsy any suspicious skin lesions early. Your skin should be examined by this physician at least twice a year for the rest of your life. Be certain that the doctor carefully examines your scalp, as well as the rest of your skin. Scalp lesions do occur and require careful examination for detection. Although a Dermatologist or Plastic Surgeon will be most likely to have the appropriate training, some General Surgeons, Internists and Family Physicians will also have a special interest in skin problems.
Know the melanoma danger signs.
Change in the size of a mole, especially gradual enlargement; sudden enlargement occurs less frequently.
Change in the surface of a mole, such as oozing, scaling, flaking, erosion (as when a scab comes off), or bleeding.
Change in how a mole feels to the tough (becoming lumpy or hard).
Change in shape or outline of a mole.
Change in mole color (particularly the appearance of red, white, and blue colors mixed together).
Change in skin color around a mole (pigment leakage).
Development of itchiness in a mole.
Halo formation around a mole of non-pigmented skin.
If any of these conditions develop in a mole on your skin, see your skin doctor immediately.
Know the danger signs of other types of skin cancer (basal cell and squamous cell cancers).
Dryness, roughness, and flaking of any part of your skin - particularly those areas exposed to the sun.
A skin ulcer that fails to completely heal or that heals, only to re-occur.
Any lump or bump in or under the skin, or a lump or bump which occurs near ulcerated skin.
Skin that was burned or skin grafted many years ago, which suddenly develops an ulcer or nodule.
Cracking lips that re-occur despite lip balms or ointments - also grey-white areas of discoloration on your lips.
Any area of your body which has received radiation (presently or in the past) has a much higher incidence of the formation of skin cancers. Any changes in the skin near or within the fields of such irradiation require immediate biopsy!
If any of these conditions occur, see your physician immediately.
Minimize your exposure to sunlight. Ultraviolet (UV) radiation from the sun is the major know causative factor for melanoma of the skin. Sunlight exposure should be minimized:
Avoid getting sunburned and do not try to get a "good tan."
If you must play in the sun, avoid prolonged sun exposure between the hours of 10 a.m. and 3 p.m. from May 1st through October 31st, when the sun is strongest. If you live south of 35 degree N latitude, sun exposure between 10 a.m. and 3 p.m. should be avoided year round.
If you must play in the sun, apply something to your skin to reduce harmful UV radiation exposure. Sunscreens chemically block out harmful sun rays. There are commercial products for this purpose such as Super-Shade, Eclipse or Pre-Sun (ordinary "suntan lotions" will not do the job). However, these products tend to be expensive. You can ask your pharmacist to prepare a solution of 5% paraaminobenzoic acid in alcohol," which has the same effect and is much less costly (no prescription needed). There are also products which physically block out harmful sun rays. The most readily available of these (such as zinc oxide or A-Fil) are cosmetically unattractive and thus suitable primarily for beach use. There is a special type of make-up (Cover Mark) which is both suitable protection and cosmetically acceptable.
A grade 15 sunscreen is mandatory when in the sun. All exposed areas should be covered with it. Re-apply it after swimming or showering, even if they claim it to be a waterproof sunscreen. Try the various over-the-counter sunscreens. They vary in smell, consistency, type of base and price. Initially try small samples (Physicians Formula, Solar Ban and Total are other popular sunscreens). Various lip balm sunscreens, such as Eclipse, are commercially available.
If you must spend time in the sun, wear your hair long (to protect the back of the neck), use a broad-brimmed hat, long-sleeved shirt or blouse, and long slacks.
Remember that sun lamps used for indoor tanning are also a source of UV radiation and should not be used. X-ray treatments for acne or other chronic skin conditions should not be used. Regular, prolonged exposure to bare fluorescent lights (as in an office or the kitchen) should also be avoided.
Changes is hormone balance may cause moles to change. Particularly careful medical supervision is required during adolescence and pregnancy. The use of hormonal medications, such as oral contraceptives ("the pill") or estrogens for treatment of menopausal symptoms should be avoided, if possible.
Over 90 percent of early stage melanomas are completely curable, but advanced melanoma is a very serious, potentially lethal disease. Minimizing UV radiation exposure decreases the chance of getting a melanoma. Frequent, careful skin examinations will result in the early recognition of melanoma, at a time when the tumor is still curable by surgery.
Most of the other skin cancers do not spread and can be managed locally (if treated early) without much treatment, e.g., topical ointments surgery, or irradiation.
Please feel free to seek our assistance in explaining these instructions more fully or in helping to locate a qualified doctor in your area. If you have any suspicious skin lesions consult your doctor for either treatment or referral.
