Hawaii outdoor lifestyle may lead to skin cancer - ways to treat pre-cancerous growths.
Posted on Tue, May 17, 2011
By Marné CarMichael Walsh, M.S., P-AC
I understand that there has been an increase in the rate of skin cancer cases in Hawaii. Are all growths and odd patches on the skin cancerous? What is the best way to find out if I need treatment?
Pre-cancerous growths (actinic keratoses or AK’s) occur on the skin as a result of numerous years of sun exposure and abuse. The DNA in either the squamous or basal layer of the skin is damaged by the ultra-violet radiation of the sun, resulting in abnormal growth. This initial process takes decades to start. Eventually, the normal skin markings disappear and are replaced with a dull, rougher and sometimes raised appearance. Once the pre-cancerous growths appear, they don’t usually go away unless treated. If left untreated, there is a good chance that they will continue to advance to a deeper level and turn into a skin cancer such as basal cell carcinoma or squamous cell carcinoma.
Cryosurgery
There are many methods to treat pre-cancerous growths. Depending on the number, size, and location, as well as patient preference, we customize a treatment plan for each individual patient. The most common treatment method involves the destruction of each growth with a freezing spray, usually liquid nitrogen. This method is called cryosurgery. You can expect a little stinging and redness over the treatment area and possibly a blister with this treatment. If the growths are very small, they can also be burned with electrodessication or a laser.
Other treatment methods
If a patient has numerous pre-cancerous growths within a small area, we can perform field treatment with acid peels, photodynamic therapy (PDT), or a cream such as 5-flourouracil or imiquimod. The acid peels are usually performed once a month and offer the advantage of minimal or no downtime. Patients usually peel for 1-2 days, 3-7 days after the peel. This method works best for rougher, bumpier types of pre-cancerous growths.
PDT - Photodynamic therapy
After several peels, once the rougher types are smoother, photodynamic therapy is optimized to target the flatter, smoother pre-cancerous growths at a deeper level. PDT uses aminolevulinic acid, a naturally occurring acid in our body, to target the damaged skin and chemically destroy the pre-cancerous growths. Downtime is usually 3 days and the patient must stay completely out of the sun for 48 hours following the treatment. We usually recommend three PDT treatments the first year followed by one a year thereafter for best results.
Creams
The topical creams (5-flourouracil, imiquimod), which are applied by the patient at home for 6-16 weeks at a time, also offer another effective choice for field treatment. However, compliance and weeks of irritation during the treatment make this method difficult to tolerate.
Active/DeepFX provides additional side benefits
For those patients with cosmetic concerns such as wrinkles, scars, bumps, and brown spots, Active/DeepFX laser resurfacing also destroys pre-cancerous growths as an added benefit. The downtime is 7-10 days and although this is not covered by medical insurance, the cosmetic and medical results are amazing. Other benefits include smoother, tighter, even-colored skin that is healthier and youthful.
No matter which method you feel works best for your lifestyle, they all work very well to treat pre-cancerous growths and thus prevent you from getting the two most common types of skin cancer, squamous and basal cell carcinoma.
