¬ Skin Cancer and the Treatment

Skin cancer is the most common form of cancer in the world and in our country that rapidly becomes widespread. Regardless of race, skin color, age and gender, anybody can suffer from a skin cancer. It may appear on any region of body. Frequently 80 % is found in the face, head and neck area. Most of them can be removed out by plastic surgeons using surgical method. Depending on the lesion size, treatment is performed on an outpatient basis with local anesthesia allowing the patient to resume normal life immediately. In most cases, results without a significant scar are achieved that can be covered with make-up easily.

Which forms of skin cancer can be removed out by plastic surgeons?

Even most skin cancer forms can be removed out surgically, a treatment protocol is needed according to the type of lesion, stage and where its is located. Small lesions are removed out totally and sent to a lab for pathologic examination than diagnosis is compled.  In larger lesions, incisional biopsy was performed than the specimen is examined by patologist, finally a  diagnosis is achieved. Then appropriate treatment is planned. Plastic surgeons can treat all kinds of skin cancers mentioned below:

Basal Cell Carcinoma (BCC): This is the most common and the least dangerous type of skin cancer.It progresses very slowly and it occassionally spreads.

Squamous cell carcinoma (SCC) :This is the most second common skin cancer type. Often it is seen on the lips, face or ears. It can spread to other parts of the body.

Malignant melanoma: It is a rare type of skin cancer but it is the most dangerous type. If it is not treated it can spread other parts of the body and it can be deadly.

Your plastic surgeon can also treat other skin lesions:

Moles:  They may be darkly pigmented, raised or flat and appear in clusters on the skin. While most of them are not dangerous especially the ones with irregular shape and mottled color may develop malignant melanoma pattern. In fact moles are removed out for cosmetic reasons surgically to prevent irritation caused by excessive contact to undergarments .

Keratoses : When the skin is damaged rough, brown or red, scaly skin patches can occur on the skin which is called keratoses. Sometimes they may turn into squamous skin cancer.

What should I expect after the consultation?

Primary step is to have a consultation with the doctor if you have been diagnosed with skin cancer or you have the potential. In this consultation your doctor will examine your skin and general status.

Basal and squamous cell cancers can differ in shape and appearance. Often they may appear in conditions mentioned below:

Small, white or pinky nodule or raised,

Rough, dry or scaly red dots shaped,

Rough, red, raised, nodules in groups or in clusters,

Wound that is bleeding and not healing for 2-4 weeks and wound that is recurring after healing

They can be scar shaped and can be mildly sunken or raised.

How is skin cancer is removed out?

After clinical examination prediagnosis is made for the present lesion. Generally, one of BCC or SCC skin cancer types can be prediagnosed. Removal of cancerous cells differs according to its type, stage and location. Plastic surgeon removes the underlying skin aesthetically by putting his best efffort forward. If cancer is small it may be removed smoothly leaving an inconspicous scar by using a surgical method. If the size of this lesion allows  to remove all of the lesion without  any  cosmetic problem the excisional biopsy can be performed. Removed part is sent to pathologic examination. Depending upon the result of the pathology further treatment may be started. A fine scar can remain after this procedure.

If the cancerous site is wide or if the cancer is spreaded to lenf nodules a more complicated surgery may be necessary. In this situation, a small incisional biyopsy can be done and  the removed  speciment is sent to a lab for pathology to clarify the diagnosis. If it is diagnosed with cancer the entire lesion has to be removed widely. Skin graft which means relocating the healthy skin patch removed from other parts of the body to the wound site or flap which means repositioning the adjacent tissue over the wound can be performed. With the help of these tchniques removal site is treated and a better appearance and function is provided. Depending on the case further treatments may be required.

How will be the primary care on the operation day?

Most of the removals of cancerous cells  are performed under local anesthesia in a doctor’s office . In the late stages it may be perofrmed under general anesthesia. Your surgeon will guide you through treatment and advise you on the best and the most secure anesthesia option for you. 

How will I feel and look after the surgery ?

There may be swelling after the treatment.In the beginning scar is red or pink. It will gradually fade and may become undetectable. Ifa complex tissue transfer like skin graft or flap is performed healing process may extend comparing to a simple excision. For a better recovery you should follow post-op instructions that your surgeon advised.

What should I know about the result?

You should acknowledge that skin cancer may require surgical excision of the cancerous growths. Fast recovery is related to on post-op care of the wound , the quality and the nature of your skin.

Prof. Dr. Muhitdin Eski