“I appreciate how friendly the staff is as well as Dr. Piasecki.  They have early morning appointments and run on time!”

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Skin Cancer Treatment

There are many different treatments available for skin cancer.  Each treatment has pluses and minuses in terms of invasiveness, recovery time and cure rates.  

Aldara

Aldara is a topical cream that is FDA-approved for specific types of BCC cancers in non-cosmetically sensitive areas. Best for small, shallow basal cell cancers on the trunk, arms or legs

Benefits

  • Non-surgical

Challenges

  • Only approved for a few cancers and locations
  • Lowest cure rate, with an 83% clearance
  • Treatment course is 6 weeks, as skin slowly sloughs off
  • Unclear if cancer is fully treated

E, D & C (Burning and scraping)

This treatment involves burning, then scraping the wound base. Best for small cancers in non-facial, non-cosmetically sensitive locations

Benefits

  • Quick, without stitches

Challenges

  • Scarring
  • Unclear if cancer is fully treated

Liquid Nitrogen

Best for small cancers in non-facial, non-cosmetically sensitive locations

Benefits

  • Non-surgical
  • Quick

Challenges

  • Scarring
  • Unclear if cancer is fully treated

Radiation

Multiple daily treatments for 4-6 weeks as the cancer is exposed to radiation. Best for patients who are not surgical candidates.

Benefits

  • Non-surgical

Challenges

  • Unclear if cancer is fully treated
  • Tissue is permanently affected by radiation

Simple excision with wide margins

Cutting out the cancer with a wide enough margin that, statistically, all the cancer is gone. Best for small, well-defined cancers in less cosmetically sensitive areas where there is tissue excess.

Benefits

  • Can be done by a dermatologist or a plastic surgeon
  • Some margin information achieved

Challenges

  • Only 4% of margins evaluated
  • Leaves a large defect

Mohs micrographic surgery

Thin layers of tissue are systematically excised and examined under a microscope for malignant cells.  When all areas of tissue are tumor-free, surgery is complete. Best for good surgical candidates with BCC or SCC of the face.

Benefits

  • Highest cure rate
  • Best tissue preservation

Challenges

  • Not every patient is a good surgical candidate
  • Mohs doctors are often not board-certified surgeons and therefore for some defects, patients need a referral to a plastic surgeon for reconstruction following Mohs surgery

Plastic Micrographic Surgery

Dr. Piasecki pioneered Plastic Micrographic Surgery.  It is Mohs excision, followed by functional and cosmetic reconstruction performed by one doctor fellowship-trained in Mohs surgery and board-certified in plastic and reconstructive surgery and facial plastic surgery. Best for surgical candidates with BCC or SCC in cosmetically sensitive areas (facial).

Benefits

  • Cure rate same as Mohs
  • Pre-operative visit is performed by plastic surgeon prior to removing any tissue
  • Excision and reconstruction are done in the same visit
  • Most convenient treatment
  • Most cost effective treatment
  • Gold standard cosmetic results
  • Can be combined with cosmetic surgery

Challenges

  • Not every patient is a good surgical candidate
  • Some reconstructions can have lengthy recovery processes

Click here for more information on Plastic Micrographic Surgery.