Mandan News

Talking about cancer

Concerning Your Health
By Dr. Richelle Knudson

What does skin cancer look like?
There are various forms of skin cancer. Almost all skin cancers, with the exceptions of some melanoma cancers, are evident on the skin’s exterior and can occur anywhere on the body. Become familiar with what is normal for your skin and look for changes in size, shape or color. Scrutinize new moles, and changes in existing moles. If they have irregular shapes and/or blue or blackish coloring, they may be a concern. If you see any changes in your skin any place on your body, such as spots with irregular borders or different colors, lumps or areas that feel hard, swollen and/or itchy, or areas with unexplained bleeding – make an appointment with your primary care doctor or a dermatologist.

How is skin cancer determined?
Your doctor will examine the suspicious spot. If there is indication of skin cancer, your doctor will do a biopsy, which is removal of a small portion of the affected skin and surrounding tissue. This tissue will be sent to a laboratory for analysis. If the biopsy report confirms cancer cells, treatment will be recommended. Treatment will include surgically removing the cancerous tissue and may also include other types of treatment, depending on the type of cancer and whether or not there is spread.

What should I know about having skin cancer surgery?
Request a dermatologist trained in Mohs surgery, which has a high cure rate. All dermatologists are qualified to do skin cancer surgery but to perform Mohs surgery, a dermatologist must have completed additional medical training. With Mohs surgery, the surgeon removes the visible skin cancer, then begins removing cancer cells one skin layer at a time. The surgeon removes and examines the tissue specimen at each layer. If there are still remaining cancer cells, this layer-by-layer removal continues until there are no longer any tissue specimens with cancer cells. Mohs surgery is very effective because each skin layer is evaluated for cancer cells and 100 percent of the margin is evaluated under the microscope, eliminating the possibility of some cancer tissue remaining in the margin areas around the original cancer. Mohs surgery is the only type of skin surgery where 100 percent of the surgical margin is evaluated the day of surgery while the patient is waiting. A Mohs surgeon completes extensive training in facial reconstruction, and after the skin cancer is completely removed, the defect is reconstructed that day.

Can skin cancer be cured easily?
Skin cancers are very curable and treatable with surgery. Treatment is most effective when caught in early stages. That is particularly true for melanoma, the most serious skin cancer which can become deadly when it has advanced to the point where cancer has spread throughout the body. So it’s important that you know what is normal for your skin, watch for changes and call your doctor promptly if you see skin changes.

Richelle Knudson, M.D., a dermatologist at Sanford North Clinic in Bismarck, specializes in dermatologic surgery, including Mohs micrographic surgery, cutaneous reconstructive surgery and laser surgery. She completed undergraduate and medical degrees at the University of North Dakota and UND School of Medicine, Grand Forks, and an internship at UND School of Medicine in Fargo. She also completed a residency in dermatology and a fellowship in dermatologic surgery at Mayo School of Graduate Medical Education, Rochester, Minnesota.