Skin Cancer

When a skin cancer biopsy returns positive for cancer, the news can feel devastating. The incidence of melanoma, the most aggressive form of skin cancer, has steadily risen over the past ten years. Yet when caught early and treated properly, patients in The Woodlands and Conroe have an excellent prognosis for a full recovery with minimal discomfort.


Types of Skin Cancer

Close Up of Skin Cancer Melanoma Mark

Although this is one of the less common types of skin cancer, melanoma causes the large majority of cancer-related deaths.

Although this is one of the less common types of skin cancer, melanoma causes the large majority of cancer-related deaths.

An annual skin cancer exam by your dermatologist can quickly distinguish normal moles and skin tags from suspicious ones. After a biopsy determines the type of skin cancer, your dermatologist will create a treatment plan to ensure the complete removal of cancer. The three different types of skin cancer are Basal cell, Squamous cell, and melanoma.

Basal Cell

Basal cell carcinoma is the most common type of skin cancer. According to the American Cancer Society, Basal cell cancers affect more than four million American’s every year, a number that continues to rise. Basal cell cancers are most common in those who have fair skin, although anyone can develop skin cancer. They appear as a flesh-colored round bump or a pink-colored patch of skin. Basal cell cancers are most commonly found on the head, neck, and arms, as these are the areas of the body that receive the most sun exposure. Annual deaths from Basal cell cancers range between two and three thousand people.

Squamous Cell

Squamous cell carcinoma is considered the second most common skin cancer. Again, this type of cancer is common in those with fair skin and appears as a firm red bump, a scaly patch, or a sore that continues to heal and re-open. As with Basal cell, squamous cell cancers form on skin that is frequently exposed to the sun. Squamous cell cancers affect between one and two million people annually. Early detection and treatment are essential as squamous cell cancers can grow deep into the tissue or spread to other areas. Data from the Skin Cancer Foundation shows that squamous cell cancers’ death rate is approximately fifteen thousand each year.

Melanoma

Melanoma diagnoses account for only approximately one percent of skin cancers, yet this skin cancer remains the deadliest. The American Cancer Society estimates over one hundred thousand Americans will be diagnosed with melanoma this year, and of those, approximately seven thousand will lose their lives. Melanoma can develop within a mole already present on the skin or appear (suddenly) as a dark spot that looks different from others. Early diagnosis and treatment are crucial to treatment success. Melanoma is significantly more common in Caucasians. Also, the risk for developing melanoma increases with age; however, it is quite common in those younger than thirty.


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Evaluating Treatment Options for Skin Cancer

Dr. Perri bases all treatments on the location, depth, and width of the cancer to find the right option for your specific situation. Most skin cancer treatment can be performed with a local anesthetic at Dr. Perri’s office in The Woodlands or Conroe. In addition to the type of skin cancer and its location, Dr. Perri uses certain measurements to determine the treatment that will be most successful for your type of skin cancer. The two measurements used in melanoma are:

Breslow’s Depth

Breslow’s depth helps Dr. Perri determine how far melanoma has spread into the body. Understanding the depth of melanoma is essential for deciding future treatment. The tumor thickness is measured from the top of the tumor to the bottom of the deepest tumor cells. Thin tumors (or stage 0) are those where the melanoma cells remain present only in the skin’s outer layers. Thicker tumors or deeper tumors (stage three or four) are considered advanced and more challenging to treat. In these cases, the melanoma cells have spread to nearby nodes or even other areas of the body.

Clark’s Level

Clark’s level is a type of staging system that describes the depth of the melanoma tumor as it grows in the skin. Like Breslow’s depth, the depth of the tumor is measured, and a level is determined. Clarks level ranges from level one, where the melanoma is confined to the outer layer of skin, to level five, where the melanoma has reached the fat layer. These measurements are different than Breslow’s depth as they do not consider whether the cancer cells have spread to other areas of the body. Dr. Perri may provide both a level and a stage. These numbers mean different things.

These measurements provide Dr. Perri with an overview of how aggressive your melanoma is. From that point, he can provide patients in The Woodlands and Conroe with the option that has the highest chance of success.


Treatment for Melanoma and Dysplastic Nevi

Although affecting approximately 1% of skin cancer patients, melanoma is responsible for the majority of deaths related to skin cancer. Melanoma can be broken into two categories based on depth and location:

Melanoma In Situ (Thin) Stage

The earliest stage of melanoma. Cancer is limited to the epidermis (topmost layers of skin). Dr. Perri will remove the cancer as well as a 1 cm margin of skin under local anesthesia in his office.

Deep or Aggressive Melanoma Stage

Melanoma has progressed beyond the upper layers of skin. Patients may require outpatient surgery under general anesthesia. A wider margin of skin will need to be removed, and sometimes lymph node biopsy is performed to assess whether the melanoma has progressed to local lymph nodes.

The recommended treatment for this type of skin cancer is to remove the entire area of skin and a small margin of healthy skin. This method of excision, known as free surgical margins, significantly reduces the risk of cancer from returning to this area and developing in the surrounding regions.

Treatment for Basal and Squamous Cell Cancer

Both basal and squamous cell cancer have lower mortality rates than melanoma. However, patients in The Woodlands and Conroe will need to undergo treatment to remove the cancer and prevent its spread to tissue and bones. Treatment for basal and squamous cell cancer tends to be less invasive and is broken into four categories:

Excision

During a skin cancer excision, the cancer, as well as a 5 mm skin margin, is removed. This is performed under local anesthesia at Dr. Perri’s office.

Moh’s Surgery

Moh’s surgery is reserved for more sensitive areas such as the lips, nose, and ears, this treatment addresses very large, aggressive cancer by removing skin one layer at a time. After removal, the Moh’s surgeon will examine each layer under a microscope to determine if he needs to continue. This procedure is performed in-office under local anesthesia.

Curettage/Electrodesiccation

For small, non-aggressive cancer, patients receive treatment in Dr. Perri’s office under local anesthesia. A curette is used to scrape away cancer cells. The treatment area is then desiccated using a hyfrecator.

Medication

Certain medications for skin cancer treatment can remove superficial cancer in low-risk areas such as the trunk, arms, and legs. Patients apply a topical cream such as 5-fluorouracil or efudex every day for 1-2 months. The treated area becomes inflamed and irritated, eliminating the cancer.

While the ultimate choice of treatment is at the discretion of each patient, Dr. Perri cautions patients in The Woodlands and Conroe that milder forms of cancer treatment may not be as effective as excision and Moh’s surgery for long-term prevention.


Recovering from Skin Cancer

Skin cancer patients have an excellent chance of recovering from skin cancer, and mortality rates are very low. However, because melanoma is on the rise, Dr. Perri recommends that patients come in for an annual skin examination to identify signs of skin cancer and seek treatment early to avoid more invasive procedures.

To schedule a skin cancer consultation with Dr. Perri, call our office in the Woodlands at (281) 943-2749 or Conroe at (936) 522-4966.