Skin Cancer

Skin Cancer Specialist
By far the most common form of cancer, skin cancer, affects 1 out of every 5 Americans over the course of their lives. Early detection and prompt treatment greatly increase the chance for full recovery. Both Dr. David and Dr. Jordana Herschthal specialize in skin cancer treatment, making The Herschthal Practice in the Boca Raton and Fort Lauderdale area your first choice for skin cancer assessment and care.

Skin Cancer Q & A

What are the main types of skin cancer?

There are three primary types of skin cancer, each named for the skin cells affected. Melanoma is the most serious skin cancer. When untreated, melanoma can become life-threatening in as little as 6 weeks. Squamous cell carcinoma isn’t as life-threatening as melanoma, but it can cause local destruction and invasion of surrounding tissue and spread to other parts of the body when left untreated. Basal cell carcinoma is the most common and least threatening of the main skin cancer types. Typically found in sun-exposed areas, these develop slowly and may be mistaken for unhealed sores. Basal cell carcinomas can also cause local destruction and invasion of surrounding tissue. These carry a small but real risk of spreading to other parts of the body.

I have some new dark spots on my skin. How do I check for melanoma?

Round spots, darker than the surrounding skin, minor blemishes, freckles, and moles usually appear because of sun damage, age, genetics, and other environmental or chemical exposures. However, if these seem to be changing in size or color, book a visit to The Herschthal Practice as soon as possible. Starting at the age of 40, you should have an annual skin cancer screening performed by a dermatologist.

Melanoma may appear on parts of the body that aren’t normally exposed to the sun. Melanomas can be flat or textured, irregularly shaped, and they vary widely in color from pink to black. The mnemonic, “ABCDE” helps assess a spot that needs immediate medical assessment:

  •         A – The spot is asymmetrical, that is, not round
  •         B – The borders of the spot are uneven or ragged in appearance
  •         C – Unusual or uneven colors indicate potentially troubling spots
  •         D – Those spots with a diameter larger than one-quarter inch should be checked
  •         E – A spot that is evolving

Are there risk factors associated with skin cancer?

People who spent a significant amount of time outdoors, whether sunbathing, using tanning beds, or simply being active outside, have an increased risk of skin cancer. Exposure to sunlight causes most incidents of skin cancer. Family history can be a factor, but it accounts for less than 5% of skin cancer cases. People with more moles than average have a greater risk of developing melanoma. Those with light colored eyes, fair, pale white skin, often with freckles, have the greatest risk of developing skin cancer.

What treatment options are available?

For certain types of skin cancer, such as basal or squamous cell carcinoma, the doctors may perform Electrodesiccation and curettage (ED/C). The 15-minute-long procedure can be done in the comfort of the office, with just local anesthesia administered to the specific treatment area. A sharp tool, called a curette, helps scrape away thin layers of skin, followed by a light cautery. This process is repeated three times. The cure rate is around 85%.

A traditional excision may be performed on skin cancer, usually located on the body or limbs. This involves local anesthesia, removal of the skin cancer with 4-5mm borders, and then a closure with sutures. The cure rate is around 90%.

Mohs is an excision technique that involves precise removal of a skin cancer with greater control of the margins around the skin cancer. Mohs is indicated for complex skin cancers or those located in cosmetically sensitive areas such as the face, hands, feet, and genitals. Performed in the office, the procedure involves local anesthesia and removal of the skin cancer with a 1mm margin. The tissue removed is then frozen and stained in the office. The doctor will examine the slides under a microscope to see if any cancer remains. Small sections of the skin are then removed based on the presence of cancer remaining in the slides. Once the area is clear of skin cancer, the remaining defect is cosmetically closed with sutures. The cure rate is around 99%.

Other treatment options such as radiation and topical chemotherapy are also available. The best treatment plan is determined by you and the doctor.

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