Ear, Nose and Throat Associates

     Skin cancer is an ever increasing problem worldwide and in most cases is directly attributable to sun exposure. This exposure typically occurs many years before any skin cancers surface. People with light complexions (those that sunburn) are at highest risk although skin cancers do occasionally occur in darker skin peoples. The most common type of skin cancer is basal cell carcinoma (BCCA). While this is a locally aggressive cancer, it seldom metastasizes (spreads to distant sites) and if caught early is highly treatable. The most common manifestation of the BCCA is known as the pearly papule, although appearances can vary. The most common areas affected are those that get the most sun exposure and in the head and neck include the nose, cheeks, forehead, ears and scalp. Squamous cell carcinoma (SCCA) is the next most common and although it shares the same risk factors and some features with BCCA it is somewhat more aggressive. Most often this is still a highly curable lesion if caught early. Melanoma is the third most common, and the most serious of all skin cancers. Melanoma can be both locally aggressive and can spread to lymph nodes and distant organs. If caught early melanomas usually have good prognosis. Lesions that are larger and deeper have higher risks of developing metastases.
     There are several ways to treat skin cancers but often BCCA and SCCA are treated with wide local excision, or in the head and neck often with MOHS micrographic surgery. This surgery, typically done by specialized dermatologists is a highly technical and precise technique that ensures as much as possible total excision of the tumor while limiting removal of normal or uninvolved tissue. However, this does often leave the patient with a defect that can range anywhere from less than an inch to a few inches in diameter. In order to close these defects and to achieve the best possible cosmetic and functional outcome, certain surgeons such as ourselves have expertise in using local skin flaps. 
     In comparison to BCCA and SCCA, melanoma typically requires removal of more tissue to ensure complete tumor removal. Depending on the depth of the tumor this may require up to an inch diameter of normal tissue surrounding the defect. In some cases a representative lymph node called a sentinel node that is labeled with a radiotracer is removed to see if it harbors cancer. Occasionally more extensive surgery with removal of the parotid gland or even neck dissection is necessary to ensure the best chance for cure (or more information about parotid surgery click here, for more information about neck dissection click here).  Occasionally people with advanced melanoma will be candidates for some types of chemotherapy and immunotherapy.
     If you have questions about skin cancers or their treatment please give us a call.