Skin Cancer
Of all the cancers that humans can get, skin cancer is the most common. According to the Skin Cancer Foundation, there are more new cases of skin cancer in the US each year than the combined incidence of breast, prostate, lung, and colon cancer. The practitioners at Alliant Dermatology treat all types of skin cancer and pre-cancers. Two of the most common and effective treatments for skin cancer include Mohs Surgery and Superficial Electron Therapy.
Mohs Surgery and Plastic Surgery
Originally developed in the 1930s, Mohs Micrographic Surgery is an advanced and effective skin cancer treatment procedure. As the most exact and precise method of tumor removal, it minimizes the chance of cancer recurrence. This outpatient (in-office) procedure utilizes a microscope, mapping, and marking to evaluate 100% of the skin margin. The Mohs procedure involves surgically removing skin cancer layer by layer and examining the tissue under a microscope until healthy, cancer-free tissue around the tumor is reached (called clear margins). It offers the highest chance for identification and complete removal of the skin cancer while sparing the surrounding healthy tissue. Although there are always exceptions to the rule, most tumors require 1 to 3 stages for complete removal. Depending on the complexity of the skin cancer and the number of layers needed for complete removal, your surgery could take from 1 – 4 hours. Please read our Mohs surgery brochure below for more information.
Resources: Mohs Surgery Brochure, SCF: Mohs Surgery, Mohs Surgery Operation Video
Providers: Dr. David Casper, MD, Dr. Leonik Ahumada, MD, Dr. Nora Vera, MD, Dr. Jeff Morris, DO
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It is important to note that Mohs surgery is not appropriate for the treatment of all skin cancers. Mohs micrographic surgery typically is reserved for those skin cancers that have recurred following previous treatment, or for cancers that are at high risk for recurrence. Mohs surgery also is indicated for cancers located in areas such as the nose, ears, eyelids, lips, hairline, hands, feet, and genitals, in which maximal preservation of healthy tissue is critical for cosmetic or functional purposes.
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After the skin cancer has been removed, your Mohs surgeon and Plastic Surgeon will consider various repair options. These may include:
Allowing the wound to heal without any additional surgical repair (“healing by secondary intention”).
Wound repair performed by our Mohs Surgeon.
Wound repair performed by our Plastic Surgeon - Dr. Leonik Ahumada. Often times and especially for larger defects or critical areas such as the nose, lips and ears we will take extra caution and have your Mohs surgery wound repaired by Dr. Ahumada who is a board certified Plastic Surgeon with over 10 years of experience.
Superficial Electron Therapy
Superficial Electron Therapy (SET) offers patients a state-of-the-art nonsurgical management option for basal cell and squamous cell skin cancers. It is particularly well-suited for treating cancers located near the eyes, ears, nose, or lips because it can produce favorable cosmetic outcomes. The treatment uses a very superficial, non-penetrating electron beam to destroy cancer cells in the targeted area while allowing protection of healthy cells. For most patients, the regimen involves four to six weeks of daily treatments, five days a week, depending on the size and location of the cancer.
Resources: SET Brochure
Providers: Dr. April Mendoza, MD
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90% to 98% cure rate, depending on location
Little or no discomfort during treatment
Each treatment lasts less than five minutes
Side effects are limited to the treatment site, usually involving gradual development of skin irritation, redness or “sunburn” that gradually dissipates after completing treatment
Cosmetically satisfying results, with minimal or no scarring
Throughout the course of treatment, normal everyday activities can be continued, including work and sports. There are no restrictions or limitations.
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Superficial Electron Therapy is well suited to treat most non-melanoma skin cancers, in particular:
Cosmetically sensitive areas, such as the ear, nose, lips or around the eyes
Slow healing areas such as the lower legs or feet
Patients who are on blood thinners or who bleed easily
Patients who are at risk for infection
Patients who are elderly and/or are considered high risk for surgical procedures who otherwise are not able to undergo skin cancer surgery
There are no restrictions or limitations. Throughout the course of treatment, normal everyday activities can be continued, including work and sports.
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Electrons and Radiation are a very important tool in the fight against cancer. When radiation interacts with a cancerous cell, it alters the cell’s DNA (or genetic make-up) and its ability to reproduce, which ultimately leads to cell death in the cancerous tumor. The Superficial Electron Therapy system used at Alliant Dermatology protects healthy tissues. It works by delivering a series of superficial electron beam treatments to the cancer site that destroy cancer cells but allow healthy cells to heal.
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Superficial electron beam treatment is very effective at destroying both basal cell and squamous cell carcinomas. Most of the published studies report cure rates ranging from 90% to 98%. However, many factors can affect the likelihood of cure, including the cancer size and location, the sub-type of histology, if the cancer was treated previously, etc.
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The total length of treatment time depends on several factors, including the size and location of the cancer and the overall desired cosmetic outcome. Most patients complete treatment in 10 to 30 sessions, each lasting less than five minutes. The longer treatment courses tend to deliver better cosmetic results. Throughout the course of treatment, normal everyday activities can be continued, including work and sports. There are no restrictions or limitations.
