Mohs Surgery

NEW PRO-NOX Pain Management & Anxiety Relief

August 20, 2020 by The LASSI Leave a Comment

We are excited to offer patients another option for procedural comfort and pain management: PRO-NOX.

PRO-NOX is a combination nitrous oxide and oxygen analgesia system, offering rapid onset pain management and anxiety relief. The system provides a fixed 50/50 mixture of nitrous oxide and oxygen, self-administered by the patient via inhalation.

Pain Management & Anxiety Relief With PRO-NOX

The PRO-NOX system is safe and effective while empowering the patient to self-administer as needed for pain and anxiety. Through inhalation, relief is immediate. When finished, the effects clear the body in a matter of minutes. In fact, if you’re seeing us for a non-surgical procedure, you will be able to drive yourself to and from your appointment (unless told otherwise).

PRO-NOX is a safe and non-invasive way to feel more comfortable during laser treatments for the skin, hair, and veins; microneedling; cosmetic injectables; skin biopsies; skin cancer removal and more.

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How PRO-NOX Works

Nitrous Oxide diminishes pain and pain awareness and relaxes feelings of anxiety by triggering the release of endorphins and dopamine in the brain. It moves quickly from the lungs to the blood, providing rapid relief after just 2-5 inhalations.

Who is a Good Candidate for PRO-NOX Pain Management?

PRO-NOX is safe for most patients who require pain management and/or anxiety relief during their procedures. It can be used in addition to other pain management applications. For patients who cannot use topical or injectable numbing during their procedure, PRO-NOX is another way to ensure comfort.

Some patients, however, should not use PRO-NOX. Contraindications for nitrous-oxide inhalation include pregnancy; hypersensitivity to nitrous oxide; decompression sickness; some ear conditions, like infection or blockages.

PRO-NOX Safety

If you’ve ever received nitrous-oxide during a dental procedure, then you have experienced the safe use of this inhaled analgesic. The difference is that you’re in control, only breathing in the mixture as needed for pain management and anxiety relief. Nitrous-oxide has been used around the world for decades. It is non-addictive and reduces the need for other pain management options, like pills or injections.

Nitrous-oxide is used safely in hospitals, surgery centers, and even during labor & delivery.

What to Expect While Using PRO-NOX

Before we begin, we will provide you with a nose clip. To ensure comfort, we can provide you with gauze between the skin and the clip. This is important to ensure that you’re getting a full dose of N2O when you breathe in.

Next, we will advise you to form a tight seal with your lips around the hose. We will begin by coaching you through a pre-treatment dose. This involves approximately 5-9 deep inhalations, where you will hold your breath for a few seconds and then exhale through the mouthpiece.

Once you feel the effects, we will begin with the procedure, coaching you to stay ahead of the anxiety and pain, inhaling as needed for preventative pain management and anxiety relief.

PRO-NOX FAQ

Are there any side-effects with PRO-NOX?

Some patients report feeling nausea; however, this feeling subsides after taking several deep breaths of fresh air without the PRO-NOX.

Do I need to do anything to prepare before using PRO-NOX?

There is no preparation necessary prior to using this analgesia system.

Can I drive myself to and from my procedure?

After 5-10 minutes of breathing fresh air without any N2O, the effects will subside, allowing you to drive yourself home. Please note that for some of our procedures, we do require that you have a friend or family member bring you in or drive you home. Discuss the requirements for your specific procedure with our providers.

Do I need to breathe in the N2O mixture the entire time for pain management?

No. We recommend inhaling the mixture only as needed for pain and anxiety relief. It’s important to also breathe normally during your procedure.

Discuss Your Options for Procedural Pain Management and Anxiety Relief

At the Laser and Skin Surgery Center of Indiana, we want you to know that you have options. Your safety and comfort are top priorities, and we are here to answer any and all questions you have about your treatment and pain management options. Please reach out to our team for more information or to schedule a consultation.

Skin Cancer FAQ: Skin Cancer Types & Symptoms

January 25, 2018 by The LASSI

Skin cancer is the most common form of cancer in the United States. In 2014, nearly 77,000 people alone were diagnosed with melanoma, the deadliest form of skin cancer. There are, however, several skin cancer types that are diagnosed each year. In this article, you’ll learn about the different skin cancer types and their symptoms as well as ways we diagnose and treat them.

What is Skin Cancer?

Like other cancers, skin cancer is an abnormal growth of cells. Though skin cancer is rarely fatal, it can be disfiguring both before and after treatment. Skin cancer can appear anywhere on the body but are most often found in areas of the body that are frequently exposed to the sun, such as the arms, face, ears, back of the neck, and even the back of the calves.

