Skin Cancer Diagnosis and Treatment
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 eliminate 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 Mohs skin cancer 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.
To see more plastic surgery procedures by Dr. Darrick Antell click here.