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Comprehensive evaluation, diagnosis, and treatment of skin cancer

Skin cancer is the most common form of cancer in the United States, affecting one in five Americans over the course of their lifetime. A majority of skin cancers are caused by damage from chronic ultraviolet radiation, through sun exposure or tanning beds, but other causes of skin cancer include HPV (a virus), chronic inflammation (such as at a scar site), and genetic predisposition.

The most common forms of skin cancer include basal cell carcinoma, squamous cell carcinoma, and melanoma, but there are many less common types such as Merkel cell carcinoma, dermatofibrosarcoma protuberans, atypical fibroxanthoma, among others.

While the majority of basal cell and squamous cell cancers are cured with surgical removal, some of these cancers, especially melanoma and Merkel cell carcinoma can spread or metastasize to other parts of the body and may require further workup and multidisciplinary care.

Diagnosis and treatment

Our dermatologists will perform a comprehensive skin exam and help you identify any suspicious lesions. If a biopsy is needed to sample the lesion, this is done during your appointment, using a local injection to numb the area. The tissue sample is then sent to our dermatopathology lab where a fellowship-trained dermatopathologist will analyze the tissue and confirm the diagnosis.

If a lesion is confirmed as a skin cancer, our dermatologists will discuss treatment options with you.

Treatment depends on the type, size, and location of the cancer. Individualized treatment plans are developed to meet each patient’s needs.

Common treatments for early-stage cancers are often performed under local anesthesia in our offices and include:

  • Electrodesiccation and curettage (scraping with a scalpel and burning with an electrosurgical device)
  • Excisional surgery, in which a scalpel is used to remove the affected area of skin
  • Mohs micrographic surgery, in which a fellowship-trained Mohs surgeon provides microscopically-guided removal of skin cancers. The skin cancer is removed layer by layer and examined microscopically until no cancer cells can be seen

Other treatment options may be used, including:

  • Cryosurgery, in which the skin cancer is frozen

  • Topical chemotherapy, in which a topical chemotherapy agent is applied to the skin

  • Immunotherapy, which uses the patient’s own immune system to fight the cancer

  • Photodynamic therapy, which combines using a chemical applied to the skin and UV light to destroy cancer, as well as actinic keratosis (precancerous small red bumps on sun damaged skin)

  • Intravenous chemotherapy, which is used when cancer has spread beyond the skin

  • Radiation therapy, which uses ionizing radiation to kill cancerous cells

Reducing risk with skin evaluations

Most skin cancers can be successfully treated when detected early. That’s why our dermatologists encourage patients to have annual “skin checks,” perform regular self-examinations, and protect their skin with sunscreen and wear protective clothing.

While all people can get skin cancer, some people are at greater risk, and should be evaluated more regularly:

  • People with fair skin
  • People with a history of sunburns, or a personal or family history of skin cancer
  • People who have a large number of moles or precancerous skin lesions, called actinic keratosis
  • Organ transplant recipient

If you have had a skin cancer there may be ways to reduce your risk of future skin cancers. Our dermatologists will be able to discuss these options with you.

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