Skin Cancer

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What is the most common type of skin cancer?

There are three main types of skin cancer: basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. The most common of these is basal cell carcinoma, which makes up approximately 75 percent of the total. 

How is basal cell carcinoma different from other skin cancers? 

Fortunately, unlike other types of skin cancer, basal cell carcinoma rarely spreads from where it starts. If neglected, the lesion may erode down through the skin into fat, muscle and bone. Squamous cell and melanoma may spread to the lymph nodes and vital organs, such as the lungs. 

 

What causes skin cancer? 

 Most skin cancer is caused by ultraviolet light exposure. As we age, we are exposed to more total hours of light which means more skin cancers occur in older age groups. Skin types, such as blond and red head complexions, are more sensitive to sun exposure. These two groups tend to have more skin cancers than darker skin types. Acute severe sunburns, especially at younger ages, predispose a person to more skin cancers later in life. Exposure to tanning beds on a regular basis increases the risk for skin cancer. Excessive exposure to x-rays may contribute to skin cancer development.

 

How is skin cancer diagnosed? 

The appearance and history may be helpful, but a small biopsy is the most accurate way of determining the nature of the lesion. Confirmation of the tumor type, by microscopic analysis, determines the optimal treatment plan. 

 

How is the skin cancer treated?

The surgical removal of basal cell carcinoma, including a small rim of normal tissue around the entire periphery and deep margins, offers the highest proven cure rate.

Dr. Hobbs has an experienced (20 years), board-certified pathologist analyze all margins under the microscope for residual tumor before closing or reconstructing the area involved. If any edge of the tissue removed confirms even microscopic tumor a further piece of tissue is excised until only normal tissue remains. Finally, after receiving confirmation that all edges are free of tumor is the defect reconstructed during the SAME operation. Patients never leave the operating room with open wounds on their face or body either to heal by themselves or to be treated at a later date. This approach ensures the highest cure rate and best cosmetic result.

Usually, moving local tissue into the area where the tumor has been removed will provide the best color match and ideal thickness for a perfect blend of the skin. Skin grafts often are not the best color match and may be much too thin compared to the deep wound being reconstructed. For this reason, skin grafts are used much less frequently than flaps that move in thicker tissue with better color matching. The flap method achieves optimal cosmetic results. 

Very superficial basal cell carcinoma may be treated with topical creams that contain 5-fluorourcil or imiquimod. Early basal cells, when very small, may be treated with cryotherapy which freezes the tissue destroying the outer layer of the skin where the basal cell resides initially.

Real Results

(Click photo to enlarge.)

Will the surgery leave a scar?

Scars are visual disturbances that can become gross deformities particularly if the incisions are made in the wrong direction. Correct orientation of the reconstructive parts of the surgery may hide scars in the fine, natural creases of the face. Dr. Hobbs tries to minimize scars by performing all facial reconstruction while using 3.2X (or higher) magnification for every stitch. This allows for a more accurate vertical alignment of the skin edges, thus producing a smooth flat scar that is less visible. All surgical incisions will produce a scar, but some are very hard to see when the correct surgical technique is used. 

Contact us for questions you might have about skin cancer. 


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