A reader asks: About six months ago, I found a small, slightly raised red spot on the edge of my ear. My GP removed it using a cauterising laser beam and the lab report showed it was squamous cell cancer. My GP said margin assessment was not possible due to the cauterisation but because the wound healed well no action was necessary, so just to keep an eye on it. Is this the best action as it couldn’t be assessed for remaining cancer? Shouldn’t I have further checks up?
Dr Rosemary Leonard says: Squamous cell skin cancer is a common form of skin cancer found mainly in older people, especially over 75. They are caused by excess exposure to sunlight and are found mainly on the face, especially the ears and around the lips. They are more common in men than women and typically start as a red scaly patch that may then grow and look similar to a wart.
If left untreated, they can grow larger and deeper, and damage and erode nearby structures. They may spread to other areas of the body, but this tends to happen in later stages.
They are treated by surgical removal and, ideally, the excision should include a wide margin of normal skin to ensure that all the cancerous cells have been removed. However, this can be difficult on the ear as it can cause a very obvious change in its shape.
In your case, the cauterisation process will also have destroyed the edge of the sample that was sent to the lab, which is why it’s not been possible to check the margins were clear of cancerous cells. However, the fact the skin has healed up well would suggest all the abnormal cells have been removed.
You should though, as your GP has advised, keep a check on your ear. If you notice the scar changing or any new lesions appearing, report this as soon as possible.
If you have a health question for Dr Leonard, email her in confidence at [email protected]. She regrets she cannot enter into personal correspondence or reply to everyone
