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Is Surgery Necessary For Basal Cell Carcinoma

What Are Military Burn Pits

Basal Cell Carcinoma – Surgery

Military burn pits are large areas of land where the military and its contractors incinerated waste. Following 9/11, the United States military used burn pits as part of its waste disposal protocol in places such as Iraq and Afghanistan. The practice was effective in reducing large quantities of waste, but the pits emitted plumes of toxic smoke. The following materials have been linked to military burn pits:

  • Human waste
  • Petroleum

What Happens During Mohs Surgery

The procedure is done in stages, all in one visit, while the patient waits between each stage. After removing a layer of tissue, the surgeon examines it under a microscope in an on-site lab. If any cancer cells remain, the surgeon knows the exact area where they are and removes another layer of tissue from that precise location, while sparing as much healthy tissue as possible. The doctor repeats this process until no cancer cells remain.

Step 1: Examination and prep

Depending on the location of your skin cancer, you may be able to wear your street clothes, or you may need to put on a hospital gown. The Mohs surgeon examines the spot where you had your biopsy and may mark it with a pen for reference. The doctor positions you for best access, which may mean sitting up or lying down. A surgical drape is placed over the area. If your skin cancer is on your face, that may mean you cant see whats happening, but the doctor talks you through it. The surgeon then injects a local anesthesia, which numbs the area completely. You stay awake throughout the procedure.

Step 2: Top layer removal

Using a scalpel, the surgeon removes a thin layer of visible cancerous tissue. Some skin cancers may be the tip of the iceberg, meaning they have roots or extensions that arent visible from the surface. The lab analysis, which comes next, will determine that. Your wound is bandaged temporarily and you can relax while the lab work begins.

Step 3: Lab analysis

Step 4: Microscopic examination

Advantages Of Mohs Surgery

Mohs is an efficient, cost-effective treatment, done on an outpatient basis that usually only requires a single visit. The surgeon uses local anesthesia and an on-site lab.

The surgery results are precise. The physician examines 100 percent of tumor margins, while sparing healthy tissue and leaving the smallest scar possible.

Mohs offers the highest skin cancer cure rate: up to 99 percent for a skin cancer that has not been treated before, and up to 94 percent for a skin cancer that has recurred after previous treatment.

More on Mohs

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Getting Help With Denied Va Claims Based On Basal Cell Carcinoma

Veterans who were exposed to military burn pits and developed basal cell carcinoma as a result of their service may feel frustrated that VA does not recognize the condition as presumptive. As such, an accredited representative or lawyer may be able to assist veterans who are trying to become service-connected.

The VA disability lawyers at Chisholm, Chisholm & Kilpatrick may be able to help with your appeal for disability benefits based on your basal cell carcinoma. For a free case evaluation, call our office at 800-544-9144.

Skin Color And Being Exposed To Sunlight Can Increase The Risk Of Basal Cell Carcinoma And Squamous Cell Carcinoma Of The Skin

Basal Cell Carcinoma

Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer not having risk factors doesnt mean that you will not get cancer. Talk with your doctor if you think you may be at risk.

Risk factors for basal cell carcinoma and squamous cell carcinoma of the skin include the following:

  • Being exposed to natural sunlight or artificial sunlight over long periods of time.
  • Having a fair complexion, which includes the following:
  • Fair skin that freckles and burns easily, does not tan, or tans poorly.
  • Blue, green, or other light-colored eyes.
  • Red or blond hair.

Although having a fair complexion is a risk factor for skin cancer, people of all skin colors can get skin cancer.

  • Having a history of sunburns.
  • Having a personal or family history of basal cell carcinoma, squamous cell carcinoma of the skin, actinic keratosis, familial dysplastic nevussyndrome, or unusual moles.
  • Having certain changes in the genes or hereditary syndromes, such as basal cell nevus syndrome, that are linked to skin cancer.
  • Having skin inflammation that has lasted for long periods of time.
  • Having a weakened immune system.
  • Being exposed to arsenic.
  • Past treatment with radiation.
  • Older age is the main risk factor for most cancers. The chance of getting cancer increases as you get older.

