Prevent and Treat Skin Cancer

May is Melanoma Awareness Month. We visited with Dr. Lance Henry, Director of Advanced Dermatology & Skin Cancer Center, PLLC, to learn more about skin cancer prevention and treatment. Dr. Henry is a board-certified Dermatologist and American College of Mohs Surgery Fellowship-trained skin cancer and reconstructive surgery.  He is the most experienced skin cancer surgeon in Northwest Arkansas, having treated over 16,000 skin cancers with the Mohs technique.

As the weather warms up, most people start thinking about sunscreen. However, the truth is that you should wear sunscreen everyday–even on cloudy days in the winter or a simple walk to the mailbox!

Preventing Skin Cancer – What do you recommend?

“A broad spectrum (protects against both UV-A and UV-B rays) sunscreen of at least SPF 30 or above should be worn every day to sun exposed areas and reapplied throughout the day if sweating or in the water. Sunscreen is only one defense against the damaging effects of the sun. In addition, avoiding the sun completely or staying in the shade during the sunniest part of the day (10am – 4pm), wearing protective clothing, a wide-brimmed hat, and sunglasses are also important”, adds Dr. Henry.

Skin Cancer Facts

Some facts about skin cancer, prevention, and treatment. One in five Americans will develop skin cancer by the age of 70. That statistic is startling, but you can make a difference in decreasing your risk and improving your outcome.

“Monthly skin self-exams, annual skin checks by your Dermatologist, and early detection are extremely important. A great resource for a do-it-yourself way to perform your own monthly skin self-checks can be found at our website AdvancedSkinMD.com/skin-self-exams”, says Dr. Henry. “Skin cancer is serious. Two people die every hour in the US of skin cancer. Having five or more sunburns doubles your risk for melanoma. Prevention and detection are vital.”

The Skin Cancer Foundation and the American Academy of Dermatology recommend you visit your Dermatologist annually for a thorough, full- body skin check and bring notes on skin changes you’ve noticed from your monthly skin checks with you. Early detection starts with you!

Skin Cancer – What to look for? It’s as easy as the ABC’s, (actually the ABCDE).

A – Asymmetry (one half of the mole doesn’t match the other)

B – Border irregularity

C – Color variation (color that is not uniform)

D – Diameter greater than 6 mm (about the size of a pencil eraser)

E – Evolving (changing size, shape or color)

Skin Cancer Treatment – Mohs Surgery and Others

There are various treatments for different types of non-melanoma skin cancer, and your Dermatologist will recommend the best one for your type of skin cancer. Treatments can include Mohs Micrographic Surgery, excision, scraping and burning, radiation, and in some cases, the use of a cream. There is the risk of some of these treatments leaving behind cancerous cells, meaning the lesion will regrow and have to be treated again in the future. In fact, this happens more than 10-15% of the time, but that is rarely the case for Mohs Micrographic Surgery, especially when performed by a Fellowship-trained Mohs surgeon.

What is the Mohs Surgery Process?

“This high recurrence rate of other treatments is why Mohs micrographic surgery is the Gold Standard for the treatment of skin cancers on the head and neck, and for high risk cancers on the trunk and extremities. The Mohs technique has a cure rate of up to 99%”, states Dr. Henry.

The Mohs process removes the skin cancer surgically in layers during an in-office surgical visit.

 Step 1: The roots may extend beyond the visible portion. If these roots are not removed, the cancer will recur.

Step 2: The visible portion of the tumor is removed.

Step 3: A layer of skin is removed, divided into sections and color-coded.

Step 4: The edges and undersurface are then immediately examined by a fellowship trained American College of Mohs Surgery physician microscopically for remaining cancer.

Step 5: If cancer cells are found under the microscope, another layer is excised; but only in the area where the cancer cells are located. This process is repeated until all of the cancer has been completely removed. What this means to you is the maximum amount of healthy tissue is kept intact. Additionally, with Mohs surgery, reconstruction can be done at the same time, which means you start on the road to healing faster.

How do you pick a Mohs Surgeon?

“Most importantly, look for a Mohs surgeon that is Fellowship-trained and a member of the American College of Mohs Surgery. Fellowship-trained means this surgeon has had 1-2 years of additional training that focuses solely on Mohs surgery and reconstructive surgery–literally thousands of hours becoming an expert on the removal of skin cancer and reconstructive cosmetic surgery”, replies Dr. Henry.

The Mohs Fellowship Difference – The Gold Standard for Skin Cancer Removal

This is an important distinction that often goes unnoticed. There have been several published articles in the dermatology medical literature highlighting the importance of this training experience.

Unfortunately, other dermatologists try to perform Mohs surgery with either no formal postgraduate training or by doing a weekend course to try to learn the technique. These physicians are not Fellows of the American College of Mohs Surgery, and they can never be – as becoming a Fellow of the ACMS requires a 1-2 year training program that focuses on Mohs surgery and reconstructive surgery. This extensive training includes participation in at least 650 Mohs surgery cases under the supervision of an experienced ACMS-approved Mohs surgeon.

Mohs surgery fellowship training programs must pass a rigorous application and review process before being allowed to train a fellow. Once the training program is approved, it must continue to adhere to the standards set by the Mohs College. All ACMS-approved training programs are periodically re-evaluated on a 1 to 5-year basis to ensure that their academic and clinical requirements are being followed and fulfilled.

There are only around 1500 Fellowship-trained Mohs surgeons worldwide. We are fortunate in Northwest Arkansas that we have two Mohs Fellowship-trained surgeons. Dr. Lance Henry, at Advanced Dermatology & Skin Cancer Center, PLLC has treated over 16,000 skin cancers with Mohs surgery and is the most experienced skin cancer and reconstructive surgeon in NWA. Their clinic in Fayetteville, AR is the only facility of its type in the state—with a Dermatology office, full-service medical spa (Revive Medical Spa, LLC), a Mohs surgery laboratory, a pathology laboratory, and licensed and accredited Ambulatory Surgery Center for advanced reconstructive surgery.