Skin cancer is the most common type of cancer in the United States. It is estimated between two to three million Americans develop skin cancer each year and the numbers are constantly climbing. However, with early detection and proper treatment, skin cancers have more than a 98% cure rate. This is why checking regularly for any changes in ones skin and annual screenings with a dermatologist are essential to skin safety and health.

Types of Cancers

The most commonly occurring types of cancers are Basal Cell Carcinoma, (BCC), Squamous Cell Carcinoma, (SCC), and Melanoma. Basal cell carcinoma, (or just BCC) is the slowest growing and most common form of non-melanoma skin cancer, (NMSC). Also, BCC's rarely spread to other parts of the body.

Squamous cell carcinoma is a more aggressive type of NMSC and has the potential to spread to lymph nodes and organs inside the body.

Melanoma is a form of cancer that arises in melanocytes, which are the cells that produce pigment in the skin. It has the ability to quickly spread to other organs and lymph nodes inside the body. It can be the deadliest of all skin cancers.

Risk Factors

Research has shown that there are certain risk factors that may make a person more susceptible to developing skin cancer.

UV Rays: Ultraviolet radiation (UV rays) come from the sun, sunlamps, and tanning beds and booths. UV rays are present in any type of weather including the cold and cloudy days.

Fair skinned and light complected people may burn easily and have a higher risk for developing skin cancer. These people often have red or blond hair, lightly-colored eyes, and a fair or light complexion. However, even people who may tan easily can still develop skin cancer.

Other risk factors include:

• Scars or burns that are chronic or longstanding
• Diseases that make the skin sensitive to the sun
• Radiation therapy
• Medical conditions or drugs that suppress the immune system
• Personal history of one or more previous skin cancers
• Family history of skin cancer

Prevention

The best way to protect yourself from skin cancer is to protect yourself from the sun. Stay out of the sun, especially during midday, between 11 and 3. A wide brim hat and sunglasses along with protective clothing is key to sun protection. Lastly, sunscreen with an SPF of at least 15-30 should always be worn even in cold weather to protect from UV rays. Remember, exposure to artificial UV rays are even more dangerous. Resist the temptation to tan yourself in a tanning booth or bed.

Symptoms

A change in the skin is the most important sign to look for. This can be in the form of a new growth on the skin, a sore that will not heal, or a change in an old growth. It is important to know not all skin cancers look the same. Skin cancer may be painful, but in most cases it is not. Some other changes to watch for are:

• Small, smooth, shiny, pale or waxy patches or lumps
• Firm, red, tender bumps
• A sore, bump or lump that bleeds or develops a crust or scab that usually is not sore
• Flat red spots that may be rough, dry, or scaly and may become itchy or tender
• Red, brown, or black patch that may or may not be rough or scaly

Diagnosis

In order to diagnose a skin cancer, a biopsy (ie: a sampling of the skin) must be performed. This means the dermatologist would remove all or part of the area that does not look normal. Biopsies can be preformed in our offices with local anesthesia. The biopsy specimen will then be sent out to a lab where a pathologist will give a final diagnosis. If the biopsy comes back as a cancer, an appointment will be scheduled for MOHS surgery.

Treatment

MOHS surgery is a technique in which cancerous areas anywhere on the skin are removed one stage at a time. A layer of tissue is removed by the dermatologic surgeon and then is examined microscopically. If it is determined that cancerous tissue still exists after examining the tissue under the microscope, a second stage will be taken. This process will continue until all of the cancer is removed. Once it is determined the cancer is completely removed, the dermatologic surgeon will then close the wound with sutures, and bandage the area. Most patients return to the office within 1-2 weeks to have the sutures removed from the surgical site. This is generally painless.

MOHS is performed in our office under local anesthesia only, meaning just the area is numbed. The patient is awake and alert throughout the process

The benefit of MOHS surgery as compared to other techniques is that all margins and the depth of the cancerous lesion are fully examined microscopically while the patient is still in the office. This will assure a complete and total removal of the existing skin cancer. MOHS surgery provides the highest cure rate in treating skin cancers and offers the lowest chance of cancer re-growth. Also, the chances of scarring are dramatically reduced as compared to other techniques, because Mohs surgery is a tissue sparing, conservative surgical procedure. Only cancer laden tissue is removed and normal non-involved skin is left alone and intact. Mohs surgery can take all day for some patients, however most patients surgery can be finished within 2-3 hours.

Dr. Anthony Benedetto has been practicing Mohs Surgery for over 30 years. He was trained in Dermatology and Mohs surgery at the Cleveland Clinic, and at the University of Wisconsin at Madison by Dr. Frederic Mohs for whom the procedure is named. In 1983 the Dermatologic SurgiCenter at 1200 Locust Street, the first privately operated certified ambulatory surgery center in Philadelphia was opened. In 1992, the second Dermatologic SurgiCenter was opened in Drexel Hill.

Dr. Ernest Benedetto has been practicing MOHS Surgery since 1991. He joined his brother in 1991, after completing his internship and residencies in internal medicine and dermatology at the Cleveland Clinic, Cleveland, Ohio.

Both locations are certified by the Commonwealth of Pennsylvania, Centers for Medicare and Medicaid Services, and accredited by the Accreditation Association for Ambulatory Healthcare.

If you have any questions or concerns about a skin cancer you may have, please feel free to contact either office for an appointment. Our doctors and staff truly care about your skin's health and safety and are always here to help you!