Skin cancer
How common is skin cancer?
Skin cancer is the most common of all cancer types and more than 1 million skin cancers are diagnosed annually in the U.S. That is more new cases of skin cancer than breast, prostate, lung and colon cancer combined. 1 in 5 Americans will develop skin cancer in the course of a lifetime.
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What factors increase risk of developing skin cancer?
Any of the following can affect your risk of sun damage and thereby your risk of developing skin cancer:
• High number of moles or irregular moles
• Fair skin or freckles
• Blond, red or light brown hair
• Personal history of skin cancer
• Family history of skin cancer
• Live or vacation at high altitudes
• Certain medications (ask your doctor, nurse or pharmacist)
• Intense sun exposure
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Skin cancer diagnosis
What happens during a physical exam for screen cancer?
You will be asked to remove all exterior clothing and will be provided with a gown. During the exam, your health professional will examine your skin looking for suspicious growths, moles or lesions. A bright light and magnifying glass may be used.
If the doctor detects an abnormal growth, he will biopsy the spot to determine whether it is cancerous. Results are generally available within 1-2 days.
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How often should I be examined?
If you are at risk for skin cancer or over age 40, you should see a dermatologist for an annual skin exam. If you have already had skin cancer, you may need to see your doctor more frequently. In addition, you should examine your skin on a monthly basis.
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Mohs surgery
What is Mohs Surgery?
Mohs surgery was initially developed by Dr. Frederic E. Mohs and has been refined over 70 years. It is the most effective procedure for treating basal cell and squamous cell skin cancers, with the highest success rate of all skin cancer treatments—up to 99% success rate. This technique enables surgeons to identify and remove tumors one layer at a time, while preserving as much of the healthy tissue as possible.
Mohs surgery is recommended for skin cancer removal in the following situations:
• Anatomic areas where preservation of healthy tissue is critical for cosmetic or functional purposes, e.g., eyelids, nose, face, fingers, genital area
• Recurrent tumors
• Cancers with indistinct margins
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What should I look for in a Mohs surgeon?
This procedure is most effectively performed by specially trained surgeons who have completed a rigorous and selective post-residency fellowship. Surgeons with the highest degree of training become members of the American College of Mohs Surgery, which is the “gold standard” in Mohs Micrographic surgery. This organization is different from the American Society for Mohs Surgery which does not require an intensive 1-2 year training fellowship. Only a few physicians in southern Colorado have completed a fellowship approved by the American College of Mohs Surgery.
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How do I schedule an appointment for Mohs surgery?
If you are already diagnosed with a skin cancer, have your referring physician notify our office at 719-355-1585. Once we receive the necessary information from your physician, our office will call you to schedule an appointment.
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Will it hurt?
When we start the procedure, you will be given local anesthesia with a small needle. Patients generally find that the procedure is remarkably painless.
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Will I be hospitalized?
No. Mohs surgery is performed under local anesthesia in a pleasant outpatient surgical suite and you may return home the same day. Procedures performed under local anesthesia eliminates the risk of general anesthesia and minimizes recovery time. Hospital facilities are available, but rarely necessary.
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What happens the day of surgery?
Our staff will escort you into a surgical suite where the surgeon will numb the area around the skin cancer. Once it is numb, the visible cancer and a thin layer of tissue will be removed. This tissue is carefully mapped and coded by the surgeon and taken to an adjacent laboratory where the technician will immediately process the microscope slides. You will have a temporary dressing placed over the wound while you wait in your surgical suite.
The surgical procedure alone takes only 10-15 minutes. However, it takes a 1-2 hours to prepare and microscopically examine the tissues. Several surgical stages and microscopic examinations may be required. Although there is no way to predict before surgery how many stages will be necessary, most cancers are removed in 3 stages or less. Magazines, television and beverages will be available. You may bring reading materials, work, portable music player or a personal computer. If your visit extends through the lunch hour, your companion may leave to bring you a snack or lunch. You are asked not to leave the premises until all surgical procedures are completed. The most difficult part of the procedure is waiting for the results of the surgery. Since we do not know in advance how much time is necessary to remove the cancer and repair the wound, we ask that you plan to be in the office, essentially, the entire day and that you make no other commitments. If surgery is performed around your eyes or on your hands, it is necessary that someone drive you home.
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Will the surgery leave a scar?
Yes. Any form of surgery will leave a scar. Because Mohs surgery removes as little normal tissue as possible, scarring is minimized and this yields the best aesthetic outcome. Immediately after the cancer is removed, we will discuss options with you so we can try to provide the best cosmetic result.
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What can I expect after the surgery?
Plan on wearing a pressure bandage and not getting the surgical area wet for 48 hours. As with any surgical procedure, you may experience some swelling, pain, redness, or bleeding.
If there is any discomfort, Tylenol is all that is usually necessary for relief. A prescription for a stronger pain medication will be written, if necessary. Most patients find that they do not need it.
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When can I return to work?
We recommend that you not return to work the same day as your procedure. Although Mohs surgery is an out patient surgery with local anesthesia, patients are often tired afterwards. Additionally, any activity that puts strain on your surgical site or elevate your blood pressure should be avoided immediately after surgery.
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When can I exercise?
The resting period is based on the location and extent of your surgery. In general, we recommend avoiding strenuous activity for one week if the surgery was on your head or neck area. We recommend two weeks for the body or extremities.
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Can someone be in the surgery room with me?
We ask all family members and friends to remain in the waiting area during the surgical procedure. However, when waiting for the tissue slides to be prepared between surgeries, one person may wait with you in the surgical suite.
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How long will the surgery take?
This will depend on the size and site of your cancer. We ask that you plan to be with us for at least 3-4 hours, although it may take much less time.
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Source: American Cancer Society, Skin Cancer Foundation, CDC, American Mohs College
Links
• American Academy of Dermatology (www.aad.org)
• American College of Mohs Surgery (www.mohscollege.org)
• Skin Cancer Foundation (www.skincancer.org)
Vanguard Skin Cancer Specialists is providing information and services on the Internet as an informational benefit and service to its patients and prospective patients. The information provided on the Vanguard Skin Cancer Specialists’ website is not intended as medical advice and should not be used as medical advice. Medical advice is only provided by your personal physician, whom you should consult with any questions. See disclaimer for more information.