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    Taking Care Of Yourself

    After you’ve been treated for basal cell carcinoma, you’ll need to take some steps to lower your chance of getting cancer again.

    Check your skin. Keep an eye out for new growths. Some signs of cancer include areas of skin that are growing, changing, or bleeding. Check your skin regularly with a hand-held mirror and a full-length mirror so that you can get a good view of all parts of your body.

    Avoid too much sun. Stay out of sunlight between 10 a.m. and 2 p.m., when the sun’s UVB burning rays are strongest.

    Use sunscreen. The suns UVA rays are present all day long — thats why you need daily sunscreen. Make sure you apply sunscreen with at least a 6% zinc oxide and a sun protection factor of 30 to all parts of the skin that aren’t covered up with clothes every day. You also need to reapply it every 60 to 80 minutes when outside.

    Dress right. Wear a broad-brimmed hat and cover up as much as possible, such as long-sleeved shirts and long pants.


    Post Mohs Surgery Experience

    After my parents drove me home from the surgery I promptly climbed into bed. I felt emotionally exhausted and the wound on my face was starting to hurt. The surgeon prescribed me a pain killer to take every six hours for three days. I took a pill and fell asleep for about an hour. When I woke up, I was in excruciating pain. The right side of my face was also temporarily paralyzed from the anesthesia.

    Truthfully, I felt horrible over the next few days. The pain killers dulled the searing pain on the side of my head, but never numbed it completely. The medication upset my stomach too. When I was out of pain killers I moved to alternating Motrin and Tylenol. As long as I took something every 3-4 hours I was able to function.

    Showering was unpleasant. I was allowed to let water run over the area, but it felt uncomfortable. Thankfully my sister and husband helped clean the stitches and surrounding area. Sleep wasnt enjoyable either since I prefer to sleep on my stomach on the right side of my face.

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    General Principles In Outer Nose Repair

    Most of nasal skin is of the sebaceous type. Whenever possible, scar lines should be placed along relaxed skin tension lines. Aesthetic units of the nose need consideration although tumours do not respect their borders. Aging affects the nose anatomy. Characteristic symptoms are frown lines , transverse crease on the nasal root, drooping of tip of nose, and deepened nasolabial folds. Skin diseases of elderly, like rosacea and rhinophyma can interfere with surgical techniques.

    The skin covering the bony parts is highly movable, while the skin over cartilage parts is thicker, tighter and bound to the cartilage. Healing by second ary intention of convex surfaces like the nose tip should be avoided since healing often is delayed and may lead to uneven scars.

    Ask The Expert: Why Am I Having Surgery To Remove A Small Basal Cell Carcinoma

    Basal Cell Carcinoma Mohs Surgery

    Although the nonmelanoma skin cancer basal cell carcinoma is rarely life-threatening, it can be troublesome, especially because 80 percent of BCCs develop on highly visible areas of the head and neck. These BCCs can have a substantial impact on a persons appearance and can even cause significant disfigurement if not treated appropriately in a timely manner.

    The fact is, BCCs can appear much smaller than they are. On critical areas of the face such as the eyes, nose, ears and lips, they are more likely to grow irregularly and extensively under the skins surface, and the surgery will have a greater impact on appearance than might have been guessed. Even a small BCC on the face can be deceptively large and deep the extent of the cancer cannot be seen with the naked eye.

    If such a BCC is treated nonsurgically , the chance of the cancer recurring is high. Unfortunately, treating a BCC that has returned is usually much more difficult than treating it precisely and completely when initially diagnosed.

