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Over 80,000 cases of skin cancer are diagnosed in Canada each year, more than 5,000 of which are melanoma, the mostly deadly form of skin cancer. While skin cancers can be found on any part of the body, about 80 percent appear on the face, head or neck, where they can be disfiguring as well as dangerous.
A plastic surgeon can play a role in the diagnosis and treatment of skin cancer and other skin growths.* If you are concerned about a changing mole, a new growth or unusual discolouration anywhere on your body, don’t hesitate to consult with Niagara Falls plastic surgeon Dr. Huq. Call Niagara Plastic Surgery & Laser Centre to book an appointment.
* Individual results may vary.
The primary cause of skin cancer is ultraviolet radiation — most often from the sun, but also from artificial sources like sunlamps and tanning booths. In fact, researchers believe that our quest for the perfect tan, an increase in outdoor activities, and perhaps the thinning of the earth's protective ozone layer are behind the alarming rise we're now seeing in skin cancers.
Anyone can get skin cancer — no matter what your skin type, race or age, no matter where you live or what you do. But your risk is greater if...
By far the most common type of skin cancer is basal cell carcinoma. Fortunately, it's also the least dangerous kind. It tends to grow slowly, and rarely spreads beyond its original site. Though basal cell carcinoma is seldom life-threatening, it can grow deep beneath the skin and into the underlying tissue and bone if left untreated. The damage it causes is serious, particularly if located near the eyes.
Squamous cell carcinoma is the next most common kind of skin cancer, frequently appearing on the lips, face, or ears. It sometimes spreads to distant sites, including lymph nodes and internal organs. Squamous cell carcinoma can become life-threatening if it's not treated.
A third form of skin cancer, malignant melanoma, is the least common, but its incidence is increasing rapidly, especially in sunnier, southern climates. Malignant melanoma is also the most dangerous type of skin cancer. If discovered early enough, it can be completely cured. If it's not treated quickly, however, malignant melanoma may spread throughout the body and is often deadly.
Two other common types of skin growths are moles and keratoses.
Moles are clusters of heavily pigmented skin cells, either flat or raised above the skin surface. Most pose no danger. You should pay attention to large moles present at birth, or those with mottled colours and poorly defined borders since they can develop into malignant melanoma. Moles are frequently removed for cosmetic reasons, or because they're constantly irritated by clothing or jewelry, which can sometimes cause pre-cancerous changes.
Solar or actinic keratoses are rough, red or brown, scaly patches on the skin. They are usually found on areas exposed to the sun, and sometimes develop into squamous cell cancer.
Basal and squamous cell carcinomas can vary widely in appearance. The cancer may begin as small, white or pink nodule or bumps; the affected skin can be smooth and shiny, waxy or pitted on the surface.
Then again, basal and squamous cell carcinomas might appear as a red spot that's rough, dry or scaly; a firm, red lump that may form a crust; a crusted group of nodules; a sore that bleeds or doesn't heal after two to four weeks; or a white patch that looks like scar tissue.
Malignant melanoma is usually signaled by a change in the size, shape or colour of an existing mole, or as a new growth on normal skin. Watch for the "ABCD" warning signs of melanoma:
Choosing a Doctor
If you're concerned about skin cancer, your family physician is a good place to start. He or she should examine your skin at your annual physical, and can refer you to a specialist if necessary.
If you notice an unusual growth yourself, consult a plastic surgeon or a dermatologist. Both are skilled at diagnosing and treating skin cancer and other skin growths.
A plastic surgeon can surgically remove the growth in a manner that maintains function and offers the most pleasing final appearance — a consideration that may be especially important if the cancer is in a highly visible area. If a treatment other than surgical excision is called for, the plastic surgeon can refer you to the appropriate specialist.
Diagnosis and Treatment
Skin cancer is diagnosed by removing all or part of the growth and examining its cells under a microscope. It can be treated by a number of methods, depending on the type of cancer, its stage of growth and its location on your body.
Most skin cancers are removed surgically by a plastic surgeon or a dermatologist. If the cancer is small, the procedure can be done quickly and easily, in an outpatient facility or the physician's office, using local anaesthesia. The procedure may be a simple excision, which usually leaves a thin, barely visible scar. Or curettage and desiccation may be performed. In this procedure, the cancer is scraped out with an electric current to control bleeding and kill any remaining cancer cells. This leaves a slightly larger, white scar. In either case, the risks of the surgery are low.
If the cancer is large or has spread to the lymph glands or elsewhere in the body, major surgery may be required. Other possible treatments for skin cancer include:
A special procedure is Mohs surgery, in which the cancer is shaved off one layer at a time. Mohs surgery is performed only by specially trained physicians and often requires a reconstructive procedure as a follow-up.
Discussing Your Options and Concerns
All of the treatments mentioned above, when chosen carefully and appropriately, have good cure rates for most basal cell and squamous cell cancers — even for malignant melanoma if caught very early, before it has spread.
You should discuss these choices thoroughly with your doctor before beginning treatment. Find out which options are available to you, including:
If you have any doubts about the outcome, get a second opinion from a plastic surgeon before you begin treatment.
A Word about Reconstruction by a Plastic Surgeon
The different techniques used in treating skin cancers can be lifesaving, but they may leave a patient with less than pleasing cosmetic or functional results. Depending on the location and severity of the cancer, the consequences may range from a small but unsightly scar to permanent changes in facial structures such as your nose, ear or lip.*
In such cases, no matter who performs the initial treatment, the plastic surgeon can be an important part of the treatment team. Reconstructive techniques, which can range from a simple scar revision to a complex transfer of tissue flaps from elsewhere on the body, can often repair damaged tissue, rebuild body parts and restore most patients to acceptable appearance and function.*
* Individual results may vary.
Preventing a Recurrence after Treatment
After you've been treated for skin cancer, your doctor should schedule regular follow-up visits to make sure the cancer hasn't recurred.
Your physician, however, can't prevent a recurrence. It's up to you to reduce your risks by changing old habits and developing new ones.
These preventive measures apply to everyone — skin cancer survivors or not: