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Skin cancer is the most common cancer in humans, affecting 1 in 5 Americans over their lifetime, and over 1,000,000 in new cases are diagnosed in the US annually, with the state of Washington among the highest rates. Basal cell cancer is the most common skin cancer followed by squamous cell cancer, and then melanoma. Thankfully, due to slow growth and early detection, dying from skin cancer is very rare. The presence of a nodule or lesion on the eyelid that grows, bleed or ulcerates should be evaluated. This involves examination and sometimes a biopsy.
Basal cell tumors represent approximately ninety percent of skin cancers These skin cancers grow slowly over months and years. They most often appear as a pearly nodule that eventually starts to break down and ulcerate. Despite being a cancer, these tumors don't spread to distant areas but rather just continue to grow and infiltrate the surrounding tissue. They typically can be cured by simple excision followed by reconstruction of the defect left behind after the cancer removal.
These types of tumors occur much less common but are more aggressive and require more involved care to ensure complete treatment. Again, primary treatment involves removing the cancer, but care must also be taken to ensure the tumor has not spread anywhere, causing larger health problems. Your surgeon will help coordinate this as part of your treatment depending on the size and circumstances of the tumor at presentation.
Some lesions may be obviously benign (cysts and moles) and there may be no need to remove them. However, any suspicious lesion needs to be biopsied to determine if it is benign or malignant. At times, the skin cancer needs to be removed surgically by a skilled individual who can not only remove the tumor but also reconstruct the area of the face where the tumor was removed. Sometimes surgeon will do this themselves at a surgical facility with an on site pathologist who can immediately examine the specimen to ensure the whole tumor was removed. Other times, the help of a dermatologic surgeon specializing in Mohs surgical excision will be utilized. This procedure is completed into two steps, the first in the dermatologist’s office with immediate examination of the tumor to ensure its complete removal, followed by the reconstructive surgery by your surgeon.
Usually not. Most skin cancer excision and repairs can be done in the outpatient setting. A dressing will be applied to the area of reconstruction which will be removed one day after surgery. There are times, however, when the surgery for removing and or reconstructing the area after cancer removal is quite extensive. In that case, staying overnight at the hospital may be recommended. Your surgeon will give you specific instructions for post-surgical care.
Typically, an insurance company will cover a biopsy if there is a concern for a skin cancer. If your provider is confident that a lesion is benign based on the clinical examination, then there will be no need to biopsy or excise it. In these instances, the removal of the lesion would be considered cosmetic and would not be covered by insurance. However, if there is a suspicion that the tumor could be malignant, insurance will cover the cost of a biopsy, and excision if the lesion is proven to be a cancer.