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Believe it or not, skin cancer is the most common form of cancer in the United States. There are more than 500,000 new cases being reported each year. Even more alarming is the fact that this number is rising faster than any other type of cancer. Although 80 percent of skin cancers can be found on the face, head, or neck, they can also appear on any part of the body. They can be disfiguring, and disconcerting to look at as well as very dangerous.

The purpose of this website is to provide the reader with as much generalized information as possible, but as our disclaimer so aptly states, there is no substitute for receiving a comprehensive medical evaluation by a highly trained doctor who can either put your fears to rest or provide you with the correct treatment options. Our purpose is to educate the reader about the different types of skin cancer, their causes, and everyday preventive measures you can take. It is also important to know when to consult a doctor. We will also explain the role of a plastic surgeon in the diagnosis and treatment of skin cancer and other skin growths. Dr. Ortega has been successfully treating skin cancer for many years and is an advocate for prevention by means of applying sun-screen and limited exposure for those who are known to be predisposed to skin cancer.

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WHY DO SOME PEOPLE GET SKIN CANCER WHILE OTHERS DO NOT?

The leading cause of skin cancer is ultraviolet radiation, usually directly from the sun, but one can also be exposed to ultraviolet radiation from artificial sources like sunlamps and tanning booths. Current beauty trends which encourage the perfect year-around tan and an increase in outdoor activities can be partially blamed for the alarming rise in reported cases of skin caner. Some experts feel that the depletion of the earth's protective ozone layer is also a contributing factor.  

However, anyone can get skin cancer regardless of what your skin type, race or age, no matter where you live or what you do. But your risk is greater if:

• Your skin is fair and freckles easily.
• You have light-colored hair and eyes.
• You have a large number of moles, or moles of unusual size or shape.
• You have a family history of skin cancer or a personal history of blistering sunburn.
• You spend a lot of time working or playing outdoors.
• You live closer to the equator, at a higher altitude, or in any place that gets intense, year-round sunshine.
• You received therapeutic radiation treatments for adolescent acne.

THE DIFFERENT TYPES OF SKIN CANCER

Hands down, the most common type of skin cancer is basal cell carcinoma. Fortunately for many, it is also the least dangerous kind in that it tends to grow slowly, and rarely spreads beyond its original site. Although basal cell carcinoma is not necessarily life-threatening, if it is left untreated, it can spread to the underlying skin, tissues, and bone, and can even cause serious damage (especially if it's near the eye.)

Squamous cell carcinoma is the next most common kind of skin cancer, usually appearing on the lips, face, or ears. It can and routinely does spread to distant sites, including lymph nodes and internal organs. Squamous cell carcinoma can become life threatening if it is left untreated.

A third form of skin cancer, malignant melanoma, is the least common, but unfortunately, the occurrence of reported cases is increasing rapidly, particularly in and around the Sunbelt states. Malignant melanoma is by far the most dangerous type of skin cancer. If it is detected early and proper treatment is sought, it can be completely cured. If, however, early diagnosis is not made and it is left untreated, malignant melanoma may spread throughout the body and is often fatal.

The key to success is prevention and early detection. If you have a suspicious mole or a new growth, you should visit your doctor and find out if a biopsy is necessary or indicated by your physician. You have nothing to lose and everything to gain.

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SKIN GROWTHS YOU SHOULD BE AWARE OF: Is this Cancer?

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. While a vast majority of moles pose no danger, some very large moles (even ones that have been present since birth), or those with mottled colors and poorly defined borders-may develop into malignant melanoma. Moles are commonly excised (removed) for aesthetic 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.

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HOW CAN I RECOGNIZE SKIN CANCER?

It can all seem very confusing, but basically, when in doubt, see your doctor and get his opinion. Basal and squamous cell carcinomas can look very different at times and can vary widely in appearance. The cancer may begin as a small, white or pink nodule or bump; it can be smooth and shiny, waxy, or pitted on the surface. Or it 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 usually presents with a change in the size, shape, or color of an existing mole, or as a new growth on normal skin. Signs to watch out for include : Asymmetry-a growth with unmatched or uneven halves; Border irregularity-ragged or blurred edges; Coloration-a mottled appearance, with shades of tan, brown, and black, sometimes mixed with red, white, or blue; and Size/Diameter- a growth more than 6 millimeters across (about the size of a pencil eraser), or any unusual or rapid increase in size.