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Side effects are limited to the treatment site. The type of side effects experienced depends on the size and location of the cancer and the length of treatment. In general, most patients gradually develop skin irritation or a sunburn-like redness in the treatment area. Prescription creams or lotions are available to help the healing process. Side effects do not usually begin until the second or third week of treatment and peak a few days after treatment is completed. Then, over the course of two to four weeks, the side effects gradually dissipate. You may lose hair at the treatment site, which might not grow back. There may be subtle lightening of the skin in the treatment area or the development of small spider veins years later. However, most patients are very pleased with their treatment results.
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Electron beam therapy is a medically accepted form of treatment for skin cancer. It is covered by Medicare and most major insurance carriers. Our billing specialists can confirm your insurance benefits to determine any out-of-pocket expenses you may incur with this treatment.
Total Body Skin Examinations
At Alliant Dermatology, our standard of care is total body skin exams. That means at your dermatology visit, we will ask you, “Would you like a total body skin exam?”
Why? Because...
Skin cancer affects 1 in 5 Americans
Skin cancer can appear anywhere there is skin from head to toe
Skin cancer is easily treatable when detected early
Our goal is early diagnosis and treatment of skin cancer. As Dermatologists, we’re committed to helping you maintain your skin health. Here are the most common questions patients ask us regarding total body skin exams. If you have a question that we have not answered here, be sure to ask us during your next appointment.
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We typically recommend you start having routine skin exams by the age of 35. However, if you have a family history of skin cancer, a history of tanning, or have lesions that are concerning, you should go ahead and make an appointment.
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For patients who don’t have a history of skin cancer or abnormal moles, we recommend an in-office skin exam once a year. Those who have numerous concerning lesions or a history of skin cancer may need to come more often.
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Typically, you will be chaperoned to a private patient room and be given a gown or drape. You may undress to your level of comfort. For many people, this means removing all clothing except for undergarments. However, some people prefer to remove undergarments as well.
Your dermatology provider will carefully and intentionally review all areas of your body, including your scalp, face, ears, eyelids, lips, neck, chest, abdomen, back, arms, legs, hands and feet, including nails. You may request an exam of the breasts, groin, and buttock or you may decline.
Your provider will point out and discuss any concerning lesions as well as answer any questions you may have about what something is, what changes to watch out for, and what skin care regimen is appropriate for your skin type and needs. Be sure to ask your provider when you need to come back for another evaluation.
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While you may wear makeup, even light makeup can obscure what your dermatology provider sees on exam. Therefore, we encourage you to remove your makeup prior to your appointment and reapply if desired before leaving.
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Having a skin exam isn’t just for worrisome lesions. A dermatology professional can also check hard-to-see areas, such as your scalp, back, and other difficult-to-assess locations. Moreover, dermatology professionals have a trained eye and can identify lesions that may have concerning features even if the lesion looks “normal” to you.
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Your dermatology provider will never pressure you to undress or expose yourself in a way that makes you feel uncomfortable. However, it is important to undress for a thorough exam, as concerning lesions can affect any area of the skin, including hard-to-see or non-sun-exposed places.
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While ultraviolet radiation does play a large role in the development of skin cancer, skin cancers can also arise in skin that has not had much, or any, sun exposure such as the scalp, groin, or bottom of the feet. There is also a genetic component that can predispose otherwise unlikely individuals to skin cancer.
Sun Safety
Sun safety is always in season, and it’s important to protect your skin from sun damage throughout the year, no matter the weather. Exposure to the sun can cause sunburn, skin aging, eye damage, and skin cancer. In fact, the sun's ultraviolet (UV) rays can damage your skin in as little as 15 minutes.
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If you use common sense and take care to be sun smart, you can safely work and play outdoors without increasing skin cancer risk or premature aging. It’s never too late to start protecting your skin.
Here’s how to stay safe in the sun:
Generously apply a mineral based broad-spectrum, water-resistant sunscreen with a sun protection factor (SPF) of 30 or more to all exposed skin. A mineral based broad spectrum sunscreen provides protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays. Re-apply approximately every two hours, even on cloudy days, and after swimming or sweating.
Wear protective clothing, such as a long-sleeved shirt, pants, a wide-brimmed hat, and sunglasses, where possible.
Seek shade when appropriate, remembering that the sun’s rays are the strongest between 10 am and 4 pm. If your shadow is shorter than you are, seek shade.
Protect children from sun exposure by playing in the shade, wearing protective clothing, and applying sunscreen.
Use extra caution near water, snow, and sand because they reflect and intensify the damaging rays of the sun, which can increase your chance of sunburn.
Get vitamin D safely through a healthy diet that may include vitamin supplements. Don’t seek the sun.
Avoid tanning beds. Ultraviolet light from the sun and tanning beds can cause skin cancer and wrinkling. If you want to look like you’ve been in the sun, consider using a sunless self-tanning product, but continue to use sunscreen with it.
Check your birthday suit on your birthday. If you notice anything changing, growing, or bleeding on your skin, see a Alliant Dermatology practitioner. Skin cancer is very treatable when caught early.
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If you notice that a mole differs from another or a spot on your skin changes, itches, or bleeds (even if it is small), immediately make an appointment to see a Alliant Dermatology practitioner. These changes can be signs of skin cancer. With early detection and treatment, skin cancer has a high cure rate.
Years of sun exposure also accelerate the signs of aging, such as freckles, sun spots, and wrinkles. If you dislike signs of aging that appear on your skin, you also may want to see a Alliant Dermatologist to learn about the different options to treat or help reduce the signs of aging skin.
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