In the seven years since I completed my dermatologic surgery fellowship with Harvard dept of dermatology, I have surgically removed over 10,000 skin cancers.
Because skin cancer is visible on the surface, we have the benefit of early detection that we don’t have with internal cancers. And as a result, I fortunately get to give a lot of good news, that “we got it all.” But I will never forget the tough conversations, the patients who had a delay in diagnosis or a particularly aggressive type of cancer, the ones who weren’t so lucky.
Skin cancer affects people of ALL ages so please take a look at your body once a month and look out for signs of cancer. These signs could include changing moles, skin lesions that hurt or itch, pink spots that bleed or “come and go” or scaly areas that won’t heal. Basal cell carcinoma, squamous cell carcinoma, and melanoma are the most common types and it’s a great idea to look a few pics up on google to get an idea of what they look like. If you have any family history of skin cancer or concerns about your skin, see a dermatologist for evaluation. Early detection of skin cancer is the key to survival! And the next step is the Mohs Micrographic surgery, learn more about that here.
Mohs micrographic surgery
Mohs micrographic surgery is the best way to remove many types of skin cancer with the lowest chance of the cancer coming back. After I remove the skin cancer, my histotechnologist freezes the specimen, stains the tissue, and prepares the sections on glass slides. I look at 100% of the deep and lateral margins under the microscope to see if any cancer cells are still present, and the patient waits comfortably in the office (by comfortable I mean usually listening to 60s hits, watching hgtv, eating snacks, and making friends with the other patients or chatting with my staff). If there are still cancer cells lurking on the edges I mark it out like a map and remove more skin exactly where I saw the tumor. Once I see clear edges everywhere, I repair the patient’s wound with a line of sutures, a flap, or a skin graft. I love having the opportunity to be both the surgeon and pathologist, and I especially love getting to know my patients throughout the day.