Skin Cancers
Dr. Wittenborn treats all types of skin lesions. This includes benign non-cancerous skin lesions as well as precancerous and known skin cancers. Many precancerous lesions as well as skin cancers are caused by sun exposure. It is thought that sun burns during your childhood change the skin cells at the level of their DNA. Once the cells have been changed or initiated, repeated sun exposure then promotes the development of the skin cancers. The body has an ability to fight off skin cancers through its immune system. As people age their immune sytems work less efficiently and older people develop more skin cancers. The use of a sun block that protects against both UVA and UVB rays is important at any age to help prevent the development of skin cancers. The argument that the damage has already occured is not valid here, and everyone benefits from protection
Basal Cell Cancer
This is a very common type of skin cancer that is usually slow growing There is very little risk of spreading anywhere other than enlarging. Treatment consists mainly of surgical excision or freezing
Actinic Keratosis
These are red scaling patches that come and go and never completely go away. They have a 15% chance of developing into a squamous cell cancer. They can be treated with Efudex, Photodynamic therapy or curretage
Squamous Cell Cancer In Situ
Progression of an actinic keratosis. This is an early cancer that has not invaded deeper into the skin layers. This is treated with curretage, surgical excision if persist or recurrent
Squamous Cell Cancer
These are caused by sun exposure, and can arise out of actinic keratoses, or warts. They can spread if left untreated, however need to be present for long periods before doing so. They usually need surgical excision with normal margin of tissue or radiation therapy.
Dysplastic Nevus
These are moles that have changed. This can be the beginning of a mole turning into a skin cancer. The changes that are seen are usually a mole which has darkened or has variable color. These should be removed and sent for pathologic evaluation
Melanoma In situ
This is an early melanoma, and can be the progression of a dysplastic nevus. These need to be removed surgically with a normal surrounding tissue margin usually 0.5 - 1 cm. Surgical excision is usually all that is necessary
Melanoma
This is an aggressive skin cancer that needs aggressive prompt treament. Melanoma is graded on its depth into the skin. This gives information about how aggressive it may be. Melanoma can spread to lymph glands, or to any other part of the body. The deeper the melanoma, the more likely it has spread. Surgical excision of melanoma is the mainstay of treatment with tissue margins around the area from 1cm -3 cm depending on the depth. Radiation is usually only used for palliative care in advanced cases. Immunotherapy has been under investigation for many years, and is used in clinical trials.For more information please go to National Cancer Institute http://www.cancer.gov/"