Skin cancer is definitively diagnosed by a process known as a biopsy where part or all of the lesion is removed and examined under a microscope. Skin cancers are treated by a number of methods depending upon its type, location on your body, size and stage of growth. Some methods of treatment of skin cancer are:

• Surgical removal
• Curettage and dessication – The cancer is scraped with a sharp instrument and the area is then treated with an electric current to control bleeding and eliminate any residual cancer. This usually leaves a scar shaped like the lesion that is wider than with surgical excision.
• Cryosurgery - freezing the tumor
• Radiation
• Moh’s surgery - A specially trained physician shaves the cancer one layer at a time with immediate microscopic examination. Patients treated with Moh’s surgery often require a reconstructive procedure following removal of the cancer.
• Topical Medication – Some skin cancers are amenable to treatment with topical immunomodulatory medications (e.g. Aldara).

SURGICAL TREATMENT

Surgical removal is the way in which most skin cancers are treated. Most small lesions can be removed using local anesthesia in your plastic surgeon’s or dermatologist’s office or other outpatient facility. Your plastic surgeon’s goal is to adequately remove the tumor and close or reconstruct the resulting defect in a way that optimizes both the functional and aesthetic appearance with a minimum of scarring. The cosmetic result is especially important if the cancer is on the face or other visible area. In some circumstances a more complex surgical procedure may be required to reconstruct the defect following surgical removal. Flaps, where tissue is transferred from an adjacent area, are commonly used on the face.

An Example of a Flap

An Example of an Excision

Skin grafts are another means of closing larger defects and are commonly used on the trunk and extremities. In such cases the plastic surgeon can be an important part of the treatment team regardless of who performs the initial treatment. Plastic surgeons are specifically trained to use reconstructive techniques, ranging from simple scar revision to grafts and flaps, to minimize cosmetic defects, rebuild facial structures and help restore appearance and function. Remember that all scars are permanent and all surgery carries risks. You should thoroughly discuss the various treatment options as well as the possible risks, side effects and complications with your doctor and plastic surgeon prior to beginning treatment.

Treatment of Bowen's Disease (squamous cell carcinoma in situ) with a skin graft