THE "BASICS"
WHAT IS SKIN CANCER?
Cancer is unregulated replication of cells that our bodies cannot stop. As the cancer cells replicate, they form a tumor. It is this tumor which invades and damages your normal healthy tissue. The most common cause of skin cancer is long-term exposure to sunlight.
Skin cancers therefore occur most often on sun-exposed areas of the body, particularly the head and neck. People who are prone to sunburns are more at risk for skin cancers because their skin lacks melanin, the body’s natural sunscreen.
Other factors that can contribute to an increased risk for skin cancer include exposure to x-ray therapy, trauma (e.g. a thermal injury), and some rare inherited diseases.
WHAT ARE BASAL & SQUAMOUS CELL CARCINOMA?
The most common skin cancer is basal cell carcinoma (accounting for 80% of skin cancers) which arises from the cells in the lowest layer of the epidermis. The next most common skin cancer, squamous cell carcinoma (16% of skin cancers), is derived from the epidermal cells (keratinocytes). Melanomas, which account for only a small percentage of skin cancers, develop from melanocytes, the cells that produce pigment in your skin. Many people wonder if basal cell carcinomas can progress to melanoma. You can be assured that cancer of one cell type does not transform to another cell type – that is, basal cell carcinomas do not “become” melanomas.
Basal cell carcinomas almost never spread (metastasize) to distant parts of your body. However, certain squamous cell carcinomas do have a higher risk for spreading. Risk factors include the size of the tumor, the location, and whether your immune system is suppressed.
There are also subtypes of basal cell and squamous cell cancers. Some remain on the surface of the skin, while others can form “roots” underneath the skin. Therefore, what you see may only represent a small portion of the tumor that needs to be removed. We distinguish the different cancer subtypes with a skin biopsy and examination under a microscope. It is important to diagnose the cancer subtype so that we can advise which treatments are best for you.
BASAL CELL CARCINOMA
SQUAMOUS CELL CARCINOMA
HOW COMMON IS SKIN CANCER?
Skin cancer is the most common form of cancer in humans. Over 2 million new cases of skin cancer will be diagnosed this year in the United States. One in five Americans will develop skin cancer in their lifetime.
Please click here for more information on skin cancer from the American Academy of Dermatology
HOW IS SKIN CANCER TREATED?
The treatment of skin cancer has four goals:
1. completely remove the cancer,
2. preserve normal skin,
3. preserve function, and
4. provide an optimal cosmetic result.
To be cured, skin cancers must be destroyed or removed. They may be treated by cryotherapy (freezing), curettage and electrodesiccation (scraping and burning with an electric needle), excision (surgical removal), radiation therapy or Mohs micrographic surgery. Mohs provides the highest cure rate while removing the least amount of normal skin. For primary, untreated skin cancers, the non-Mohs surgery methods may offer a cure rate of 90-95%. For recurrent, previously treated skin cancers, these non-Mohs surgery methods may offer cure rates of only 60-80%.
WHAT IS DERMATOLOGIC SURGERY?
Dermatologic surgery is a subspecialty recognized by the American Medical Association dedicated to the diagnosis and treatment of medically necessary and cosmetic conditions of the skin. The purpose of dermatologic surgery is to diagnose and remove skin cancer but also to reconstruct (repair) and/or improve the function and appearance of skin tissue.
WHO IS A MOHS/DERMATOLOGIC SURGEON?
A Mohs/dermatologic surgeon is a board-certified dermatologist who has undergone additional extensive fellowship training and board certification in Micrographic Dermatologic Surgery. Diplomats in Micrographic Dermatologic Surgery are experts in Mohs. Both Dr. Miller and Dr. Starr are board certified in micrographic surgery, reconstructive surgery, and cosmetic procedures.