Skin Cancer Types & Symptoms

There are different types of skin cancer, and they have somewhat different signs and symptoms. Pre-cancerous growths and skin cancer types include:

Actinic Keratosis

Actinic keratosis is a precancerous condition, which means the cells can become malignant if the condition isn’t treated. It’s a patch of rough, scaly skin that most often appears on the scalp, neck, face, ears, forearms or other places that have a lot of sun exposure. Actinic keratosis is not painful, but it begins as a small red, pink or brown spot that gradually enlarges. It can be flat, somewhat bumpy or feel like a hard wart. Sometimes, it burns and itches. Since it is hard for a layperson to tell whether they have an actinic keratosis or something more benign, you should consult a dermatologist if you suspect the lesion might be precancerous.

Basal Cell Carcinoma

Basal cell carcinoma is the most common type of skin cancer. Like actinic keratosis, it is found on areas of the body most exposed to the sun, although it can appear anywhere. Basal cell carcinoma skin cancer symptoms include:

A lesion that has a dome that is pink or the color of your skin – You may be able to see tiny blood vessels inside of it. Sometimes, the center of the dome forms a crater, and the growth bleeds, oozes and then crusts over.
A patch of skin that is both shiny and scaly – You might think it is a patch of eczema. It is often red or pink.
A hard, pale growth that looks like a scar and has a waxy feel – It can be the color of your skin, yellow or pale.
A sore that doesn’t heal

Basal cell carcinoma grows slowly and rarely spreads to other organs in the body, but it is a cancer that can cause disfigurement if it is not treated promptly.

Squamous Cell Carcinoma

Squamous cell carcinoma is different from basal cell carcinoma in that it can metastasize or invade other organs of your body. Squamous cell carcinoma skin cancer symptoms include:

A lump or bump that feels rough
Like basal cell carcinoma, this lesion can grow into a dome, bleed and crust over
A slowly growing scaly patch of skin that is reddish in color
A sore that doesn’t heal – In some cases, the sore heals but then reopens

Melanoma

One person dies from melanoma every hour in the United States. It also claims the lives of very young people, even patients in their teens and early 20’s. Melanoma is often mistaken for a regular mole, but there are some distinct traits of malignant melanoma you can spot and have evaluated by a board-certified dermatologic surgeon right away:

Asymmetrical shape
Has more than one color
Has irregular or indistinct borders
Is bigger around than a pencil eraser and keeps growing
Itches, hurts, bleeds and doesn’t heal

Dermatofibrosarcoma Protuberans

This is a rare type of skin cancer that starts in the deeper layers of the skin. It is slow-growing and rarely metastasizes. Dermatofibrosarcoma protuberans skin cancer symptoms include a little purplish bump that looks like a rough patch, a scar, a bump, or a birthmark. At first, it is not painful or tender. As it grows, the lesion becomes tender, bleeds and feels hard. It is more common in young people.

Merkel Cell Carcinoma

Merkel cell skin cancer is also rare. It appears as a nodule that is either bluish-red or the color of your skin. It’s most often found on your head, neck or face. Like melanoma, Merkel cell carcinoma grows quickly and can metastasize. Some doctors believe that a virus called the Merkel cell polyomavirus has a role in causing this cancer.

Sebaceous Carcinoma

This cancer is also uncommon but is one of the skin cancer types that can be aggressive. It usually starts on your eyelid as a painless round lesion. It can also develop in a sebaceous gland, which lubricates your hair and skin. It is also called a Meibomian gland carcinoma.

Diagnosing Skin Cancer Types and Treatment Options in Indianapolis

At the Laser and Skin Surgery Center of Indiana, we diagnose and treat skin cancer in our Indianapolis dermatology practice. Our founder and board-certified dermatologic surgeon, Dr. C. William Hanke, is a leader in Mohs micrographic surgery and other common, effective skin cancer treatments. He was the president of the American College of Mohs Surgery, the American Society for Dermatologic Surgery and senior vice-president of the Skin Cancer Foundation, and he has authored peer-reviewed articles on the diagnosis and treatment of different skin cancer types. Our center is also a renowned clinical trials facility and is accredited by the Accreditation Association for Ambulatory Health Care, Inc.

It’s important to note that you are an integral part of your diagnosis and treatment. As stated above, early detection saves lives. That is why we urge everyone to do monthly skin checks at home. Additionally, a yearly skin check with a board-certified dermatologic surgeon is essential to check spots or areas that are less obvious. Your physician may encourage you to come in more frequently, depending on your skin condition, family history, or history of sun damage. Additionally, if you find a questionable spot on your skin, don’t wait until your yearly appointment to get it checked out by a professional. Call us and schedule a skin check so that Dr. Hanke can examine the spot and, if necessary, take a biopsy.

Finally, we will provide you with recommendations for effective sun protection, such as high-quality sunscreens, wide-brimmed hats, and even UV-protective clothing. Prevention, combined with routine skin checks, will help protect you against aggressive skin cancer types.

