Skin cancer is the most common form of cancer in the United States.
New treatments for skin cancer have been evolving rapidly in recent years.
Today, a surgical technique called “Mohs surgery” has come to be accepted as the single most effective technique for removing Basal Cell Carcinoma and Squamous Cell Carcinoma, the two most common skin cancers.
Moh’s surgery saves healthy skin, while removing cancerous cells effectively.
Tune into SMG Radio to hear SMG’s Dr. Hari Nadiminti discuss Mohs surgery and skin cancer.
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Mohs Surgery: The Latest Technique for Skin Cancer
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Learn more about Dr. Hari Nadiminti
Hari Nadiminti, MD
Dr. Hari Nadiminti is a board-certified dermatologist and micrographic surgeon with expertise in diagnosing and treating skin cancer and benign growths. His expertise includes scar revision.Learn more about Dr. Hari Nadiminti
Transcription:
Mohs Surgery: The Latest Technique for Skin Cancer
Melanie Cole (Host): Skin cancer's the most common form of cancer in the United States. New treatments for skin cancer have been evolving rapidly in recent years and today, a surgical technique called the MOHS Surgery has come to be accepted as the single most effective technique for removing basal-cell carcinoma and squamous cell carcinoma. My guest today is Dr. Hari Nadiminti. He's the Chairman of Medical Subspecialties in the Department of Dermatology at Summit Medical Group. Welcome to the show. Dr. Nadiminti, tell us a little bit about skin cancer. What are you seeing going on today?
Dr. Hari Nadiminti (Guest): Thanks, Melanie. Thanks for having me. In the United States today, there's a skin cancer epidemic. Over 5 million cases of skin cancers will be diagnosed this year alone within three million people. There's more skin cancer today than breast, prostate, lung and colon cancer combined. One in five Americans will develop skin cancer in their lifetime. So, it's a very important problem and I'm glad we're addressing it today.
Melanie: So, who's at risk for skin cancer? I have dark skin, so I always feel I'm a little safer but that's not true, is it?
Dr. Nadiminti: That's not true. Everyone's at risk. Obviously, what you're saying is true that the fairer the skin that you have, the more at risk you are. Everyone's at risk and it's important that everyone treat their skin carefully and get examined very closely by themselves or, if there's any questions, have a doctor take a look and it's important that if there's any question, that you see a trained professional like a dermatologist.
Melanie: Dr. Nadiminti, where do you want people to examine their skin the most? Do you want us looking at our faces, our trunk and torso? Where are you seeing it the most that we should pay close attention?
Dr. Nadiminti: The whole body. It's important to look from head to toe as best you can and there are great resources through the Skin Cancer Foundation and the American Academy of Dermatology that basically have nice instructions to look at your skin from head to toe and they have nice maps that you can print out. Basically, if there's any question, you can put a little “x” where you think there may be a questionable mole or questionable lesion and bring that in to your doctor and have them examine that particular mole as well as a total body skin exam.
Melanie: What are we looking for? And, before we get into some treatments, what is it you want people to notice about moles and spots that are on their skin?
Dr. Nadiminti: Definitely. Again, it's very important that this issue comes to fruition because 40-50% of Americans, who live to 65, will develop a skin cancer. There are three major types of skin cancer. The most common type is something called a “basal cell carcinoma”. There are close to 3 million of those annually in the United States alone and those are most common in sun-exposed areas such as the head and neck, scalp, arms, legs, but they are also common in non-exposed areas like the trunk. The most important thing to look for is something new that doesn't quite go away like a normal pimple. They're typically shiny in appearance. They're classically describes as a pearly dome-shaped lesion, especially on the face. They often, if left untreated, continue to grow and to bleed or ulcerate. Sometimes, they appear more flat as spread patches. But, anything out of the ordinary that doesn't quite go away should be brought to a doctor's attention. The second most common type of skin cancer is a squamous cell carcinoma. That's typically more scaly and thicker lesions and they can hurt or be tender. Those are more common on sun-exposed areas such as the head and neck, arms and legs. Again, if there's any lesion that continues to persist, that doesn't go away after a month, it should be brought to a professional's attention. The third most common skin cancer is melanoma, which is the most deadly type. There's 76,000 invasive melanomas that will be diagnosed this year and, unfortunately, 10,000 people will die from melanoma this year. So that adds up to about one person dying from melanoma every hour. It happens to be the most common cancer in adults aged 25-29 and the second most common cancer from ages 15-29.
Melanie: Wow.
Dr. Nadiminti: The most important thing here…Yeah, it's striking.
Melanie: It's striking.
