Skin Cancer Removal

More than 25% of the total population will get a skin cancer in their lifetime. Plastic Surgery is involved in removing a large share of these as most of them occur on the "sun belt" of the face which includes the nose, the cheeks, the temples and the ears. Almost all skin cancers are caused by sunburns. Aging people should also not burn as the damage caused by ultraviolet light is not as well reversed by DNA repair enzymes as you age. In other words, the older you are when you get sunburn, the more likely you are to get a skin cancer from the sunburn.

This is why no one should sunburn anymore. The longer you wait to have a skin cancer removed, the bigger it gets, and the more complicated the reconstruction becomes to make the patient look as close to normal as possible. This is why it is best treated early while it is still small. Basal cell skin cancer is the most common kind of skin cancer. It is usually a smooth pink or red flat or lumpy area.

Basal skin cancer does not go away but gradually gets larger and larger.  These cancers generally do not spread elsewhere (metastasize). They therefore do not generally get into the blood and do not spread to the lungs, liver or brain as do many cancers such as breast or bowel cancer. Basal cell skin cancers do not tend to grow deeply and usually what you see is what you've got.

Because of this, basal cell skin cancer generally never kills people unless you refuse to do something about it and you let it grow out of control, as it will not stop growing. The cure rate with removing these surgically is over 95%. Those who are not cured simply have not had all of the cancer cells removed and will require additional surgery to remove the leftover cancer for cure.

Squamous cell skin cancer is very much the same as basal cell skin cancers in appearance except the red areas tend to have hard rough spots on them and bleed more easily. Squamous cell skin cancers also have a slightly higher risk of metastasizing than basal cell skin cancers.

However, the risk of metastasis and death is usually less than 5% if the squamous cell skin cancer is in a sun induced area (i.e. not on the genitals, inside the mouth or in the anal areas).  Squamous cell skin cancers on the hand, the lip, and the ear do have a higher risk of metastasis than sun induced squamous cell skin cancers on the rest of the face and body.

Malignant melanoma occurs in 1% of the population. This kind of cancer does know how to metastasize and results in death. However, if you catch it early and have it removed, the cure rate is high.

There are three things that make melanoma obvious, as this is not a subtle skin cancer in most instances: 1) Melanoma is usually black or has black in it, and arises from moles 1/3 of the time. 2) Melanoma tends to grow quickly and will often double in size over weeks. 3) Melanoma tends to have an unusual shape, as opposed to benign moles which are usually round or oval.

If you have a thin melanoma (<1mm thick), we will usually recommend a 1cm excision of normal looking skin around the tumor followed by no further treatment. If you have an intermediate thickness melanoma (1-4mm thick), you will usually have 2cm of normal looking skin removed from either side of the tumor followed by a sentinel lymph node dissection.

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