Skin Cancers
Basal Cell Carcinoma
Basal cell carcinoma (BCC) is the most common form of cancer, with about a million new cases estimated in the U.S. each year. It is estimated that one in three adults will develop basal cell carcinoma in their lifetime. Basal cells line the deepest layer of the epidermis. Basal cell carcinomas are malignant growths–tumors–that arise in this layer.
Basal cell carcinoma can usually be diagnosed with a simple in-office biopsy and is fairly easy to treat when detected early.
Five to ten percent of BCCs may be resistant to treatment or locally aggressive, damaging the surrounding skin and sometimes invading bone and cartilage. If a basal cell carcinoma is not treated, it will grow larger over time and can become difficult to eliminate. Fortunately, however, this is a cancer that has an extremely low rate of metastasis, and although it can result in scars and disfigurement, it is not usually life-threatening.
Treatment
Treatment options include: electrodessication and curettage (simply creating a man-made “brush burn”), excision, Mohs micrographic surgery, and radiation. Treatment choice depends on the type of basal cell carcinoma, its location, size, and the patient’s age.
Melanoma
Melanoma is the most serious form of skin cancer. However, if it is recognized and treated early, it is nearly 100 percent curable. If not treated promptly, the cancer can advance and spread to other parts of the body, where it becomes hard to treat and can be fatal. Although it is not the most common of the skin cancers, it causes the most deaths.
Melanoma is a malignant tumor that originates in melanocytes, the cells that produce the pigment melanin that colors our skin, hair, and eyes. The majority of melanomas are black or brown. However, some melanomas are skin-colored, pink, red, purple, blue or white.
Risk factors for melanoma include: sunbathing, tanning bed use, fair skin, family history of melanoma, multiple dysplastic nevi, personal history of other types of skin cancer, and weakened immune system.
The ABC’s of Melanoma
- Asymmetry — if you draw a line through a normal mole, the two halves match; in contrast, most melanomas are asymmetric.
- Border irregularity — the borders of a melanoma tend to be uneven and appear scalloped
- Color — having a variety of colors within the same mole is concerning
- Diameter — melanomas are often greater than the size of a pencil eraser or 6 mm when first detected.
- Evolution — any change, such as itching, change in color, size, or shape may suggest something concerning
Treatment
For the vast majority of melanomas, simple excision is adequate. The margins of the excision (amount of normal skin we take in addition to the lesion) are determined by the depth of the lesion on the original biopsy. If the melanoma is greater than 1 mm depth, we often recommend that the patient consider a sentinal lymph node biopsy to sample the node most likely to drain the region of the melanoma at the time of the excision. Your provider will discuss the best plan of care for the depth of your melanoma.
Squamous Cell Carcinoma
Squamous cell carcinoma is the second most common form of skin cancer, with over 250,000 new cases per year estimated in the United States. It arises in the squamous cells or keratinocytes, which compose most of the upper layer of the skin.
Most squamous cell carcinomas are not immediately life-threatening. When identified early and treated promptly, cure rates are high. However, if overlooked, they are harder to treat and can cause disfigurement. While 96 to 97 percent of squamous cell carcinomas are localized, a small percentage may travel along a nerve or spread to other areas of the body. Squamous cell carcinomas on the ear and lip are among the most likely to spread.
Treatment
Treatment options include: electrodessication and curettage (simply creating a man-made “brush burn”), excision, Mohs micrographic surgery, and radiation.
Before Your Visit
Please be sure to bring a list of all medications and allergies. If you are covered by an insurance plan that requires prior authorization, the authorization or referral form must be presented to our office before or at the time of your appointment. It is your responsibility to obtain necessary referrals. If you don’t have one, we will ask you to sign a waiver stating you are responsible for the bill. Payment will then be expected at the time of service. Please bring your insurance cards to each visit so the information can be checked and a copy placed in your chart.
Financial Information
Your insurance coverage is an agreement between you and your insurance company. Financial responsibility rests with the patient for deductibles, co-insurances, and non-covered services. Insurance coverage is a variable, and we cannot guarantee what services will be covered by your particular plan. We request that you sign an authorization form, which will enable us to receive insurance payments directly when applicable. Co-payments are due at the time of service. For your convenience, we accept personal checks, Visa, MasterCard, Discover, American Express, and cash.
A no-show fee of $50.00 will be charged to patients who fail to appear for their appointment and provide less than 24 hours' notice of cancellation.
Pathology, Labs, and X-rays
Surgical specimens are sent to a laboratory for analysis. The fee for this is a separate charge from the office visit and may be billed directly by the processing lab. Results are usually available 7-10 days after the test has been performed. Questions regarding payments for laboratory services should be directed to the laboratory.
Prescription Refills
Prescription refill requests will be taken only during regular office hours.