Summit Health Oregon

Skin cancer

Most of us love the outdoors, but our skin hates the high desert sun. The longer wavelengths (known as UVA: think “A” for aging) penetrate and damage deeper structures like elastic fibers and collagen, as well as pigment cells (melanocytes), where melanoma starts. Such damage causes premature aging with wrinkles, fine lines, rough leathery texture, and mottled discoloration, as well as skin cancers.

Sunlight suppresses your skin’s immune system. Skin cancer results from a one-two punch: The first “hit” is nuclear damage from UV radiation; adding up over decades. The second “hit” is ongoing, daily UV suppression of your skin’s immune system.  Exposure to UV radiation adds up causing increasing, cumulative skin damage.

  • UVB rays are five to ten times stronger in the middle of the day
  • UVA penetrates window glass, clouds, mist, and even fog
  • Shiny surfaces, like snow, water, and concrete, will reflect up to 95% of solar rays back at you
  • 50% shade cover gives only about SPF2 protection, and 90% shade cover gives only about SPF 10
  • 50% of all UVA exposure occurs in the shade.

  • Minimize exposure of your skin to sunlight
  • Try to enjoy your outdoor activities in the mornings or evenings
  • Look for an SPF of at least 30 for maximal protection from skin cancer and premature aging
  • Apply sunscreen every morning to your sun-exposed skin
  • Make a habit of using lip sunblock every day, all year.
  • Wear long sleeves and a hat with a broad brim
  • Wear sun-protective clothing

Avoid Tanning Beds

Ultraviolet light from the sun and tanning beds can cause skin cancer and wrinkling. If you want to look tan, consider using a self-tanning product or spray, but continue to use sunscreen with it.

Avoid Sunburn

Sure, it hurts, but what’s so bad about a sunburn?

Sunburn means your skin has been damaged. Ultraviolet light enters the skin to damage your cell’s DNA (your body’s instruction manual). Repeated exposure to ultraviolet light can cause a lot of problems:

  • wrinkles
  • brown spots
  • eye problems
  • moles
  • saggy skin
  • skin cancer

A sunburn can increase the number of moles on your body. While moles are common, they can become cancerous. Keep an eye on your moles with the “ABCDE” rule and talk with a health care provider if you notice anything abnormal.

A Asymmetry

Photo of mole asymmetry

One half is unlike the other half.

B Border

Photo of mole border

An irregular, scalloped or poorly defined border.

C Color

Photo of mole color variation

It varies from one area to another, has shades of tan, brown, or black, or is sometimes white, red, or blue.

D Diameter

Photo of mole diameter

Melanomas are usually greater than 6mm (the size of a pencil eraser) when diagnosed, but they can be smaller.

E Evolving

Photo of a mole that has evolved in size, shape, and color

A mole or skin lesion that looks different from the rest, or is changing in size, shape, or color.

Mohs micrographic surgery is considered the single most effective technique for removing skin cancer, including basal cell carcinoma and squamous cell carcinoma. An extremely precise skin cancer treatment, the Mohs procedure allows surgeons to remove a thin layer of tissue and examine it during rather than after surgery. As a result, surgeons know exactly when tissue is free of cancer cells so that healthy tissue is not removed unnecessarily.

Cure rates for patients who have Mohs micrographic surgery are higher than those for patients who have standard or other surgical methods to remove skin cancer.

Advantages of Mohs skin cancer treatment

  • Precisely tracing and removing skin cancer cells that cannot be seen with the naked eye
  • On-the-spot tissue examination to identify and remove malignant skin cancer cells to their roots
  • Minimizing the chance skin cancer will regrow
  • Preserving more normal tissue compared with standard or other surgical methods
  • Less Mohs surgery scars and disfigurement
  • Effective treatment for complex skin cancers, cancers of the face, sensitive areas, and visible areas
  • Cure rates as high as 99% compared with 50% to 60% for other methods
  • The highest cure rate for basal cell and squamous cell carcinomas

Our specialist is trained to perform Mohs micrographic surgery. In addition to having expertise in the surgical technique, surgeons with Mohs micrographic surgery training also have expertise in examining tissue (pathology) and reconstructive surgery.

What to expect from Mohs surgery for skin cancer

If you are scheduled to have Mohs micrographic surgery to remove your skin cancer, your specialist will discuss the benefits and risks of the surgery and tell you what you can expect. He will also instruct you on how to care for your wound and heal from your surgery.

The procedure will involve:

  • Local anesthesia will be administered at the site of the tumor to numb the area.
  • Removing the tumor by gently scraping the area with a semi-sharp, scoop-shaped instrument known as a curette, and a scalpel to precisely excise involved skin – a process that allows the surgeon to determine the margin between the tumor cells and healthy tissue.
  • Tumor mapping to ensure the tumor is precisely located (mapped) and with reference to local landmarks such as the nose, cheek, and chin. The tissue will then be labeled and color-coded to correlate with its position on the map. The surgeon will then process and examine tissue sections to look for cancer cells. It takes approximately 60 minutes to process, stain, and examine each tissue section. Your wound will be bandaged during this time, and you may leave the operating suite.
  • Removing all cancer cells. If cancer cells are still present after tissue examination, your surgeon will return to the tumor area indicated on the map to remove, remap, color code, and examine another thin layer of tissue. The surgeon will continue this process until the cancer is completely removed.
  • Reconstruction. In addition to having expertise in the surgical technique and pathologic process for examining tissue, surgeons trained in Mohs micrographic surgery are reconstruction experts. Because the location and extent of cancer differ for each patient, your surgeon will tailor reconstruction to meet your needs, preserve the normal function of the affected area, and yield the best aesthetic outcome with minimal Mohs surgery scars.

Dermatology

Clinics

Old Mill District Clinic
Bend, Oregon