Schedule an Appointment With Dr. Hanke in Indianapolis

If you have a lump, a strange mole or a sore that simply won’t heal and are worried about skin cancer, don’t hesitate to schedule a consultation with Dr. Hanke at the Laser and Skin Surgery Center of Indiana. With skin cancer, the sooner it is diagnosed, the easier it is to treat. Furthermore, if you haven’t had a routine skin check in over a year, it’s time to come in! Yearly skin checks help with early detection.

Which Skin Cancer Removal Surgery Has the Most Success?

January 24, 2017 by The LASSI

A cancer diagnosis is always a scary one, but when it’s skin cancer and caught early, the disease is at its most treatable. Whether you need skin cancer removal surgery or a non-surgical solution, with the help of your dermatologic surgeon, you’re sure to receive the right treatment with the best possible outcome.

Skin Cancer Removal Surgery in Indianapolis at the LASSI

When it comes to treatment options through the Laser and Skin Surgery Center of Indiana, the choices are considerable. Our claim to fame, specifically, is Mohs surgery, or Mohs Micrographic Surgery, a name coined by Dr. Hanke himself in the late 1980s. Dr. Hanke has contributed to the development of modern-day Mohs skin cancer removal surgery techniques, a treatment first developed by Dr. Frederic Mohs. Dr. Hanke also served as president of the American College of Mohs Surgery and developed the first Mohs surgery training program at Indiana University School of Medicine.

In addition to Mohs surgery, other skin cancer treatment options we offer include cryosurgery, excision, and curettage with electrodesiccation.

Mohs Micrographic Surgery: When you need skin cancer removal surgery, Mohs micrographic surgery is one of the most effective options, but is currently limited to non-melanoma skin cancer*. It’s been around since the late 1930s, which means that dermatologic surgeons have had time to perfect it. During this procedure, tumors are precisely identified and removed while the surrounding healthy tissue is left intact.

Cryosurgery: During cryosurgery, your dermatologic surgeon will freeze precancerous skin lesions, causing them to fall off. Many people prefer this method because it doesn’t require the use of a scalpel. Stinging, swelling, and blistering are common side effects of cryosurgery.

Excision: Excision is a skin cancer removal surgery that removes the cancerous area as well as the surrounding tissue to prevent the disease from returning. Your dermatologic surgeon will then use sutures to close the area. Once the cancer is removed, your surgeon will send it to a lab just to make sure that the cancerous cells are gone.

Curettage and Electrodesiccation: With curettage and electrodesiccation, your dermatologic surgeon will give you a local anesthetic. They will then use a curette, which is a device that features a sharp ring-shaped tip, to remove part or all of a precancerous lesion. Electrodesiccation is a process that uses heat to cauterize the area and eliminate any remaining cells that may be abnormal.

Mohs Micrographic Surgery: The Gold-Standard in Skin Cancer Removal Surgery

The Mohs micrographic surgery is considered the best option for skin cancer removal because the surgery involves extracting the diseased skin layer by layer. Your dermatologic surgeon will then examine each layer under a microscope until reaching skin that is healthy and cancer free around the tumor. Of all skin cancer treatments, Mohs surgery offers you the highest success rate.

The microscopic evaluation process is what makes Mohs surgery unique and exceedingly effective. The pathologic assessment of the excised tissue is completed on site by a Mohs surgeon who has the training to differentiate cancer tissue from tissue that is healthy.

Mohs surgery is preferred because it takes extra precautions to make sure that cancers are completely removed during the surgery. This step practically ensures that the cancer won’t grow back and also minimizes the amount of healthy tissue that you lose. With Mohs surgery, you’ll likely experience a better surgical and cosmetic outcome. In addition, the site of the cancer is repaired at the same time that the cancer is removed. Studies show that Mohs micrographic surgery is able to provide a cure when other techniques have been unable to do so. It’s cost-effective since most people only need one surgery, and it also decreases the psychological impact of skin cancer returning that people experience when they face multiple procedures.

Why Choose the LASSI for Your Skin Cancer Removal Surgery?

When you receive a skin cancer diagnosis, you want only the most experienced professionals providing treatment. You’ll get that at the LASSI. With Dr. C. William Hanke on your case, you’ll have a surgeon who went above and beyond to obtain his educational and medical background. Skin cancer research is also a big part of our mission at the Laser and Skin Surgery Center of Indiana, so you’ll have access to the latest treatment techniques and a knowledgeable staff for your skin cancer removal surgery.

Whether you’ve been diagnosed with skin cancer or suspect you may have skin cancer, an appointment with Dr. Hanke will provide you with the best chance for success. Schedule your appointment today.

*Mohs Micrographic Surgery is currently being explored as an option for melanoma skin cancers.

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