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Skin Cancer

There are TWO parts in treating skin cancer with surgery:

  1. Removing the cancer
  2. Reconstructing the area of cancer removal

Mercy Plastic Surgeons have expertise in BOTH…

  • No matter where your skin cancer is, or what type, we will guide you through treatment and reconstruction

Skin Cancer

  • The most common form of cancer in the U.S.
  • Two most common types are basal cell carcinoma and squamous cell carcinoma
    • Usually form on the face, head, neck, hands, or arms
    • Mercy Plastic Surgeons are specialists in treating and reconstructing these sensitive areas
  • Melanoma is more dangerous, but less common
    • When found early, treatment is likely to work well
    • Depending on the results of your biopsy (characteristics of tumor), you may be a candidate to have your lymph nodes tested for spread of the cancer
    • Mercy Plastic Surgeons can discuss these options with you

Procedures We Offer Related to Skin Cancer

  • Reconstruction after Mohs skin cancer removal
    • Certain skin cancers are removed in a unique way (Mohs) by specially-trained dermatologists; however, reconstruction may require plastic surgery expertise
       
  • Reconstruction of all types and severity
     
  • Removal of…
    • Melanoma
    • Squamous cell carcinoma
    • Basal cell carcinoma 
       
  • Melanoma:
    • Biopsy of lymph nodes
      • Melanoma of certain characteristics (thickness, etc.) may be more likely to have early spread to lymph nodes in the region of the skin cancer
      • Mercy Plastic Surgeons can help you decide if you are a candidate for this
    • Removal of lymph nodes (Head, neck, parotid, axilla, groin)
      • When melanoma is known to have spread to the lymph nodes, Mercy Plastic Surgeons can treat those areas by removing all regional lymph nodes in the area. This may include one of the following procedures…
        • Neck dissection
        • Parotidectomy
        • Axillary dissection
        • Groin dissection

There are certain skin spots that are precursors to skin cancer. That is, even if they are not cancerous now, they can become cancerous. Because a precancerous skin spot means there is sun-damaged skin, having a precancerous spot usually means you are at increased risk for skin cancer at a separate skin site as well.  Patients who have these can be evaluated by Mercy Plastic Surgeons to determine if a biopsy is indicated. Here are a few precursors to skin cancer:

Actinic Keratosis (AK)

  • Rough, scaly, spots
  • From sun damage – commonly on hands, face, and head
  • AKs themselves are harmless, but they can be uncomfortable and unsightly
  • They have a very low risk of developing into squamous cell cancer, but people with 10 or more of these have a 10-15% risk of squamous cell cancer elsewhere on the skin
  • Usually removed because they are unsightly, uncomfortable, or the risk of cancer. AKs that become ulcerated or thickened should be removed to test for cancer

Lentigo maligna

  • Early form of melanoma that grows very slowly (over 5-20 years) as a discolored patch of skin
    • At first, resembles common freckles or brown marks
  • Becomes more distinct over time, growing over an inch or more over several years or decades
  • Most patients are older than 40 yrs (most are 60-80 yrs old)
  • Risk of transformation to invasive cancer is less than 5% overall
    • If larger than 1.5 inches (4cm), up to 50% have a small portion that has transformed into invasive cancer
  • Usually on face, temple, forehead, or neck due to sun damage
  • You should consider having it biopsied if there are the following features:
    • Thickening of a portion of the spot
    • Increasing number of colors (especially blue, black, white)
    • Ulceration or bleeding
    • Itching or stinging
    • Rapid increase in size
    • Edges have become irregular

Atypical Moles

  • Occur in 5-10% of the U.S. population
  • How often does any single mole turn into melanoma?
    • Very infrequently. But in melanoma-prone families, it can happen in 80% of the time
  • If you have multiple moles, you are at higher risk of developing melanoma elsewhere than within a mole
  • Characteristics of a mole that should be biopsied:
    • Change in symmetry, size, edges
    • Thickening of a portion of the mole
    • Increasing number of colors (especially blue, black, white)
    • Ulceration or bleeding
    • Itching or stinging
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Des Moines, Iowa 50314

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