Medical Dermatology & Cutaneous Surgery
Specialty Services
There are many different types of treatments for skin cancer, just as there are many different types of skin cancers. Some cancer types are more amenable to certain treatments than other types of cancer. To complicate things, cancers growing on different areas of the body may need different treatments. If you have a skin cancer, it is important to find a doctor who is trained and experienced in all the different methods. Medicine shouldn’t be one-size-fits all.
At Anew Dermatology, we offer the full-range of treatments for skin cancer, both surgical and non-surgical. Having treated thousands of skin cancer patients at the world-class Johns Hopkins University, our skin cancer specialist Dr. Egbers has the experience and the options available to tailor a treatment plan for your unique case.
Mohs Surgery
Multiple research studies have shown that Mohs surgery is the most effective method for removing certain types of skin cancers, in certain locations. These are the cancers that have a higher risk for recurrence or are located in places without much extra skin to stitch together once the cancer has been removed such as the head/neck, hands/feet or shins. More simply, its used for either higher-risk skin cancers, or higher-risk locations.
With Mohs surgery, you remove the cancer with a narrow 1-2 mm margin. It is processed so that 100% of the peripheral margin and 100% of the deep margin is inspected under the microscope. And this is done in real-time so you know the results right then and there, and the process is repeated until no skin cancer is left. At the same time, because only a narrow margin is removed, the amount of skin removed and the subsequent scar is as small as possible.
Please see our related articles related to Mohs surgery to learn more, and ask your doctor if Mohs surgery is right for your skin cancer.
“Slow” Mohs Excision
Some types of skin cancer or “pre-cancer,” usually melanocytic lesions, are best treated with a surgery called “slow” Mohs.
These usually are cancers or “pre-cancers” that don’t appear as clearly on the frozen sections of Mohs surgery.
“Slow” Mohs combines the 100% margin control of traditional Mohs surgery with permanent section pathology. This method is inherently slower in arriving at a result, but is more reliable when used for those skin cancers and “pre-cancers” that do not show up as readily on the froze sections of traditional Mohs surgery.
Traditional Excision
Traditional excision is used to treat the majority of skin cancers around the world.
Depending on the type of cancer being treated, a pre-determined safety margin is applied around the cancer and included in the removal.
The entire excision is sent to an outside lab for permanent section bread-loaf evaluation of the margins. Typically this is performed by the skin cancer experts in pathology at the University of Rochester.
If it looks to the pathologist that there is still skin cancer at the edges of the excision, they will say that the margin is positive and more will have to be removed in follow-up.
Traditional excision is usually the treatment of choice for a lower-risk skin cancer in a lower-risk location. Although only a small % of the margin is evaluated with bread-loafing, when used on an appropriate low-risk skin cancer, the cure rate remains very high.
Reconstructive Surgery
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Skin Cancer Screening
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Non-Surgical Treatments
Surgery, be it Mohs, standard excision or the square technique, remains the the treatment choice for the vast majority skin cancers. This is because surgery offers the highest cure rates and excellent cosmetic results, usually with limited down-time. Sometimes, a non-surgical option might be appropriate as either the only treatment for your skin cancer, or in addition to surgical treatment.
The ability to use a non-surgical treatment depends on the type of cancer you have, where it is located, the size of it, and if there is an alternative that even exists. We are happy to discuss these options with you and if a non-surgical approach would make sense in your case.