Dr. Nadiminti: Striking. The most important thing here is if melanoma is detected early, it has a 98% cure rate--98% cure rate. But if it's detected late, it has a much poorer prognosis. If it is detected when it has spread to other parts of your body there’s a 17% cure rate. So, the cure rate goes down dramatically. That's why we're so focused on trying to get people in and trying to get people where this skin cancer epidemic that's going on.
Melanie: So, if somebody notices these things, they get into a dermatologist and you do determine it's skin cancer, as we look at the treatments--and we're talking today, Dr. Nadiminti, about MOHS Surgery. Tell people what that is because they worry, especially if the skin cancer's on their face that they're going to have scars. I mean, vanity plays a huge part in resistance to getting these things taken care.
Dr. Nadiminti: Absolutely. That's a great. I'm glad you brought up that point. So, it's important to have it first diagnosed. So, the first step is to see a professional. If they are suspicious of the lesion, they would biopsy it. So, that's a small procedure that's relatively straightforward. You put a little local anesthetic in and take a small, representative piece of the lesion and send it out to the lab. Usually, within a week, we can get the results of that lab test. If it is confirmed that it's a skin cancer and the most common types are the basal and squamous cell skin cancer. The best way to treat that now is this procedure called MOHS Surgery. The great thing about MOHS surgery is it has the best of both worlds. It can give you the highest cure rate but also take the least amount of normal skin. Basically, the way it works is, we try and map out the skin cancer as precisely as possible. So, by mapping it out, we just take what we need and leave behind as much normal skin as possible. By doing it this way, we get the highest cure rate and we take the least amount of skin necessary, thereby leaving you the smallest scar. You're right--because a lot of these skin cancers are on the face or on cosmetically sensitive areas, it's important to take that into account while treating these and the MOHS micrographic surgery technique is an elegant way of doing this.
Melanie: So then, tell us, doctor, is this more expensive than other types of skin cancer treatment? Is there any difference for the patient except for the better part that it doesn't leave quite the same scar?
Dr. Nadiminti: It's the most cost-effective way of treating skin cancers on the head and neck. There are a lot of studies that show that. The beauty of the technique is the surgeon also acts as the pathologist and also commonly acts as the person reconstructing the area and has expertise in all those areas. So, by combining all those fields of expertise into one specialty, we often get the most cost-effective way of treating this skin cancer.
Melanie: Does it take longer? Is there any kind of time frame and what about recovery? Do you have to sit and wait until you've checked it out first and made sure? I mean is that how the procedure works? Give us a little bit of that.
Dr. Nadiminti: Absolutely. So, the way the procedure works is once a patient has been diagnosed with skin cancer, if it is an area that's indicated for MOHS, like the head and neck, they're referred to a MOHS surgeon like myself. We, obviously, go through the technique with the patient and this is the way it works: basically, we identify the area with the patient and show them exactly how much we think we might have to take out. Then, we clean the area with a surgical prep and put a local anesthetic in the area called Lidocaine, and take a small area around what we've seen and bring it to our lab and process that tissue. During that time, the patient can comfortably wait in the exam room or in the waiting room with a small bandage over the area. During that time, we're in the lab processing the tissue. We freeze the tissue and stain it. By doing that, we can highlight the tissue and see basically the areas of problem and see where the skin cancer is. This is the process of mapping it out. By mapping it out, we're able to tell if there is any remaining and if there is, we know exactly where it is. That process takes about 45 minutes. If we have to take more, then we bring the patient back to the exam room, take a little bit more of the area that's affected, and bring it back to the lab and repeat that process. On average, we go back once or twice and the total amount of time is usually about 2-3 hours. But most of that time is waiting for the lab to work on the tissue. So, most of the time, the patient is comfortably waiting, reading or just relaxing. It is a more time-consuming technique but it is nice to know within the same day you come in with the skin cancer and you leave without it.
Melanie: That is absolutely fascinating. Thank you so much. In just the last few minutes, Dr. Nadiminti, give your best advice for people on skin cancer and why they should come to Summit Medical Group for their care.
Dr. Nadiminti: Skin cancer is an epidemic. There's no doubt about it. The incidents are rising rapidly. There are a lot of reasons for that but a lot of it can be prevented and can be treated. There's no reason to be afraid to go to see your doctor. There's no reason not to be checked out because oftentimes, if we catch it early, we can treat it. This can be life-saving, because just last week, I found a melanoma in a young patient and if she didn't come in, and if she came in a few years later, she may not be in such a good situation as she is today. There's no doubt, check your skin, get examined, and if you do get diagnosed with a skin cancer, know that if it's caught early, it can be treated. At Summit Medical Group, we're blessed to have 12 excellent dermatologists with probably the best training locally, you know, from Harvard, Penn--all the best programs in the country--and we have a really great group of dermatologists and they're very skilled at diagnosing and treating skin cancer. The integrated care that we have at Summit Medical Group really highlights the ability for the patients to not only be diagnosed, but treated, and followed. So, we can do the whole thing here and take excellent care of you.
