Norman Harris, II, MD.

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Skin Cancer

Excessive sun exposure over time can result in the development of skin cancer. Skin cancer is the most common form of cancer in the United States. More than 500,000 new cases of skin cancer will be diagnosed in the United States this year - and the incidence is rising faster than any other type of cancer. About 80 percent of the new skin cancer cases will be basal cell carcinoma, 16 percent are squamous cell carcinoma, and 4 percent are melanoma.  While skin cancers can be found on any part of the body, about 80 percent appear on the face, head, or neck, where they can be disfiguring as well as dangerous. Skin cancer is diagnosed by removing all or part of the growth and examining its cells under a microscope. It can be treated by a number of methods, depending on the type of cancer, its stage of growth, and its location on your body. Most skin cancers are removed surgically. If the cancer is small, the procedure can be done quickly in Dr. Harris' office, using local anesthesia. Naturally, the first priority in the treatment of skin cancer is to entirely remove the cancer: the second priority is to reconstruct the resulting defect to look and function as normally as possible.

 

Basal Cell and Squamous Cell Carcinomas

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Skin cancer can appear as a red patch

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Beware of crusty, scaling, bleeding lesions

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"heaped up", pearly basal cell carcinoma

Basal Cell Carcinoma: By far the most common type of skin cancer is basal cell carcinoma. Fortunately, it's also the least dangerous kind - it tends to grow slowly, and rarely spreads beyond its original site. Though basal cell carcinoma is seldom life-threatening, if left untreated it can grow deep beneath the skin and into the underlying tissue and bone, causing serious damage (particularly if it's located near the eye).

Squamous Cell Carcinoma:  Squamous cell carcinoma is the next most common kind of skin cancer, frequently appearing on the lips, face, or ears. It only rarely spreads to distant sites, including lymph nodes and internal organs. Squamous cell carcinoma can become life threatening if it's not treated.

Basal and squamous cell carcinomas can vary widely in appearance. The cancer may begin as small, white or pink nodule or bumps; 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 sore that bleeds or doesn't heal after two to four weeks, or a white patch that looks like scar tissue. Remember, skin cancers are not usually painful. The best strategy is to detect these lesions while they are small: early treatment of skin cancer significantly reduces mortality risks and disfigurement.

 

Melanoma

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Asymetrical

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Borders are irregular and vauge
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Colors are strange: black, blue, purple, red

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Diameter usually greater than 1/4"

Malignant melanoma is also the most dangerous type of skin cancer. If discovered early enough, it can be completely cured. If it's not treated quickly, however, malignant melanoma may spread throughout the body and is often deadly. In 2004, at current rates one in 37 Americans have a lifetime risk of developing melanoma and one in 65 Americans have a lifetime risk of developing invasive melanoma. One person dies of melanoma every hour. In 2004, 7,910 deaths will be attributed to melanoma. The incidence of melanoma more than tripled among Caucasians between 1980 and 2003. Malignant melanoma is usually signaled by a change in the size, shape, or color of an existing mole, or as a new growth on normal skin. Watch for the "ABCD" warning signs of melanoma: Asymmetry - a growth with unmatched halves; Border irregularity - ragged or blurred edges; Color - a mottled appearance, with shades of tan, brown, and black, sometimes mixed with red, white, or blue; and Diameter - a growth more than 6 millimeters across (about the size of a pencil eraser), or any unusual increase in size. Remember: melanomas are not painful. They get larger in size over time and sometimes bleed. The treatment of a malignant melanoma consists of a wide resection of the involved skin, and (depending on the depth of the tumor) possibly sentinel lymph node biopsies. 

Reconstruction after skin cancer resection

After the skin cancer tumor has been totally removed, the next objective is to reconstruct the area of resection to make it look and function as normally as possible. Many times, the skin cancer can simply be surgically excised and the surrounding skin pulled together with sutures, resulting in a fine scar. Other times, the resulting defect is too large to pull together with stitches, and the defect needs to be repaired with skin grafts (skin removed from another place on the body) or by skin flaps (skin that is shifted from an area near the site of the tumor resection). Typically, a skin flap will have a better post operative appearance, as it retains a blood supply of its own. Furthermore, the skin of the flap will have a color more similar to the skin of the area being reconstructed since it is from a part of the body that is already close to that area. Below are some illustrations of reconstructions that Dr. Harris has done on areas of the face that commonly develop skin cancer.

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After the skin cancer has been removed
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Postoperative photo at 6 months
 
 
 
This next case is a typical skin cancer of the nose.
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After the cancer has been removed
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Immediately after the operation
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Postoperative photograph at 4 months

5115 Bernard Drive  Roanoke, Virginia 24018
(540)776-6979

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