The most appropriate treatment for any particular patient with melanoma depends upon the “stage” of the melanoma.
The factors that determine the stage of a melanoma include; the thickness of the tumor within the skin and whether or not it has spread beyond the skin.
In the very earliest stages of melanoma, “melanoma-in-situ”, the disease is limited to the epidermis and has not yet started to invaded into the dermis below. At this stage surgical removal with a 0.5 cm. margin of normal appearing skin is the standard. However in cases involving the face or hands there is good evidence showing that Mohs Micrographic surgery may be advantageous. Furthermore, a few small studies have demonstrated a potential benefit from topical imiquimod (Aldra), although this approach is not the standard of care and is still experimental at this stage.
For early thin melanomas that are unlikely to have gone beyond the skin, surgical excision of the tumor with a 1 cm. wide safety margin is all that is required.
For thicker tumors that may have spread to local lymph nodes a “sentinel node biopsy” should be considered. This is a method of sampling the group of local lymph nodes to asses if the melanoma has spread or not.
For very thick tumors and those that have spread to local nodes then, in addition to the surgical removal of the primary melanoma itself, several other steps should be considered:
As director of The Skin Cancer Group, Dr Massey is able to make all of these options available for patient. Of cause for each individual patient a detailed discussion of the pros and cons of these choices will help guide the patient towards the most appropriate treatment course for him or her.
Basal Cell Cancer and Squamous Cell Cancer (None Melanoma Skin Cancer (NMSC)
There are many different options for the treatment of Basal Cell and Squamous Cell Cancers (NMSC). Which approach is most appropriate for any individual patient will depend on the type of cancer, its location, whether any previous treatments have been tried and of cause the patients general health and desires.
Through the Skin Cancer Group Dr. Massey is able to offer patients all of the above treatment options.
Loose extra skin on the upper eyelids or bags and wrinkles of the lower lids can make you look tired and add years to your appearance. This can be corrected with a safe cosmetic surgery called blepharoplasty. This surgery can rejuvenate your eyes and take away that sleepy, tired look. Dr. Massey has perfected an “electrode blepharoplasty” that can be performed under the safety of local anesthesia, with practically no down time. The procedure take about 45 minutes and patients can usually be back to full activity after one week.Learn More
With time the effects of gravity can show themselves as loose extra skin on the cheeks and jowls. These can add years to your appearance. The old fashioned type of face-lift required general anesthetic, many weeks of down time and often left patients looking “unnatural” with their skin pulled much too tight. With the new “Lipo-Lift” Dr. Massey has integrated a new, less invasive face-lift procedure with the tissue contraction gained from micro-liposuction and the benefits of tumescent anesthesia, to produce amazing results. As soon as ten days later, patients don’t look like they have just had surgery, they just look better!Learn More
Until recently, procedures for body contouring through fat removal involved extensive operations. These resulted in large scars and significant safety risks. Several years ago, dermatologists developed tumescent liposuction. This allows fat removal through tiny incisions that do not leave significantly visible scars. A large volume of extremely dilute local anesthetic is infiltrated into the area to be treated. Then utilizing straw like, extremely thin metal tubes (cannulas) and a high-pressure suction system, the fat cells are extracted through tiny incisions.Learn More
A heavy, drooping forehead and eyebrows (rather than just eyelids) can give a sleepy, tired look. Many of these patients are mistakenly treated with a blepharoplasty alone, which takes extra skin from the upper eyelids, still leaving them with their flat, “heavy” eyebrows shadowing their eyes. If these patients are correctly diagnosed preoperatively, they can get a much better cosmetic result from a brow lift, either alone or in combination with blepharoplasty. This is the type of careful analysis and deeper knowledge that allows Dr Massey to guide patients towards the best procedure for them.Learn More