    BCCs on the trunk, arms and legs that cause concern are typically larger in size, but even a small BCC in these areas can have an irregular growth pattern under the skin if the initial biopsy shows the tumor is aggressive. In addition, a small BCC in an area previously treated with radiation may be much more aggressive than it appears on the surface. Again, treating such a tumor nonsurgically is likely to leave cancer cells behind.

    About the Expert:

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    Service Connection For Basal Cell Carcinoma

    When filing a claim for service connection for basal cell carcinoma, the veteran will need to demonstrate a connection between their military service and their basal cell carcinoma. The veteran will also need to submit a diagnosis of their condition. In total, the veteran will need to submit the following to VA:

    • A diagnosis of basal cell carcinoma
    • An in-service event, illness, or injury and
    • A nexus linking the veterans in-service occurrence with their basal cell carcinoma

    In the instance of presumptive service connection, the veteran will not necessarily need a nexus linking the veterans in-service occurrence with their basal cell carcinoma.

    To support the veterans claim for service connection, the veteran may submit lay evidence. Lay evidence, or lay statements, can be written by the veteran or anyone who knows the veteran and can speak to their condition. Importantly, lay evidence may also be submitted by fellow service members.

    Can Basal Cell Carcinoma Turn Into Melanoma

    Basal cell carcinomas cannot progress or turn into melanoma. Basal cell carcinoma forms in the basal cells in the epidermis. They occur when DNA in the cells is damaged by exposure to ultraviolet radiation from the sun or tanning beds. This triggers changes in basal cells in the outermost layer of the skin, resulting in uncontrolled growth. This is a basal cell carcinoma.

    Melanoma begins in cells known as melanocytes. While they are also found in the epidermis, melanocytes are different than basal cells. Melanocytes produce a pigment, known as melanin, which gives the skin its color. When the skin is exposed to UV radiation, it causes skin damage that triggers the melanocytes to produce more melanin. This tanning of the skin is a protective mechanism. But when the burning of the skin causes DNA damage, mutations in the melanocytes result in uncontrolled cellular growth, melanoma.

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    Different Types Of Cancer Start In The Skin

    Skin cancer may form in basal cells or squamous cells. Basal cell carcinoma and squamous cell carcinoma are the most common types of skin cancer. They are also called nonmelanoma skin cancer. Actinic keratosis is a skin condition that sometimes becomes squamous cell carcinoma.

    Melanoma is less common than basal cell carcinoma or squamous cell carcinoma. It is more likely to invade nearby tissues and spread to other parts of the body.

    This summary is about basal cell carcinoma, squamous cell carcinoma of the skin, and actinic keratosis. See the following PDQ summaries for information on melanoma and other kinds of cancer that affect the skin:

    Compensation And Pension Exams For Basal Cell Carcinoma

    Basal Cell Carcinoma

    Once a claim has been filed for basal cell carcinoma, VA may request a Compensation and Pension exam, or C& P exam. To do this, VA may call the veteran or send a letter. It is very important to make sure VA has the veterans up-to-date contact information so that the veteran does not miss any C& P exam requests. It is also very important to attend the exam, as failure to attend can result in a denial of the veterans claim.

    The exam will usually be performed by a VA physician or a VA contracted physician. Before the exam, the examiner will review the veterans c-file. This will contain any documentation that has previously been submitted to VA, as well as the veterans medical and service records. During the exam, the examiner may physically exam the veteran, particularly the areas of the skin which may be affected by basal cell carcinoma.

    The veteran may also use a DBQ, or Disability Benefits Questionnaire, to bolster their claim. A Disability Benefits Questionnaire is a form created by VA for veterans to use to address important aspects of their condition, such as symptoms, severity, possible causes, and relation to other disabilities. The veteran may also have their private doctor fill out a DBQ for them. In claims for basal cell carcinoma, a dermatologist who treats the veteran for their condition may be able to provide more detailed insight into the veterans cancer.

