Willard photo
by Mary Beth Schwartz
More than 3.5 million non-melanoma skin cancers in more than 2 million people are diagnosed in the United States each year, according to the American Academy of Dermatology. It is estimated that there will be about 139,870 new cases of melanoma, the most serious form of skin cancer, in 2014. Current estimates are that one in 50 Americans will develop melanoma in their lifetime. And melanoma incidence rates have been on the increase for at least 30 years. With that kind of math, it makes perfect sense to schedule an appointment with Robert J. Willard, MD, FAAD, FACMS, dermatologist, skin cancer expert, and Mohs surgeon to check out that suspicious mole you just discovered.
For seven years, Dr. Willard and his associates (Dr. Austin Liu, Dr. Randi M. Rush, Dr. Mark Levenberg, and Jennifer C. McFadden) have been part of the Dermatology & Mohs Surgery Center, PC. Dr. Willard has performed over 10,000 Mohs surgery cases and reconstructive surgeries, and is among 1,000-plus physicians in the country trained in this field. He is a Diplomate of the American Board of Dermatology, a Fellow of the American Academy of Dermatology, a Fellow of the American College of Mohs Surgery, and a Fellow of the American Society for Dermatologic Surgery. He has authored book chapters in general dermatology and laser surgery, has published articles in prominent medical journals, and has lectured at national meetings. Currently, he is chief of the Division of Dermatology at Abington Memorial Hospital. He also is on staff at Doylestown Hospital and Grand View Hospital.
With locations in Sellersville and Doylestown, Dermatology & Mohs Surgery Center, PC specializes in the advanced treatment of skin cancer and diseases of the skin, including disorders of the hair, nail, and mucous membranes. Performed procedures include the removal of warts, moles, cysts, benign growths, and skin cancers. “We do general dermatology for children and adults, including skin infections, rashes, dermatitis, acne, Rosacea, psoriasis, eczema, and pigment and sweating disorders. Ninety percent of my time is spent doing skin cancer removal using the Mohs technique and then doing the reconstruction of the defects caused by the skin cancer,” Dr. Willard says.
“The Mohs technique is the only method of removing skin cancer that ensures all of the tumor is removed with 99 percent certainty, preserving the maximum amount of healthy tissue and therefore minimizing cancer recurrence and the size of scars. The surgeon starts by identifying the obvious skin cancer. Local anesthesia is administered around the area of the tumor, as the patient is awake during the entire procedure. The visible tumor is removed by freezing, scraping and burning, surgical removal, or laser surgery. A thin layer of normal appearing tissue is then removed, mapped, and evaluated by the surgeon with a microscope. Additional layers may then be taken precisely in the areas of remaining cancer until the tumor is completely removed. Once clear, we are trained to do the surgical reconstruction in the most elegant way that we can,” Dr. Willard says.
According to Dr. Willard, the most common skin cancer types are, in this order, basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. “Basal cell carcinoma appears frequently on the head, neck, and hands as a small, fleshy bump, nodule, or red patch. Other parts of the body may be affected as well. People with fair skinned frequently get basal cell. This type of cancer does not grow quickly. Left untreated, it will begin to bleed, crust over, heal and repeat the cycle, and can extend below the skin to the bone and nerves, causing local damage. Squamous cell also targets fair skinned people. It can be found on the face, ear rims, lips, and mouth, as well as the backs of hands, forearms, and legs. Squamous cell can metastasize to other parts of the body. Melanoma often appears as brown or black lesions that are not uniform in border, surface, or color. In men, it is often seen on the chest, abdomen, or back. In women, on the lower legs. Melanoma can be found on other parts of the body, however. Watch for a change in sensation, spreading, scaliness, oozing, bleeding, or the appearance of a new bump,” Dr. Willard says.
The providers at Dermatology & Mohs Surgery Center, PC also can detect actinic keratoses or solar keratoses, the earliest stage in the development of skin cancer. “These small scaly spots, often found on the face, ears, neck, lower arms, and back of the hands in fair skinned people, can be treated by freezing, topical chemotherapy, chemical peeling, dermabrasion, laser surgery, curettage, and photodynamic therapy,” Dr. Willard says.
Along with its expert treatment of skin cancers, Dermatology & Mohs Surgery Center, PC has a Light Treatment Center that is unique to this area. “This is a light booth that people enter to treat a variety of skin conditions, including psoriasis, eczema, vitiligo, and T-cell lymphoma. Light therapy involves exposing the skin to wavelengths of UV light under medical supervision. We offer two types of light therapy: narrowband UVB and PUVA therapy. We also offer the XTRAC excimer laser for localized psoriasis and vitiligo. New for this year we have the Palomar Icon, a cosmetic laser for hair removal, vascular or red lesions, pigmented lesions, melasma (mask of pregnancy), acne scarring, and skin tightening,” Dr. Willard says.
Dermatology & Mohs Surgery Center, PC also is delving more into products for those who want to achieve a more youthful appearance. “We offer Botox and fillers such as Restylane, Juvederm, Voluma, and Belotero. Fillers are used in the face—cheeks, lips, jowels, marionette lines. Some people request it in the hands if they look aged. We also do chemical peels and photo facials with laser to improve color and texture,” Dr. Willard says.
Until your office visit, Dr. Willard advises strict sun protection. “Avoid the sun between 10 a.m. and 4 p.m. if possible. When you do go out in the sun, wear a wide-brimmed hat, sunscreen, and sun protective clothing. Avoid tanning booths completely.” Dermatology & Mohs Surgery Center, PC is located at 920 Lawn Avenue, Suite 3, Summit Building, Sellersville, PA 18960; phone: 267-354-1440. Their second office is located at 2003 Lower State Road, Building 200, Doylestown, PA 18901; phone: 215-345-6647. Visit them online at www.dermatologyandmohs.com.