You've Been Diagnosed With Skin Cancer. What Do You Do Now?

Skin cancer may be more than meets the eye. Not all treatments for skin cancer are equal. Options range from common treatments preferred by many physicians such as scraping and burning (electrodesiccation and curettage), freezing (cryotherapy), radiation, and surgical excision, to Mohs micrographic surgery. Mohs micrographic surgery is an advanced surgical technique performed by a highly trained specialist. You should be aware of the benefits and drawbacks of each option and choose a treatment that will remove all the cancer, minimize the risk of recurrence, and leave as little scarring as possible.

When considering options, or to understand why previous treatments may have failed, it is important to recognize that the tumor, which is visible to you or your physician, may be just the "tip of the iceberg." Cancer cells can not be seen with the naked eye. Many "invisible" cells may form roots or "fingers" of diseased tissue that extend beyond the boundaries of the visible cancer. Using a microscope to track down the roots of the skin cancer is an important step in treatment. If these cancer cells are not completely removed, they can lead to re-growth and recurrence of the tumor.

Types of cancer most likely to form these complicated root systems are those that:

• are located in cosmetically sensitive or functionally critical areas around the ears, eyes, nose, lips and scalp
• areas such as the hands, fingers, and genitalia
• grow rapidly and/or uncontrollably
• recurrent skin cancer or treatment failures

For these cancers, common treatment methods are often not successful, because they do not rely on a microscopic examination to determine the extent of the cancer. These common but less precise treatment methods can remove too little cancer or too much healthy tissue. This can then lead to a high rate of recurrence of the skin cancer necessitating additional surgery or cause unnecessary scarring.

If a cancer has been treated by one of these common methods and it recurs, the chances of it being cured when treated again by the same method becomes even less likely. The scar tissue surrounding a recurrent cancer makes it extremely challenging to separate healthy skin and cancerous tissue. Also there is a tendency to remove too much tissue when recurrent skin cancers are treated again with common methods.