Skin Cancer Prevention and Treatment Options Q&A

Q. Are there treatment options to prevent skin cancer?

A. Proper sun protection and routine self-examinations are the best prevention. A physician administered light chemical peel helps eliminate precancerous cells in those with sun-damaged skin. Physicians may also recommend prescription-strength topical treatments such as Efudex and Aldara. These treat precancerous spots (actinic keratosis), superficial basal cell carcinomas, and superficial squamous cell carcinomas. Topical treatments are usually used from three to five days a week over a one to three month period. Another topical prescription cream is Solaraze. It is a unique treatment with least amount of side effects that can help some individuals with extensive precancerous actinic keratosis.

Another treatment is photodynamic therapy. This is a light treatment that is highly effective in eliminating precancerous lesions and even early superficial skin cancers. A solution is applied to the skin two hours prior to treatment to sensitize the skin to the light. A 30-minute narrow red frequency light treatment is performed. Redness, crusting, and peeling will ensue for a week after the treatment. Physicians can also treat precancerous lesions non-surgically with liquid nitrogen in an office visit. This freezing treatment destroys the cells which then slough off in a week.

Q. I have been diagnosed with skin cancer. What are my treatment options?

A. Being evaluated at a Skin Cancer Center is recommended to determine which of the options is best for the patient. Not every skin cancer needs to be treated with an operation. Several exciting technologies are available to minimize scarring, pain, and recovery of surgery.

·         ALDARA (Imiquimod) is a topical cream that can be used for treatment of early superficial basal cell and squamous cell carcinomas.

·         SRT (superficial radiotherapy) uses a low-energy radiation beam to penetrate the top surface layer of the skin, avoiding deep tissue damage, and minimizes scarring particularly around the face. SRT provides an alternative treatment modality for basal and squamous cell carcinomas.

·         Photodynamic Therapy (PDT) although used primarily for precancerous lesion treatment, it can be effective for treatment of early superficial skin cancers as well.

·         ERIVEDGE is a skin cancer treatment breakthrough. It is a pill taken daily that can cure cancers not easily treatable with surgery.

Q. Can a spray tan protect me from skin cancer? What are effective tanning options?

A. Many sunless tanning products contain sunscreen, some even with an SPF 15. They do not provide significant protection from UV rays and are only effective for a couple hours after application. The active ingredients in a sunless spray tan solution containing SPF will have DHA (dihydroxyacetone) which is the

ingredient responsible for changing the outer layer of skin brown, and octinoxate, oxybenzone, or octyl-dimethyl-PABA which are active sun protection factors.

Sunscreen recommendations are to apply broad spectrum SPF 30 every two hours while exposed to UV rays or more frequently if in water or heavy perspiration. Compared to sun bathing or sunless tanning beds with UV lighting, sunless spray tanning or self-tanning lotions are the most effective option in that you are not exposing your skin to direct UV rays, however because most available solutions do not contain SPF or only contain minimal amounts that are not significant at protecting, daily sunscreen application and reapplication is the best defense for sun protection.

Q. Which moles should I worry about or have checked by a doctor?

A. Changing moles should be most worrisome. Odd mole shape, border, color, or size bigger than a pencil eraser should prompt a physician evaluation. Family history of skin cancers and melanoma are good reasons to have a doctor examine your skin.

Q. How will my past sunburns and UV ray exposures increase my chances of developing skin cancer?

A. Skin cancer occurs on average 15 years after skin damage by UV. However, skin cancer can occur as early as five years after exposure to as late as 30.

Dr. Madorsky is the medical director of the Skin Cancer and Reconstructive Surgery Center and specializes in high risk skin cancers and complex reconstructions utilizing innovative techniques. He has over 20 years of experience in Facial Plastic and Reconstructive Surgery and is double board certified in Otolaryngology - Head and Neck Surgery and Facial Plastic and Reconstructive Surgery.