Skin Cancer Treatment in Houston

Cancer develops when DNA, the molecule found in cells that encodes genetic information, becomes damaged and the body cannot repair the damage. These damaged cells begin to grow and divide uncontrollably. When this occurs in the skin, skin cancer develops. As the damaged cells multiply, they form a tumor. Since skin cancer generally develops in the epidermis, the outermost layers of skin, a tumor is usually clearly visible. This makes most skin cancers detectable in the early stages.

 

FAQ:

1. How many skin cancers are diagnosed each year?

2. What are the chances that I will develop a skin cancer?

3. What increases my risk of developing a skin cancer?

4. How can my skin cancer be diagnosed?

5. Why should my skin cancer be treated?  The biopsy site has healed completely.

6. What is the best treatment for my skin cancer? 

7. What treatment options are available for my skin cancer?

8. What is the least aggressive treatment option for my skin cancer?

9. What is the most aggressive treatment option for my skin cancer?

10. After surgery, how will my wound be repaired/reconstructed?

11. How about other treatment options for my skin cancer?

12. What will happen during my Consultation?

13. What is Mohs surgery?

14. Can any physician perform Mohs Surgery?

 

How many skin cancers are diagnosed each year?
It is estimated that more than 1.2 million Americans develop skin cancer every year. 

 

What are the chances that I will develop a skin cancer?
1 out of every 5 Americans will develop a skin cancer.

1 out of every 3 light skinned Americans will develop a skin cancer.

 

What increases my risk of developing a skin cancer?
Your individual skin cancer risk is dependent on several factors, including personal and family history of skin cancer. 

Medications or medical conditions that reduce one’s immune system can also increase one’s risk (ie. cancer, transplantation, diabetes, pregnancy, immunosuppressive medications, HIV). 

Environmental factors can contribute as well, including sun exposure, sunburns, radiation, well water, and smoking.

 

How can my skin cancer be diagnosed?
If you have noticed a changing, non-healing skin lesion, it is recommended to have the worrisome area examined by a skin specialist. 

A dermatologist has extensive training in identifying lesions suspicious for skin cancer. 

A sample of the skin will be taken after local numbing (ie. biopsy) and submitted to a pathologist who will determine if the lesion is a skin cancer. 

Why should my skin cancer be treated?  The biopsy site has healed completely.
The intent of a biopsy is to diagnose and not to treat.  Although the biopsy site may appear healed, if cancer cells are still present, the tumor may continue to grow and may spread to other parts of the body. 

What is the best treatment for my skin cancer?
During your Consultation, together you and the physician will tailor a plan of care based on your individual:

• Patient Factors (ie. Medical conditions, prior surgeries, medications, allergies, treatment goals)
• Tumor Factors (ie. Type of tumor, size, previous treatment, involvement of deeper tissue, spread of tumor)
• Peri-Operative Issues that impact timing and scheduling of the elected procedure (ie. Scheduling conflicts, support system available to assist in wound care, pre-operative medications, disabilities)

 

What treatment options are available for my skin cancer?
The skin specialists at Advanced Dermatology & Skin Care are knowledgeable about and can perform a wide range of surgical (ie. Mohs surgery, excision, electrodesiccate and curettage) and non-surgical skin cancer treatments (ie. medication, cryotherapy, laser, radiation). 

The advantages and disadvantages will be discussed in the context of your skin cancer, including what to expect post-treatment (ie. scar appearance, wound care, follow-up care). 

What is the least aggressive treatment option for my skin cancer?
The least aggressive treatment option is to do nothing.  Although biopsy site may appear healed, if cancer cells are still present, the tumor may continue to grow and may spread to other parts of the body. 

 

What is the most aggressive treatment option for my skin cancer?
The most aggressive treatment option is surgery.  The tissue will be cut out and looked at under the microscope.  If tumor is found at the edge, the process will be repeated until no cancer cells are seen in the tissue sections examined. 

Mohs surgery is a specialized surgical technique where the tissue is frozen and examined the same day of surgery.  Although it has the highest chance for cure, lowest recurrence rate, and smallest wound possible, Mohs surgery is limited to treatment of high risk skin cancers.  See Mohs Surgery below. 

