MALIGNANT TUMORS AND THE PLASTIC SURGEON
Malignant skin lesions (melanoma etc.) comprise a major sector of plastic surgery. The removal of skin tumors and the restoration of the area from which they have been removed from, are an exclusive task of plastic surgery.
Sadly, many patients only approach a plastic surgeon after the lesion has been removed by a doctor of a different specialty; they then request that the deficit left by the tumor’s removal be restored. This deficit will in most cases not have ‘closed’ correctly, resulting in functional irregularities in that area. For this reason, a plastic surgeon must be addressed from the get-go when dealing with skin tumors, regardless of their nature. Only such a practitioner has the knowledge to make a diagnosis, remove the lesion, and restore the area.
DIAGNOSING MALIGNANT SKIN TUMORS IN GOOD TIME
We must stress in particular that the most important factor in combating skin cancer is an accurate diagnosis made in time. This, after all, is the case with any type of cancer. Even the most malignant of tumors, if detected at an early stage, can be healed to a very great degree.
For example, even melanoma, the most malignant type of skin cancer, if addressed at a very early stage, can be completely cured. In contrast, if left unchecked even for a few months, it will develop to a very sad outcome for the patient.
Even basal cell carcinoma, a lesion of exceptionally low malignancy, if left unchecked for years on end without treatment, can cause serious health problems.
WHEN TO REMOVE NEVI
A plastic surgeon possesses the required knowledge and experience to estimate which lesions are suspect of malignancy, even at a glance. Of course, the final confirmation is made after the lesion’s removal and the biopsy.
A very mistaken belief is held in Greece which dictates that skin lesions should not be removed, as they may develop into something malignant. This is a very outdated theory, entirely lacking in scientific confirmation, which became widespread during the 19th century and has endured until today through words of mouth. This belief has caused several problems for the Greek population, leading many people to only seek out a doctor when it is much too late. We must emphasize that when there is the slightest suspicion of a lesion developing into a malignancy, the patient should approach a plastic surgeon forthwith, who will then determine whether the lesion must be removed or not.
When the lesion is at an early stage, its removal is very simple. It is performed using localized anaesthesia at the clinic, and is not taxing on the patient at all. In contrast, negligence can lead to several repetitious operations, and on several occasions can even result in the loss of the patient’s life.
Each patient should at least suspect that a mole may be developing into a malignancy when its appearance alters. This alteration may be in terms of color, shape or size. In addition, lesions which frequently experience injury (due to shaving or chafing from belts, clothing, necklaces etc.) should be removed regardless of alterations or a lack of them, as should lesions on the palms or soles of the feet.
The belief that moles should be left alone, independently from their evolution, stems from our ancestors’ conviction and has no place in modern medical practice.
The main factors which may cause skin cancer are exposition to the sun, frequent injuries around the same area, a family history of malignancies, genetic predisposition, the presence of several nevi, etc.
The best precaution one can take is to avoid exposure to the sun. The sun contains ultraviolet rays, which are very damaging to the skin. Ultraviolet does not only increase the possibility of skin cancer developing; at the same time, it destroys the skin’s elasticity and makes it appear much more aged (photoaging).
Over the last few decades, the destruction of the atmospheric ozone layer has resulted in an increase in ultraviolet radiation. This is the main factor for the rapid increase in incidents of skin cancer throughout the world in recent years. Ultraviolet radiation is also employed in tanning lamps (solariums), which are just as damaging for the skin as sunlight.
Damage caused by the sun to the skin accumulates throughout a person’s life. This means that even damage acquired during the childhood years may become apparent later in life. In addition, exposition to the sun should never be sudden. This can happen to people who work at office jobs and attempt to acquire a tan during their limited holidays. This is very damaging for the skin.
TYPES OF SKIN CANCER
The most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma. These three types of skin cancer comprise the majority of malignant skin lesions.
1. BASAL CELL CARCINOMA:
These are lesions of very low malignancy, as they do not undergo metastasis. For this reason, until recently they were not even considered malignant. They mainly appear on the face, or other areas that are frequently exposed to the sun and develop very slowly. As with any lesion, the earlier they are removed, the easier the removal will be. They appear similar to wounds that will not close, but, rather are growing wider at a very slow rate. Their removal entails a permanent recovery.
2. SQUAMOUS CELL CARCINOMA:
These appear as tumorous wounds, usually around the lips and mouth, but can actually be located anywhere on the face and body. When diagnosed at an early stage, their removal entails a permanent recovery. At later stages, however, they can cause many problems.
These have a high degree of malignancy and usually appear as a black, flat mole, which spread over the course of a few months. In some cases, a melanoma may not be flat or black, but rather exhibit a different color. If the diagnosis is made early enough, their removal may entail a permanent recovery. Neglecting to have a melanoma removed, even for only a few months, may have fatal consequences.
A thorough briefing and awareness are essential to preventing and correctly healing skin tumors. A patient should never be fully complacent, nor should they be overly anxious. If we were all to follow a few simple rules and seek out our doctors every time we feel unsure about a lesion, finding a solution for skin cancer could be much easier.