ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

Advances in Diagnosis, Treatment of Skin Cancer

by Nikki Kean • August 12, 2019

  • Tweet
  • Email
Print-Friendly Version

The last two decades have seen many advances in the diagnosis and treatment of skin cancer, and one of the biggest steps forward has occurred in the management of advanced cases.

You Might Also Like

No related posts.

Explore This Issue
August 2019

With the introduction of sentinel lymph node screening for the diagnosis and mapping of melanoma and non-melanoma skin cancers (NMSC) of the head and neck, improved training of otolaryngology residents and fellows in the removal of difficult tumors, and the innovative reconstructive work of facial and plastic surgeons, otolaryngologists are now considered the go-to specialty for performing these challenging surgeries.

“Historically, skin cancer of the head and neck has been treated by the dermatologist and the plastic surgeon,” said Stephen S. Park, MD, chair of the department of otolaryngology–head and neck surgery and director of the division of facial plastic and reconstructive surgery at the University of Virginia School of Medicine in Charlottesville. In fact, the vast majority of skin cancers are still treated fairly simply by dermatologists by either direct excision under local anesthesia or with Mohs micrographic surgery (MMS).

“In the last 20 years, Mohs surgery has become the standard of care for localized skin cancer,” said Adam M. Zanation, MD, the Harold C. Pillsbury Distinguished Professor and director of advanced rhinology, oncology and open/endoscopic skull base surgery fellowship at the University of North Carolina, Chapel Hill. But Mohs has its limitations, he noted. For larger, more complex lesions involving deep structures, or in the setting of invasive melanoma, the ability to clear the surgical margins using the technique is very limited. In those cases, he said, the dermatologist will usually refer to the otolaryngologist for treatment and repair.

According to the Centers for Disease Control and Prevention, skin cancer is reaching epidemic proportions (See “Risk Factors: Not Just Sun Exposure,” below). As the number of patients has increased, the role otolaryngologists play in the management of advanced skin cancer continues to evolve, especially in the treatment of melanoma of the head and neck and advanced basal cell and squamous cell carcinomas.

Adam Zanation, MDOur specialty [is]particularly suited to provide the best resection outcomes as well as the best reconstructive and long-term functional outcomes. —Adam Zanation, MD

Screening

Every board-certified otolaryngologist is qualified to manage facial skin cancers, Dr. Park said. One of the first things to do is screen patients for suspicious lesions, even those coming in for other issues. “If you don’t look for it, you won’t find it, especially in our aging patients, who grew up in an era that was unaware of the damages of sun exposure,” he added.

Once a suspicious lesion is found, Dr. Park encourages physicians to lower their threshold for performing a biopsy. The pathology report will determine the definitive diagnosis as well as the architecture in terms of its aggressive behavior.  “If it is a relatively small lesion [<1 mm] in a forgiving place, such as the cheek or the neck, and is well circumscribed—nodular and you can see the lesion very clearly and, more importantly, where it is not—the otolaryngologist is more than qualified to excise and close the lesion,” Dr. Park said. 

Dr. Zanation is less convinced: “In my practice, I still think Mohs surgery is a better treatment option for non-advanced skin cancers—with a primary excision, we removed more normal tissue than is needed.” But certainly, for anything beyond a localized lesion, the otolaryngologist should be called, he said.

Pages: 1 2 3 | Single Page

Filed Under: Features, Home Slider Tagged With: skin cancerIssue: August 2019

You Might Also Like:

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Second Victims: The Effects of a Medical Error on Physicians Can Be Devastating
    • Is Middle Ear Pressure Affected by Continuous Positive Airway Pressure Use?
    • Keeping Watch for Skin Cancers on the Head and Neck
    • Complications for When Physicians Change a Maiden Name
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?
    • Vertigo in the Elderly: What Does It Mean?
    • What Happens to Medical Students Who Don’t Match?
    • Complications for When Physicians Change a Maiden Name
    • Qualitative Research Shows How Patients Feel About Quality-of-Life Issues
    • How to: A Dynamic Endonasal Columellar Strut Placement
    • Second Victims: The Effects of a Medical Error on Physicians Can Be Devastating
    • Advanced Degrees Can Help Otolaryngologists Better Understand the Business of Medicine
    • Laser Laryngeal Surgery Is Safe Under THRIVE

Polls

Have you ever been, or have you ever known someone who has been a second victim?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use
  • Cookie Preferences

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2023 The Triological Society. All Rights Reserved.
ISSN 1559-4939