 

After surgery, how will my wound be repaired/reconstructed?
Plastic surgery and reconstructive principles and techniques will be used to reconstruct your wound.  During your Consultation and the day of your surgery, the surgeon will review and recommend the best options for your wound.  Repair options include:  allowing the wound to heal on its own (aka Mother Nature), closed in a line that is typically 3 to 5 times longer than it is wide, reconstructed with a graft or flap, or referred to another physician for repair. 

 

How about other treatment options for my skin cancer?
Other treatment options do not examine the tissue under the microscope.  These include: cryotherapy (aka freezing), electrodesiccation and curettage (aka scraping and burning), laser, radiation, and medication. 

Each option has advantages and disadvantages, including differences in: number of treatments, side effects, downtime, wound healing, scar size, scar appearance, cure rates, and cost. 

The skin specialists at Advanced Dermatology & Skin Care are knowledgeable about and will review the advantages and disadvantages of these options in the context of your skin cancer, including what to expect post-treatment (ie. scar appearance, wound care, follow-up care). 

What will happen during my Consultation?
The physician will ask questions about the skin cancer, such as:

• When did your skin cancer develop? 
• What symptoms does your skin cancer cause? 
• Has the skin cancer ever been treated in the past? 
• Have you ever had skin cancer before?  If so, where?  How many?  When did you develop your first one?  How were they treated?

The physician will also:

• Examine the location of your skin cancer and the adjacent skin
• Check to see if your skin cancer has spread
• Evaluate your other surgical scars to provide you an idea of how you will likely heal after treatment
• Review your pathology report
• Provide you with educational material on skin cancer types, skin cancer treatment, pre-operative instructions, post-operative instructions, as well as, a list of suggested wound care supplies to have ready for the day of surgery
• Discuss your treatment options, including no treatment.  The risks, benefits, and surgical consequences will be reviewed with time for questions.  The physician will also determine if a plastic surgeon or other medical specialist(s) will be needed to assist in the care of your skin cancer.

 

What is Mohs surgery?
Mohs Surgery is a precise surgical technique for removing various types of skin cancers.  During the procedure, the layers of cancer-containing skin are gradually frozen, removed and then examined the same day of the surgery, leaving only cancer-free tissue. This advanced, micrographically controlled surgery offers maximum removal of cancer with minimum damage to surrounding healthy tissue.

Mohs Surgery, known for having the highest cure rate of up to 99 percent, can be used for the most common types of skin cancer, basal cell and squamous cell carcinomas. It is the treatment of choice for high risk tumors.

MOHS Surgery Steps

 The Advantages of Mohs Surgery:

• Peace of mind that when you leave the office, your skin cancer will have been removed and your wound reconstructed
• The surgeon traces and eradicates areas of your skin cancer that are invisible to the naked eye preserving more normal tissue than any other method, therefore minimizing scarring
• Skin cancer treatment with the highest cure rate, and therefore, lowest risk of recurrence
• Treatment performed on an outpatient basis, under local anesthesia

Criteria for Mohs Surgery

• High risk location
• Large size
• Ill-defined borders
• Difficulty estimating depth of lesion
• Rapid growth
• Long standing duration
• Local recurrence
• Positive margins on excision
• Site of radiation
• Immunocompromise
• Patient with proven difficulty with skin cancers
• Skin cancer present in an old scar
• Genetic diseases
• Aggressive tumor type
• Local recurrence

The American College of Mohs Surgery has provided the diagrams below of the five steps that take place during the procedure: (see attached)

 

Can any physician perform Mohs Surgery?
Members of the American College of Mohs Surgery (ACMS) are fellowship-trained surgeons who have the experience and expertise required to produce optimal outcomes in skin cancer treatment. In addition, they are trained to precisely repair the skin and underlying tissue that eliminates or minimizes scarring using plastic surgery reconstructive principles.

T. Minsue Chen, M.D. of Advanced Dermatology & Skin Care is an ACMS fellowship-trained surgeon.

Call today for a Consultation.

For more information about skin cancer or Mohs Micrographic Surgery please visit the official ACMS website: www.mohscollege.org.