Melanie: Thank you so much. What great information. You're listening to SMG Radio and for more information, you can go to SummitMedicalGroup.com. That's SummitMedicalGroup.com. This is Melanie Cole. Thank you so much for listening.
Mohs Surgery: The Latest Technique for Skin Cancer
Melanie Cole (Host): Skin cancer's the most common form of cancer in the United States. New treatments for skin cancer have been evolving rapidly in recent years and today, a surgical technique called the MOHS Surgery has come to be accepted as the single most effective technique for removing basal-cell carcinoma and squamous cell carcinoma. My guest today is Dr. Hari Nadiminti. He's the Chairman of Medical Subspecialties in the Department of Dermatology at Summit Medical Group. Welcome to the show. Dr. Nadiminti, tell us a little bit about skin cancer. What are you seeing going on today?
Dr. Hari Nadiminti (Guest): Thanks, Melanie. Thanks for having me. In the United States today, there's a skin cancer epidemic. Over 5 million cases of skin cancers will be diagnosed this year alone within three million people. There's more skin cancer today than breast, prostate, lung and colon cancer combined. One in five Americans will develop skin cancer in their lifetime. So, it's a very important problem and I'm glad we're addressing it today.
Melanie: So, who's at risk for skin cancer? I have dark skin, so I always feel I'm a little safer but that's not true, is it?
Dr. Nadiminti: That's not true. Everyone's at risk. Obviously, what you're saying is true that the fairer the skin that you have, the more at risk you are. Everyone's at risk and it's important that everyone treat their skin carefully and get examined very closely by themselves or, if there's any questions, have a doctor take a look and it's important that if there's any question, that you see a trained professional like a dermatologist.
Melanie: Dr. Nadiminti, where do you want people to examine their skin the most? Do you want us looking at our faces, our trunk and torso? Where are you seeing it the most that we should pay close attention?
Dr. Nadiminti: The whole body. It's important to look from head to toe as best you can and there are great resources through the Skin Cancer Foundation and the American Academy of Dermatology that basically have nice instructions to look at your skin from head to toe and they have nice maps that you can print out. Basically, if there's any question, you can put a little “x” where you think there may be a questionable mole or questionable lesion and bring that in to your doctor and have them examine that particular mole as well as a total body skin exam.
Melanie: What are we looking for? And, before we get into some treatments, what is it you want people to notice about moles and spots that are on their skin?
Dr. Nadiminti: Definitely. Again, it's very important that this issue comes to fruition because 40-50% of Americans, who live to 65, will develop a skin cancer. There are three major types of skin cancer. The most common type is something called a “basal cell carcinoma”. There are close to 3 million of those annually in the United States alone and those are most common in sun-exposed areas such as the head and neck, scalp, arms, legs, but they are also common in non-exposed areas like the trunk. The most important thing to look for is something new that doesn't quite go away like a normal pimple. They're typically shiny in appearance. They're classically describes as a pearly dome-shaped lesion, especially on the face. They often, if left untreated, continue to grow and to bleed or ulcerate. Sometimes, they appear more flat as spread patches. But, anything out of the ordinary that doesn't quite go away should be brought to a doctor's attention. The second most common type of skin cancer is a squamous cell carcinoma. That's typically more scaly and thicker lesions and they can hurt or be tender. Those are more common on sun-exposed areas such as the head and neck, arms and legs. Again, if there's any lesion that continues to persist, that doesn't go away after a month, it should be brought to a professional's attention. The third most common skin cancer is melanoma, which is the most deadly type. There's 76,000 invasive melanomas that will be diagnosed this year and, unfortunately, 10,000 people will die from melanoma this year. So that adds up to about one person dying from melanoma every hour. It happens to be the most common cancer in adults aged 25-29 and the second most common cancer from ages 15-29.
Melanie: Wow.
Dr. Nadiminti: The most important thing here…Yeah, it's striking.
Melanie: It's striking.
Dr. Nadiminti: Striking. The most important thing here is if melanoma is detected early, it has a 98% cure rate--98% cure rate. But if it's detected late, it has a much poorer prognosis. If it is detected when it has spread to other parts of your body there’s a 17% cure rate. So, the cure rate goes down dramatically. That's why we're so focused on trying to get people in and trying to get people where this skin cancer epidemic that's going on.
Melanie: So, if somebody notices these things, they get into a dermatologist and you do determine it's skin cancer, as we look at the treatments--and we're talking today, Dr. Nadiminti, about MOHS Surgery. Tell people what that is because they worry, especially if the skin cancer's on their face that they're going to have scars. I mean, vanity plays a huge part in resistance to getting these things taken care.