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    Can You Die From Basal Cell Carcinoma

    Death from either basal cell or squamous cell cancers is quite rare. Statistics for these types of skin cancer arent tracked by cancer registries, so its difficult to have specific numbers, but its thought that less than 2,000 people in the U.S. die from both basal cell and squamous cell carcinomas each year.

    These deaths are predominantly in elderly people who have not had their skin checked in a long time and cancer has grown quite large.

    Considering there are over 4 million diagnosed cases of basal cell carcinoma each year in the U.S. , the risk of death from this form of skin cancer is quite low.

    Skin: Condition: Infomation Superficial Bccs

    • Curettage and cautery the skin is numbed with local anaesthetic and the BCC is scraped away and then the skin surface is sealed by heat .
    • Cryotherapy freezing the BCC with liquid nitrogen.
    • Creams these can be applied to the skin. The two most commonly used are 5-fluorouracil and imiquimod.
    • a special cream is applied to the BCC which is taken up by the cells that are then destroyed by exposure to a specific wavelength of light. This treatment is only available in certain dermatology departments .

    Surgical excision is the preferred treatment, but the choice of other treatments depends on the site and size of the BCC, the condition of the surrounding skin and number of BCC to be treated as well as the overall state of health of each person to be treated.

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    How Can Nodular Basal Cell Carcinoma Of Skin Be Prevented

    Currently, Nodular Basal Cell Carcinoma of Skin is a malignant skin cancer that has no preventive measures. However, the following factors may help reduce the risk for the condition:

    • Avoid or minimize sun exposure
    • Limit the use of tanning beds, tanning parlors
    • Smoking cessation
    • If it is caused by certain underlying disorders, then treating the underlying condition may help in the treatment and early cure of Nodular BCC of Skin
    • Regular medical screening at periodic intervals with blood tests, scans, and physical examinations, are mandatory, due to its metastasizing potential and high possibility of recurrence. Often several years of active vigilance is necessary

    Do All Skin Cancers Have To Be Removed

    How Dangerous are Basal Cell Carcinoma and Squamous Cell Carcinoma

    Q.My doctor says I have a small skin cancer on my scalp, but it’s not melanoma. Do I really need to have it removed?

    A. It’s true that melanoma is the most dangerous type of skin cancer, because it can spread throughout the body. You definitely need to have any melanoma removed, to try to excise it before it spreads. Two other types of skin cancer, basal cell carcinoma and squamous cell carcinoma, are more common than melanoma. It sounds like you have one of those. They spread only rarely, but they do grow larger. Not only is this disfiguring, but delay in removing them makes it harder to remove them with only a minimal scar. And cancers on the scalp, when they become large, can be particularly hard to remove.

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    Removal Of A Basal Cell Carcinoma From A Patients Eyelid

    These images were taken from a patient who initially presented at Clarus Dermatology with a nonhealing sore near his eyelid. Dr. Craig Roelke, a partner at the clinic, obtained a biopsy and interpreted the sore as basal cell carcinoma a common, slow-growing skin cancer.

    When you have skin cancer in a high-risk area like the eyelid, the optimal treatment for the patient is Mohs surgery. Board-certified dermatologist Dr. Neil Shah successfully performed the surgery at the clinic and only local anesthesia was needed for the procedure.

    The basal cell carcinoma tumor required two stages to completely clear. During the first stage, Dr. Shah removed some of the skin tissue from the patient, and he waited for it to process. Once done, board-certified dermatologist Dr. Shah looked at the microscopic slides of the skin and determined that more tissue needed to be taken during the second stage to clear the tumor.

    In image II. the carcinoma has been cleared and what you see is the post-clearance defect the tumor after all of the skin cancer was removed. The area of the defect was closed with a method similar to what is called a pentagonal wedge resection of the eyelid.

    The conjunctiva and the orbital septum were repaired using 6-0 gut sutures with the tied knots facing outwards to avoid scratching the cornea.

    This doesnt even include the costs for surgical procedures , which would be similar to the $1,340 that our clinic billed.


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