Skin Cancer Prevention, Treatment, and Testing with Dr. Christopher Spock

In this episode of Plastic Surgery Consults, Dr. Matthew McRae and Dr. Mark McRae speak with board-certified dermatologist and Mohs surgeon Dr. Christopher Spock about skin cancer prevention, diagnosis, and treatment. Dr. Spock explains how to select sunscreen, why avoiding sunburns matters, and how patients can protect post-surgical scars. He also compares topical treatments, excision, Mohs surgery, and radiation for different skin cancers. The conversation covers options for patients who develop frequent cancers, including niacinamide and other medical therapies, before examining gene-expression tests that may help assess the risks associated with melanoma and high-risk squamous cell carcinoma. Key Points From This Episode: [00:00:00] Dr. Matthew McRae welcomes Dr. Christopher Spock. [00:00:10] Dr. Spock shares his path from plastic surgery research to dermatology and Mohs surgery. [00:03:24] The hosts introduce skin cancer prevention and post-surgical sun protection. [00:03:58] What to look for in sunscreen, including SPF, broad-spectrum coverage, and mineral ingredients. [00:06:42] Skin sensitivity and inflammatory reactions associated with chemical sunscreens. [00:07:44] Improvements in mineral sunscreen formulations and the value of sun-protective clothing. [00:09:12] Protecting post-surgical scars with zinc-based gels, silicone tape, and reduced sun exposure. [00:10:28] Differences between basal cell carcinoma, squamous cell carcinoma, melanoma, and Merkel cell carcinoma. [00:10:28] How physicians choose between topical treatment, scraping and cauterization, excision, and Mohs surgery. [00:10:28] How Mohs surgery examines margins and allows surgeons to respond to findings in real time. [00:16:55] Differences in access to Mohs surgeons in Ontario and Florida. [00:18:14] Sun protection and niacinamide for patients who develop frequent skin cancers. [00:18:14] Additional medications and oncology treatments for high-risk or advanced cases. [00:20:49] The growth of in-office superficial radiation therapy and questions patients should ask. [00:23:57] When radiation may be considered for cancers that could cause significant cosmetic defects after surgery. [00:24:14] The role of radiation in localized disease and systemic therapies in advanced or metastatic disease. [00:26:45] How Breslow thickness has traditionally been used to assess melanoma. [00:26:45] Gene-expression testing as an additional tool for assessing melanoma risk. [00:30:50] Accessing melanoma gene-expression testing through a physician. [00:31:28] Using similar testing to assess high-risk squamous cell carcinoma and the need for adjuvant radiation. [00:33:03] Dr. Spock discusses how long these molecular tests have been used in his practice. Links: McRae Plastic Surgery: https://mcraeplasticsurgery.com/ Dr. Matthew McRae on LinkedIn:   / matthew-mcrae-8750ab75   Dr. Mark McRae on LinkedIn:   / mark-h-mcrae   Dr Christopher Spock on LinkedIn:   / christopher-spock-md-7942656   Editing and post-production work for this episode was provided by The Podcast Consultant (https://thepodcastconsultant.com)