Skin Cancer Treatment at Treasure Coast Dermatology

Treasure Coast Dermatology Toll Free 877.870.3376 Serving Martin County, St. Lucie County, Indian River COunty and Okeechobee County

Basal Cell Carcinoma

Basal cell carcinoma is the most common form of cancer worldwide. In the vast majority of cases, it is thought to be caused by exposure to the harmful ultraviolet rays of the sun. It is becoming more common, perhaps because people may be spending more time outdoors. Some believe that the decrease in the ozone layer is allowing more ultraviolet radiation from the sun to reach the earth's surface. Basal cell carcinoma does not usually metastasize or travel in the bloodstream; rather it infiltrates the surrounding area destroying tissue. For this reason, basal cell carcinoma should be treated promptly by your dermatologist with dermatologic surgical techniques.

What does basal cell carcinoma look like?

Basal cell carcinoma most often appears on sun-exposed areas such as the face, scalp, ears, chest, back, and legs. These tumors can have several different forms. The most common appearance of basal cell carcinoma is that of a small dome-shaped bump that has a pearly white color. Blood vessels may be seen on the surface. Basal cell carcinoma can also appear as a pimple-like growth that heals, only to come back again and again. A less common form called morpheaform, looks like a smooth white or yellowish waxy scar. A very common sign of basal cell cancer is a sore that bleeds and heals up, only to recur again.

I think I have a basal cell cancer. What should I do next?

If you have a sore that doesn't heal or that looks like a lesion described above, you should make an appointment with your dermatologist or with Treasure Coast Dermatology for evaluation. After the dermatologist examines the growth, he or she will decide whether or not to perform a biopsy. A biopsy is a simple procedure done in the office under local anesthesia. The dermatologist will first inject a small amount of anesthesia similar to the type used by your dentist. After the area is numb, the dermatologist will remove a small sample of the growth or use a small cookie-cutter device to do a "punch" biopsy. A bandage will then be placed on the wound and you will receive instructions on how to care for the wound. The area will heal over five to seven days. There are several different kinds of basal cell cancer. The biopsy results will indicate whether or not you have a basal cell cancer and what kind of basal cell cancer it is.

The biopsy shows that I have a basal cell cancer. What is the next step?

Your dermatologist will discuss with you the various dermatologic surgical options should your growth prove to be a basal cell carcinoma. Your dermatologist may perform a simple surgical excision, in which the skin cancer is cut out and the skin is sewn together using dermatologic cosmetic surgical techniques. In this case, the specimen is examined under the microscope after the procedure to determine that all the skin cancer has been removed. Other treatment methods, such as cryosurgery, radiation therapy, and laser surgery may be used in specific circumstances. In certain situations your dermatologist may opt to treat the basal cell cancer with a specialized technique called Mohs micrographic surgery. At Treasure Coast Dermatology all of our dermatologists are trained in this specialized method. In this method the skin cancer is removed under local anesthesia in the office and microscopic sections are prepared on slides while you wait. The Mohs surgeon examines the slides to determine if most of the cancer cells have been removed. If not additional layers are taken until the cancer is completely excised. The advantage of this technique is that a minimum amount of tissue is removed and all the edges of the specimen are carefully studied. This method has a high cure rate, but is not required for all skin cancers. In general, most dermatologists agree that recurrent skin cancers, that is skin cancers that were previously treated and have come back, incompletely removed skin cancers, large skin cancers, and skin cancers in cosmetically important areas, may benefit from the Mohs technique. After the skin cancer has been removed using this method, it may allow to heal naturally or reconstructive surgery using a skin flap or skin graft may be performed.

Regardless of the technique used, will I be scarred?

Because the vast majority of skin cancers occur on the face, many patients are understandably concerned about the cosmetic outcome. If the skin cancer is small, conservative methods usually produce an excellent cosmetic result. If the skin cancer requires more specialized treatment such as Mohs surgery, reconstructive options are available that, in most cases, results in an excellent cosmetic outcome.

Am I at risk for getting another?

If you have already had one basal cell cancer studies have shown that you are at a 40% risk of getting a second basal cell cancer within 5 years. It is important to follow closely with your dermatologist and be alert to any non-healing sores that develop on your skin.

Am I at risk of developing other skin cancers, such as melanoma?

Individuals who have had multiple basal cell cancers or other skin cancers, such as squamous cell, are at an increased risk for melanoma. It is important to have a full body skin examination at least once a year to check for abnormal moles which could be precursors to melanoma or melanoma itself. It is also important to know that basal cell cancer does not turn into melanoma.

Is there anything I can do to prevent basal cell cancer?

Because basal cell cancer is caused by ultraviolet radiation from the sun in the vast majority of cases, proper sun protection may help to prevent the development of further basal cell cancers. Because 85% of lifetime sun exposure is acquired in childhood by age 18, careful sun protection in children may effectively prevent basal cell cancer later in life. Follow these simple steps from your dermatologist and dermatologic surgeon:

1. Apply sunscreen with a sun protection factor of 30 or greater while outdoors.
2. While outdoors, reapply sun screen every 1 1/2 hours.
3. Wear a broad-brimmed hat and sun protective clothing.
4. Avoid the sun between 10:00 a.m. and 4:00 p.m.

Skin Cancer: the Disease

Here at Treasure Coast Dermatology, patients will benefit from the most up-to-date knowledge available as well as state-of-the-art technology. Drs Sanders and Ioannides perform Mohs Micrographic Surgery, the most advanced method for treating - and beating - skin cancer. In fact, studies show the success rate of Mohs surgery to be between 97 and 99.8 percent in patients with basal cell carcinoma, the most common form of skin cancer.

Mohs surgery succeeds
where others have failed

"This procedure has the highest surgical cure rate for both basal cell carcinoma and squamous cell carcinoma,"

The Mohs technique involves removing successive layers of tissue and immediately examining them with a microscope to determine at what point all signs of cancer have been excised.

The entire procedure may take a few hours to complete, but actual surgical time is much less. Most of the time is spent in careful preparation and scrutiny of the excised tissue.

"If cancer cells are still evident in a layer of tissue, another thin layer is excised during the same procedure," explains Dr. Sanders. "The process is repeated until all the cancer cells are removed, preserving as much healthy tissue as possible around the site of the lesion."

Mohs Procedure allows for preservation of healthy tissue

Because skin cancer surgery must be performed in such a way as to leave the patient with the most cosmetically pleasing result possible, the surgeons at Treasure Coast Dermatology are trained in Mohs micrographic surgery, a special technique for select skin cancer patients.

"Mohs surgery is a highly specialized technique for precise, minimally invasive surgical treatment of skin cancer," explains Dr. Ioannides.

Remembering Your ABC's
Can Save Your Life

It sounds almost too simple to be true, but the same little song that got you through kindergarten could now save your life. Best of all, you don't even have to be able to carry a tune to use this tool. Every sixty-seven minutes, someone dies of melanoma; a sad statistic that does not have to be. According to the American Academy of Dermatology, skin cancer is the most prevalent of all types of cancer and affects more than one million Americans every year.

Sunscreen Got You Covered?

The sun is necessary for life, but too much sun exposure may lead to poor health. More than one million people in the United States are diagnosed with skin cancer each year. However, skin cancer is largely preventable if people protect themselves from the sun, so whether it's a cool day in January or a sunny day in July, the board-certified physicians of Treasure Coast Dermatology are here to help you play it safe outdoors.