Skin cancer is diagnosed by removing all or part of the growth and examining its cells under a microscope (biopsy). Your skin cancer can be treated by a number of methods, depending on the type of cancer, its stage of growth, and its location on your body. Today's plastic surgeon is as well-trained in the excisional techniques of cancer surgery as in reconstruction. By planning ahead for reconstruction, the plastic surgeon can design the most appropriate skin excision for tumor removal.
In certain cases, some scarring may be unavoidable, but a skilled plastic surgeon can orient the closure and place the scar in an area of transition, such as the nasolabial fold or eyelid crease, so that the scar will be less noticeable. This attention to aesthetics is important to patients, especially when the features of the face are involved.
Most skin cancers are removed surgically, by a plastic surgeon or a dermatologist. If the cancer is small, the procedure can be done quickly and easily, in an outpatient facility or the physician's office, using local anesthesia. Your plastic surgeon's goal is to remove the growth in a way that maintains function and offers the most pleasing final appearance - a consideration that may be especially important if the cancer is in a highly visible area.
The procedure may be a simple excision, which usually leaves a thin, barely visible scar. In some cases, the cancer may be removed with curettage and desiccation. In this procedure the cancer is scraped out with a sharp instrument and the area is treated with an electric current to control bleeding and to treat any remaining cancer cells. This leaves a slightly larger, white scar. In either case, the risks of the surgery are low. Other methods of treatment may include radiation therapy, cryosurgery (freezing the cancer cells), topical chemotherapy, in which anti-cancer drugs are applied to the skin, or Moh's surgery, a procedure in which the cancer is shaved off one layer at a time. (Moh's surgery is performed only by specially trained physicians and often requires a reconstructive procedure as follow-up.)
If the cancer is larger in size, or if it has spread to the lymph nodes or elsewhere in the body, more complex surgery may be required. The different techniques used in treating skin cancers can be life-saving, but they may leave a patient with less than pleasing cosmetic or functional results. Depending on the location and severity of the cancer, the consequences may range from a small but unsightly scar to permanent changes in facial structures such as your nose, ear, or lip.
In such cases, no matter who performs the initial treatment, the plastic surgeon can be an important part of the treatment team. If removing the cancer leaves a cosmetic defect, your plastic surgeon can use reconstructive techniques - ranging from simple scar revision to a more complex transfer of skin and tissue - to repair damaged areas, rebuild facial structures and help restore appearance and function.
As you heal, keep in mind that a scar, however large or small, is the tradeoff for removing the cancer from your body. How quickly the scar heals depends on the size of the wound, the nature and quality of your skin and how well you care for the wound after the procedure.
All of the treatments mentioned about, when chose carefully and appropriately, have good cure rates for most basal cell and squamous cell cancers - and even for malignant melanoma, if it's caught very early, before it's had a chance to spread.
You should discuss these choices thoroughly with your doctor before beginning treatment.
If you have any doubts about the outcome, get a second opinion from a plastic surgeon before you begin treatment.
One of the most important parts of your consultation is the discussion that you and your surgeon will have about the possible complications associated with your cancer-removal surgery.
By carefully following your doctor's instructions - both before and after your treatment - you can do your part to minimize some of the risk.
After you've been treated for skin cancer, you will return to your plastic surgeon's office for regular follow-up visits to make sure the cancer hasn't recurred. It's important to keep these appointments so that your surgeon can assess your long-term results and address any questions or concerns you may have. In the meantime, it's up to you to reduce your risk of skin cancer recurrence by taking the following precautions.
Dr. Darrick E. Antell and his staff will be happy to discuss Diagnosis & Treatment Of Skin Cancer with you. Please call for a private consultation or schedule an appointment online at our office.