The biopsy area appears to have healed. Do I still need surgery?
Yes, skin cancers are like a weed in the way they grow. They often have roots that can extend in different directions. Just like when you pull a weed from your flower bed and don't get the roots, it comes back. The skin can appear to heal at a biopsy site, but the overwhelming odds are that roots remain. If the roots are left it can grow unnoticed for some time and be much larger when it is rediscovered.
What caused my skin cancer?
The overwhelming majority of skin cancers are caused by chronic sun exposure. Much of the damage probably comes from your childhood and teenage years. It just takes time to show up.
Will my skin cancer go to other areas of my body?
For most people the answer is no. Skin cancers are generally broken down into non-melanoma and melanoma skin cancers. Non-melanoma skin cancers are not related to melanoma and do not turn into melanoma. The two most common types of non-melanoma skin cancer are basal cell carcinoma and squamous cell carcinoma. Basal cell carcinomas are the most common and very rarely travel to other parts of the body. However, in extremely rare cases basal cell carcinoma can travel if left untreated for a number of years. Squamous cell carcinomas are also very common and are more likely to travel to other parts of the body. Approximately 5% of squamous cell carcinomas will travel to other parts of the body. Certain factors make this much more likely and will be evaluated by Dr. Keane at your appointment. Melanoma skin cancers are also fairly common. They also can travel to other parts of the body, but ones that are still in the skin (in situ) and thin ones (<1.0mm) are much less likely to travel.
Will I get another skin cancer?
Once you have a skin cancer you are much more likely than the average person to get another skin cancer. Approximately 30% of people who have a skin cancer will develop a new one within three years.
Will I have a scar?
Yes, scarring is the body's natural way of healing. Scars will vary depending on the person and area of the body. Dr. Keane is highly trained in minimizing scars with the reconstruction. However, this only accounts for part of the final cosmetic result. The remaining factors include the post-operative care, scar refinement techniques and genetics. Dr. Keane is also an expert in scar refinement techniques and will recommend these on a case by case basis.
Will I have pain after my surgery?
The vast majority of patients have minimal discomfort the evening following the procedure. We recommend Tylenol as a treatment for this level of discomfort. Ibuprofen and related products(Aleve, Advil, naproxen, Motrin, etc) are discouraged as they can increase the chances of bleeding in the first 48 hours. Patients that undergo more complex surgery will be given an appropriate prescription medication for additional pain control.
When can I exercise and return to work?
There is no single answer to this question. This is affected by the size and location of the skin cancer along with the type of reconstruction used. As a general rule, most people are able to return to work within 1-3 days. Specific instructions on returning to work and exercising will be given at the completion of your appointment.
Will I need to come back?
Through the use of advanced techniques, most patients will not need a follow up visit for their surgery. Patients who undergo more advanced reconstruction will need to return for follow up visits depending on the repair used. You will need to follow with your referring doctor for skin checks on a regular basis.
What can I do to protect myself from developing more skin cancer?
Minimize the amount of sun that comes in contact with your skin. Wear a good sunscreen that is at least a 30 SPF. Also, wear protective clothing and use the shade to your advantage. Hats and Caps DO NOT replace the need for sunscreen on your face. The sun is most intense from 10:00am to 4:00pm so any outdoor activity should be planned before or after this time. As already mentioned, this will not reverse the damage that has been done, but it will minimize further damage. Your referring doctor can also recommend various methods of treating pre-cancers so they do not turn into skin cancers. Take vitamin D by mouth to ensure adequate levels. This has been shown to be more effective and reliable than raising levels through sun exposure.