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Lewes, Delaware
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September 25, 1998     Cape Gazette
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September 25, 1998

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5,Kin cancer treatable when detected early: new techniques salvage tissue, appearance By Kerry Kester As summer draws to a close and tans begin to fade, some people may notice changes to the skin. Some of the changes may indicate the onset of skin cancer. Many skin cancers are easily treated "if diagnosed early; skin cancer can also be deadly. Dr. Kendall Anne Morrison, a dermatologist who recently joined practice with Dr. Mitdaell Stickler at Cape Henlopen & Nanticoke Dermatology, said one of the more common problems they see in their office is basal cell carcino- ma, squamous cell carcinoma and melanoma. "They're all sun relat- ed," said Morrison. "I've been really impressed, since I've moved here, with the sunburns and tans I've seen. I think it's important that people re- alize how directly those things correlate with the development of these cancers," she said. The basal cell and squamous cell carcinomas usually do not pose a serious threat to life. Of- ten, said Morrison, the slow- growing cancers are surgically re- moved and do not spread any fur- ther. However, melanoma more easily metastasizes; if it reaches the lymph nodes, then the cancer can work its way to major organs, become difficult to treat and cause death. "We do a lot of surgeries, and most of them are related to skin cancer," said Morrison. One of the common procedures for basal cell or squamous cell treatment, she said, is Moh's surgery. Al- though the operation can be used in several locations for skin can- cers, it is most often used on areas on or near the face, she said. "The purpose is to save tissue," she explained, "and it has a much higher cure rate than a simple ex- cision." In a standard excision, the surgeon generally takes the skin lesion and a couple of mil- limeters of tissue from all around the lesion. The tissue is then test- "ed to deter- mine whether the cancer is benign or ma- lignant and whether all of the cancerous cells were re- moved. Morrison said that some- MORRISON times a skin cancer can be as de- ceptive as an iceberg: a small tip may be visible above the surface, but there may be much more be- neath the surface. Moh's surgery, she said, is de- signed to take a. smaller amount of tissue. "You let the tumor guide what is to be removed," she said. The lesion and a small amount of tissue surrounding it are removed, then immediately tested. With each test that shows there is still some cancer present, in concentric circles, the surgeon removes an- other segment of tissue. Moh's surgery, however, is not used to treat melanoma. "There are standard margins to be taken when you have melanoma," said Morrison. Those margins are re- lated to depth, she said. Morrison said Cape Henlopen & Nanticoke Dermatology physicians do re- move lesions from melanoma, but they send their patients to oncolo- gists for full workups. In addition to treating skin can- cers, the physicians-also treat a variety of cosmetic skin problems. .For example, said Morrison, peo- ple may have a mole o.r other kind of skin lesion that they want re- moved. "Anytime you cut the skin, there's going to be a scar," she said, "but the aim is to mini- mize it. We use the lines of the face to minimize the scars." Other kinds of cosmetic prob- lems might include ache scars. Those can often be treated either by excision or laser resurfacing, she said. "We also do a lot of re- juvenation," said Morrison. For example, the skin might develop uneven pigment patches, from ag- ing or sun exposure, and modem techniques allow dermatologists to improve the skin. Morrison, who until she moved to the Cape Region worked at Dartmouth-Hitchcock Medical Center in Lebanon, N.H., has ex- perience working in a highly spe- cialized and relatively new area of women's dermatology: vulvar dermatoses. "Most of the cases are multifac- torial," said Morrison. Women experience severe discomfort in their vulvar or vaginal areas. The components of the dermatoses may include a the nerves, infec- tion or both. Women who have the dermatoses experience dis- comfort or pain. "It really is horrible for the peo- ple involved," she said. "They re- ally suffer." Unfortunately," she said, some women are reluctant to seek help or may not be aware that help is available. "The purpose [of treatment] is to try to alleviate the suffering." Patient education is important to Morrison, who said she be- Continued on page 42 UDAY A. JANI, M.D. Internal Medicine Appointments also available evenings and Saturdays. CHECK.OUR PHARMACY'S ANNUAL FLU CLINIC SCHEDULE STOP IN FOR DETAILS 4th Annual LU CLIIqilCS Edgehill Pharmacy and the Visiting Nurse Association (VNA) will sponsor an in-store Flu Shot Program in the Delaware and Maryland area this Fall to combat the serious flu epidemic forecast by the medical community. From October 1 to October 29, Flu Shot Clinics will be located at Edgehill Pharmacies where registered nurses at each site will administer flu shots. The cost of the flu shot will be $12.00. Medicare Part B is accepted for payment. OCTOBER SCHEDULE October 1 10:00 - 11:30 State Line Plaza Delmar, DE October 1 1:00-2:30 Mason*Dion Village Selbyville, DE October 1 5:00-7:00 456 West Glenwood Ave. Smyrna, DE October 2 11:30-12:30 2154 Bflttingttam Lane dncess Anne, MD October 2 2:00-3:00 10136 Old Oity Blvd. Berlin, MD October 2 5:00-7:30 Pines Plaza Ocean Pines Berlin, MD October 3 10:00-11:30 Liben'y Plaza Harrington, DE October 3 10:00-11:30 2a34.. "l'ilghman Road lisbury, MD October 3 1:00-2:00 1414 S. Salisbury Blvd. Salisbury, MD October 3 1:00-3:00 512 Middletown-Warwick Middletown, DE October 3 3:00-4:30 Pecan Square Salisbury, MD October 7 3:00-4:00 3350 Hayman RO. Federalsburg, MD October 7 5:00-7:00 Georgetown Plaza eorgetown, DE October 7 5:30-6:30 842 S. Fifth Ave. Denton, MD October 8 5:30-8:00 233 E. DuPont Hwy. Millsboro, DE October 9 5:00-8:00 100 N. Railroad Ave. Wyoming, DE October 10 10:00-11:00 101 W. Green St. Snowhill, MD October 10 12:30-3:00 Fit. 26 Millvllle, DE October 15 5:00-8:00 444 Savannah Rd. Lewes, DE October 16 5:30-7:30 834 S. Governors Ave. Dover, DE October 17 11:00-2:00 Peddlers Village Lewes, DE October 20 5:00-7:30 Peddlers Village Lewes, DE OCtober 23 12:00-3:00 Hamlet Shopping Cir. Dover, DE October 24 9:30-12:00 Rt. 1 Bay Mart Rehoboth, DE October 27 5:30-7:30 1120 S. Central Ave. Laurel, DE October 28 10:00-12:00 14 Hamlet Shopping Ctr. Dover, DE October 28 5:00-7:30 1401 Middleford Rd. Seaford, DE October 29 10:00-1:00 2 NantJcoke Plaza Millsboro, DE October 29 5:30-7:30 2 Nanticoke Plaza Millsboro, DE IIIll I III II I 41 |