Dr. Nadiminti: Absolutely. That's a great. I'm glad you brought up that point. So, it's important to have it first diagnosed. So, the first step is to see a professional. If they are suspicious of the lesion, they would biopsy it. So, that's a small procedure that's relatively straightforward. You put a little local anesthetic in and take a small, representative piece of the lesion and send it out to the lab. Usually, within a week, we can get the results of that lab test. If it is confirmed that it's a skin cancer and the most common types are the basal and squamous cell skin cancer. The best way to treat that now is this procedure called MOHS Surgery. The great thing about MOHS surgery is it has the best of both worlds. It can give you the highest cure rate but also take the least amount of normal skin. Basically, the way it works is, we try and map out the skin cancer as precisely as possible. So, by mapping it out, we just take what we need and leave behind as much normal skin as possible. By doing it this way, we get the highest cure rate and we take the least amount of skin necessary, thereby leaving you the smallest scar. You're right--because a lot of these skin cancers are on the face or on cosmetically sensitive areas, it's important to take that into account while treating these and the MOHS micrographic surgery technique is an elegant way of doing this.
Melanie: So then, tell us, doctor, is this more expensive than other types of skin cancer treatment? Is there any difference for the patient except for the better part that it doesn't leave quite the same scar?
Dr. Nadiminti: It's the most cost-effective way of treating skin cancers on the head and neck. There are a lot of studies that show that. The beauty of the technique is the surgeon also acts as the pathologist and also commonly acts as the person reconstructing the area and has expertise in all those areas. So, by combining all those fields of expertise into one specialty, we often get the most cost-effective way of treating this skin cancer.
Melanie: Does it take longer? Is there any kind of time frame and what about recovery? Do you have to sit and wait until you've checked it out first and made sure? I mean is that how the procedure works? Give us a little bit of that.
Dr. Nadiminti: Absolutely. So, the way the procedure works is once a patient has been diagnosed with skin cancer, if it is an area that's indicated for MOHS, like the head and neck, they're referred to a MOHS surgeon like myself. We, obviously, go through the technique with the patient and this is the way it works: basically, we identify the area with the patient and show them exactly how much we think we might have to take out. Then, we clean the area with a surgical prep and put a local anesthetic in the area called Lidocaine, and take a small area around what we've seen and bring it to our lab and process that tissue. During that time, the patient can comfortably wait in the exam room or in the waiting room with a small bandage over the area. During that time, we're in the lab processing the tissue. We freeze the tissue and stain it. By doing that, we can highlight the tissue and see basically the areas of problem and see where the skin cancer is. This is the process of mapping it out. By mapping it out, we're able to tell if there is any remaining and if there is, we know exactly where it is. That process takes about 45 minutes. If we have to take more, then we bring the patient back to the exam room, take a little bit more of the area that's affected, and bring it back to the lab and repeat that process. On average, we go back once or twice and the total amount of time is usually about 2-3 hours. But most of that time is waiting for the lab to work on the tissue. So, most of the time, the patient is comfortably waiting, reading or just relaxing. It is a more time-consuming technique but it is nice to know within the same day you come in with the skin cancer and you leave without it.
Melanie: That is absolutely fascinating. Thank you so much. In just the last few minutes, Dr. Nadiminti, give your best advice for people on skin cancer and why they should come to Summit Medical Group for their care.
Dr. Nadiminti: Skin cancer is an epidemic. There's no doubt about it. The incidents are rising rapidly. There are a lot of reasons for that but a lot of it can be prevented and can be treated. There's no reason to be afraid to go to see your doctor. There's no reason not to be checked out because oftentimes, if we catch it early, we can treat it. This can be life-saving, because just last week, I found a melanoma in a young patient and if she didn't come in, and if she came in a few years later, she may not be in such a good situation as she is today. There's no doubt, check your skin, get examined, and if you do get diagnosed with a skin cancer, know that if it's caught early, it can be treated. At Summit Medical Group, we're blessed to have 12 excellent dermatologists with probably the best training locally, you know, from Harvard, Penn--all the best programs in the country--and we have a really great group of dermatologists and they're very skilled at diagnosing and treating skin cancer. The integrated care that we have at Summit Medical Group really highlights the ability for the patients to not only be diagnosed, but treated, and followed. So, we can do the whole thing here and take excellent care of you.
Melanie: Thank you so much. What great information. You're listening to SMG Radio and for more information, you can go to SummitMedicalGroup.com. That's SummitMedicalGroup.com. This is Melanie Cole. Thank you so much for listening.