If all these warning signs and descriptions leave you feeling confused, don't forget that one of the best ways to interpret all this it to examine your skin regularly. Getting to know what your skin looks like and following a pattern of regular self-examinations will help familiarize you with all the different variables. You should examine all your skin from the soles of your feet to the top of your head, and don't forget your back. If you spot any suspicious lesions, moles, or growths, see your doctor. 

WHY SHOULD I SEE A PLASTIC SURGEON FOR SKIN CANCER?

If you have concerns about skin cancer, your family physician, dermatologist or plastic surgeon can help you with your concerns. He or she should perform an examination of your skin and recommend a course of action.

If you notice an unusual growth yourself, you should consult a plastic surgeon or a dermatologist. Both are skilled and highly trained at diagnosing and treating skin cancer and other skin growths. A plastic surgeon can surgically excise the lesion or growth while maintaining functionality and an aesthetically pleasing final appearance. This may be of particular interest to you especially if the growth is located on your face or in a very noticeable area of your body. It is also worth mentioning that if you require a large excision, some reconstruction may be necessary in order to preserve mobility, purpose, or just to re-establish symmetry. Plastic Surgeons such as Dr. Ortega specialize in correcting asymmetry and using the best surgical approach, taking into consideration not only aesthetics but utilitarian concerns as well.  If part of your treatment calls for options other than removing the growth or lesion, then your plastic surgeon can refer you to the appropriate specialist who can provide the correct treatment.

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DIAGNOSIS AND TREATMENT OF SKIN CANCER

Skin cancer is diagnosed by removing all or part of the growth and examining its cells under a microscope (biopsy). It can be treated by using different of methods, depending on the type of cancer, its stage of growth, and where it is located 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 anesthesia. 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 more extensive, however, or if it has spread to the lymph glands or elsewhere in the body, major surgery may be necessary. There are other surgical treatment options available such as cryosurgery (freezing the cancer cells), radiation therapy (using x-rays), topical chemotherapy (anti-cancer drugs applied to the skin), and Mohs surgery, a specialized procedure 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 follow-up.)

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DISCUSSING YOUR OPTIONS AND CONCERNS

All of the aforementioned treatments have good cure rates for most basal cell and squamous cell cancers when chosen carefully. The key is early detection and treatment. Even malignant melanoma has a good cure rate if detected and treated early before it has had a chance to metastasize (spread) to other areas.

Dr. Ortega has successfully treated numerous skin cancers throughout his career and has continually strived to bring the latest technological advances in this field to his patients. Alongside his long-standing commitment to excellence and academic pursuit of knowledge, Dr. Ortega has a strong aesthetic sense of beauty which enables him to achieve visually pleasing results while preserving functionality.

Having said all that, sometimes in an effort to save someone's life, certain techniques used in treating skin cancers can be disfiguring in a and of themselves, despite the initial changes brought about by the cancer. Despite a doctor's best efforts, depending on the location and severity of the cancer, the consequences may range from a small but unsightly scar to permanent more noticeable changes in facial structures such as your nose, ear, or lip.

In cases such as these, a plastic surgeon can be a very important part of the surgical/treatment team especially when extensive reconstruction may be necessary. Obviously, the main concern is to address the cancer as quickly and effectively as possible in order to eliminate it entirely. Reconstructive techniques- ranging 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.

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HOW TO PREVENT A RECURRENCE

Once you've been diagnosed and treated for skin cancer, your doctor should schedule regular follow-up visits to make sure there is no reoccurrence of the cancer.

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 people who have not had skin cancer as well.)

• Avoid prolonged exposure to the sun, especially between 10 a.m. And 2 p.m. and during the summer months. Remember, ultraviolet rays pass right through water and clouds, and reflect off sand and snow.
• When you do go out for an extended period of time, wear protective clothing such as wide brimmed hats and long sleeves.
• On any exposed skin, use a sunscreen with an SPF (sun protection factor) of at least 15. Reapply it frequently, especially after you've been swimming or sweating.
• Finally, examine your skin regularly. If you find anything suspicious, consult a plastic surgeon or a dermatologist as soon as possible.

If you suspect a mole, lesion, new growth or changes in an existing mole, see your doctor as soon as possible. Preventative measures for avoiding skin cancer should be followed by everyone, despite age, ethic background or skin type as everyone is susceptible. 

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