Skin cancer diagnosisand treatment in Calgary.

You cannot, reliably, by looking. A spot that is new, changing, bleeding, not healing, or simply different from all your other spots deserves a dermatologist's examination. Under dermoscopy most can be sorted into safe and suspicious on the spot, and a suspicious one is biopsied the same day. The biopsy is the only thing that gives a definite answer.

Yes. Assessment of a suspicious lesion, the biopsy, the surgery to remove a diagnosed skin cancer and the follow-up are all medical care and are generally covered when you are referred by a physician. Ask your family doctor to refer you to Dr. Paul Kuzel at Rejuvenation Dermatology Calgary South, or call the clinic if you do not have one.

For care billed to Alberta Health Care, a referral from a physician is the normal route. It can be faxed to the clinic at (403) 225-2914. If you do not have a family doctor, call (403) 286-6888 and the team will tell you the quickest way to be seen.

Suspected skin cancer is prioritised. Call the clinic and say what you have noticed. A spot that is bleeding, growing quickly or has changed colour is seen sooner than a routine check, and if a biopsy is needed it is done at that first visit rather than at a second one.

A sting from the local anaesthetic, then nothing. A shave biopsy takes the top of a raised lesion and leaves a small flat mark. A punch biopsy takes a small cylinder of skin and is closed with a stitch or two. The whole thing takes a few minutes and you carry on with your day. The sample is examined by a pathologist and results usually return within one to three weeks.

Every excision leaves a scar, and the goal is a fine line placed along a natural crease rather than across it. On the face this is planned carefully, and where the tumour is large or awkwardly placed, a flap or graft is used to close it. Scars mature over about a year and can be refined with laser afterwards if needed.

Both start in the outer layer of the skin and both are caused mostly by sun. Basal cell carcinoma is far more common, grows slowly and almost never spreads, though it will keep enlarging where it is. Squamous cell carcinoma grows faster and can spread if neglected, especially on the lip or ear or in someone with a weakened immune system. Both are usually cured by excision when caught early.

It depends almost entirely on depth at the time it is removed. A melanoma caught while it is still thin is cured by surgery in the great majority of cases. A deep one may need further staging and treatment from a cancer centre. That gap is why a changing mole is never something to watch for a few months.

The tumour itself rarely returns after a complete excision with clear margins. What is much more likely is a new, separate skin cancer, since the sun damage that caused the first is still present. About one in three people treated for a basal cell carcinoma develop another within five years, which is why follow-up skin checks are scheduled rather than left to chance.

Dr. Kuzel performs standard and wide local excisions, with reconstruction, at Calgary South. Where Mohs micrographic surgery is the right operation, usually for a recurrent tumour or one in a critical location on the face, he will say so and refer you to a Mohs surgeon, then continue your follow-up afterwards.

Dr. Paul Kuzel, MD FRCPC, a board-certified dermatologist and the founder and Medical Director of Rejuvenation Dermatology Calgary South. He sees patients in English and Czech.