New Advances in Treating Pre-Cancers on the Face

Featuring Dr. Mandy Wong, BMSc., MD, Aesthetic Physician New Advances in Treating Pre-Cancers on the Face Duration: 2 minutes, 57 seconds

Skin cancers are one of the most common things seen in a skin clinic. In North America, where we have short periods of summer and people are out there to try to get their tan, and, in the winter, go away to hot spots, sunburns are very frequent.

We see skin cancers mostly in light-skinned individuals and especially those that have had a lot of sun exposure in the past – intermittent sun exposures involving a lot of burns.

Often, skin cancer doesn’t have any symptoms but some people start to notice that there are areas of their skin where they might have a red mark that's scaly and it can come and go or persist and get thicker with time.

Skin cancers can often bleed and grow over time so these are things that you need to look out for. We like to treat skin lesions at the pre-cancer stage because there are a lot of things that we can do that don't involve cutting into the skin.

So a pre-cancer – or an actinic keratosis – are extremely common and these are the red, scaly plaques that you see on people's skin. They say for every pre-cancer that you can see, there's about ten around them that you can't see.

Traditionally, when you go to your doctor's office and they see a pre-cancerous lesion or actinic keratosis, they would take out the liquid nitrogen and spray each spot individually. While this treats that individual spot, it does nothing to all the other skin cancerous cells that are around that area.

The new concept in managing people with a lot of skin sun damage, actinic keratosis – more than a couple of spots – is to treat the entire field of the skin. So if you have many lesions over your forehead, cheeks, you want to treat the entire face.

There has been a medication that has been available for the last 50 years that&'s been used in this manner, but it's associated with a long period of downtime and it has to be applied for four weeks. Most patients, due to the symptoms they get when they're on the medication, can't complete the whole four weeks so they never get a complete treatment.

There are some newer advances in field treatment. There's medications that are involved in less treatment downtime and a shorter course of treatment. So we get patients that are much more compliant with these medications. Examples would include photodynamic therapy and some other topical medications that only involve two to three days of treatment.

To optimally prevent skin cancer, we should try to get rid of every actinic keratosis – the ones we see and the ones that we don't see. Ten percent of them will turn into a squamous cell cancer so we don't know which ones so we should try to treat as much as we can and that involves field therapy.

If you think you have pre-cancerous lesions or you've been treated many times with liquid nitrogen and see that the spots keep coming up, you should see your skin specialist and ask about field therapy of your actinic keratosis.

Presenter: Dr. Mandy Wong, Family Doctor, Kelowna, BC

Local Practitioners: Family Doctor