Patty: Three doctors — two dermatologists and one ophthalmologist — examined the growth below my eye and called it a cyst. I know they're the ones with the medical degrees, but I wasn’t convinced they were right. I'd had the lump under my left eye for two years, and I could feel that it was getting bigger.
I recalled seeing an ad for state-of-the-art skin cancer services at Memorial Sloan-Kettering Cancer Center Basking Ridge, and I decided to make an appointment. It was near my home, I didn’t need a doctor's referral, and I would be getting specialized dermatologic care from a hospital with Memorial Sloan-Kettering’s reputation. I would also, hopefully, get a definitive answer to just what was going on with the growth under my eye.
I met Steven Wang, Director of Dermatologic Surgery at Basking Ridge, and was immediately struck by his dedication, the time he took to explain how he made his diagnosis, what it meant, and what the best treatment options were. He presented a strong contrast to other doctors I’d seen. I felt like I was in good hands with him, and that the highly specialized surgeries available through Memorial Sloan-Kettering would also minimize scarring.
Dr. Steven Wang: My personal philosophy is to treat the entire patient, and not just the cancer. This means that I always want to be a good communicator, set patients’ minds at ease, and make sure that I understand and answer all of their questions.
When I performed a biopsy on Patty and found a basal cell carcinoma, I explained to her that it’s the most common form of cancer worldwide and accounts for 80 percent of all skin cancers in the US. I also explained to Patty, who is blond haired and blue eyed, that exposure to the sun was the most likely cause.;
I also very quickly explained that it’s treatable.
“ My personal philosophy is to treat the entire patient, and not just the cancer.”
–Steven Wang, Dermatologist
The fact that the tumor was on her lower eyelid – a very delicate spot – indicated to me that the best approach would be a specialized type of surgery, called Mohs surgery, that could thoroughly remove the tumor but cause minimal cosmetic damage.
We use Mohs surgery to remove tumors where scarring is a concern, and certainly Patty’s eyelid was a prime candidate. It’s a complex, time-consuming, and highly specialized procedure. We remove tumor tissues layer by layer, examining each layer for cancer cells before proceeding to the next layer.
We can ensure that the whole tumor is removed, and minimize scarring by preserving as much normal skin as possible. The cure rate for basal cell carcinoma using Mohs surgery is 99 percent – much higher than alternative methods.
I was also able to reconstruct Patty’s eyelid using healthy skin from her upper eyelid, which helped further minimize scarring and functional damage.
Patty: Back at my job as an elementary school principal, I wanted to somehow use my experience to educate our students about sun safety. That’s when I learned Dr. Wang had written a children’s book about protecting skin from the sun. I realized that with his expertise, the book, and my personal story, we had a unique opportunity to get this message across in a powerful way.
Growing up on the Jersey Shore, I didn’t know – nobody knew – that skin cancers later in life can be related to sun overexposure during childhood and adolescence. I wanted to pass that lesson on to the kids before they had to go through what I went through, or worse. So I invited Dr. Wang to Clinton Elementary School to headline a presentation on preventing overexposure to the sun.
Dr. Wang: Patty and I took turns reading my book, Alma and the Sun, and their art teacher, Christine Tischio, created these amazing illustrations to go with it. We had the students wear sunhats and sunglasses as they listened to the story. Afterwards, with the help of the Parent Teacher Association, the older kids, the fourth- and fifth-graders, went to the school library, where we’d set up stations to raise awareness about the risk of sun overexposure.
“I feel that at Memorial Sloan-Kettering it’s not just about treatment – it’s about prevention as well.”
Patty: The team from Memorial Sloan-Kettering really got into it; they brought their educational materials to our school, so students could look through microscopes at slides of healthy and damaged skin, learn about the proper amount and application of sunscreen, and try out a facial imaging system that shows sun damage. This is something I want to make into an annual event. I want to tell students, “This happened to me, but it doesn’t have to happen to you.”
Dr. Wang: The majority of ultraviolet light exposure is acquired in childhood, so I can’t stress enough the importance of early education. In adulthood, early detection is key. The correct identification of skin cancers can be very difficult.
At Memorial Sloan-Kettering, we use dermoscopy, a technology that allows microscope-like examination of skin surfaces. Using dermoscopy, diagnostic accuracy increases by 25 percent – and the need for biopsies decreases, which is a great benefit for patients.
Patty: When I went to Memorial Sloan-Kettering Basking Ridge, I was concerned and wanted an answer. I’m so grateful that I discovered not only an expert surgeon who solved my problem, but also a partner to help educate the Clinton Elementary School kids and to make a difference in their lives. I feel that at Memorial Sloan-Kettering it’s not just about treatment – it’s about prevention as well.