We Found a Skin Cancer, Let’s Talk Next Steps

You get the dreaded news that you have been diagnosed with skin cancer – what happens next, and how do we proceed with your body checks and skin care moving forward? Treatment of skin
cancers largely depends on the subtype (basal cell carcinoma, squamous cell carcinoma, or melanoma) and stage of cancer when found. Fortunately, the most common skin cancers (basal cell carcinoma and squamous cell carcinoma) are typically found early and only require an out-patient procedure.

When you are diagnosed with a basal cell carcinoma or a squamous cell carcinoma on the head/neck, hands/feet, or other special sites, a procedure called Mohs micrographic surgery is performed by our Board-Certified Dermatologist, Meghan Morrow, right in the office. The procedure differs from a typical excision in that it is a multi-staged surgery where the skin sample is tested right in our office while you wait! Subsequent reconstruction is performed once Dr. Morrow is certain the skin cancer has been fully removed. Mohs surgery allows you to keep as much healthy skin as possible because only the skin cancer cells are removed. Moreover, the cure rate with Mohs is very high.

If your skin cancer was found in an area where Mohs is not recommended (for example, the trunk), a wide local excision is performed. This is done as an in-office procedure by our providers. On the day of surgery, the area will be examined, marked, and prepped for surgery. A margin of normal tissue around the site will be taken to ensure the entire cancer is removed. You will be given an injection of local anesthetic, and the lesion will be cut out and sent to the pathology lab. Results can be expected in less than 2 weeks. Deep and superficial sutures are typically placed, and the wound is bandaged. You will likely be asked to return to the office to have the superficial sutures removed. You will want to limit your activity for about 2 weeks after surgery. There are unique instances when patients have superficial skin cancers that can be treated by non-surgical modalities. These include topical creams, curettage, and dissection, as well as laser treatments. Your provider will review each procedure’s risks and benefits so you can make the best choice for treatment.

After your treatment is complete, we recommend a 3-month follow-up exam to check the site and scan for any additional suspicious lesions. The risk of getting a second skin cancer is quite high — about 60 percent of people who have had one skin cancer will be diagnosed with a second cancer within 10 years. We recommend skin exams every 6-months for a couple of years to stay on top of any new potential growths!

Melanoma is the most serious type of skin cancer but is, fortunately, less common than non-melanoma skin cancers (basal cell carcinoma, squamous cell carcinoma). Treatment for melanoma is highly dependent on the depth of the cancer found. If the melanoma is superficial (or found early), it can be treated by an in-office excision. However, if melanoma is found late or has spread to other organs (or lymph nodes), we will refer our patients to an oncology surgeon for evaluation and surgery. Patients with metastatic melanoma may also require immunotherapy. Patients with a history of melanoma are seen for body exams frequently. Typically, every 3-6 months.

If you have been diagnosed with a skin cancer, we strongly recommend daily sun protection. Using a daily sunscreen with an SPF of at least 30, avoiding the sun during peak hours, and seeking shade has been shown to reduce the risk of skin cancer and is especially important for those with a history of cancer. Please call or text us at 847-459-6400 to schedule your next body check!