Diagnosed with Skin Cancer! Now what?

Joseph L. Cvancara, M.D., FAAD

Fellowship-Trained Mohs Surgeon
Board-Certified Dermatologist

Every specific cell in every specific organ (such as bone, nerve, muscle and skin) in your body can mutate and become a cancer. Each kind of cancer responds to different types of treatment, whether it is chemotherapy, radiation, surgical, or immunologic. That is why it is so difficult to find a “cure.” Though some cancers do not respond to any treatment, fortunately, basal cell carcinoma and squamous cell carcinoma, two of the most common types of skin cancer do typically respond well, and can be treated successfully, especially when diagnosed early on. 

What is a Carcinoma?

A carcinoma is a type of cancer that develops from epithelial cells, specifically cells that line the inner and outer (epidermis) surfaces of the body.A basal cell carcinoma (BCC) develops from the stem cells at the “basement layer” of the epidermis. Seventy percent of BCCs are caused by ultraviolet sunlight. BCCs grow slowly, and may bleed and ulcerate with trauma. While BCC has a very low risk of spreading, or metastasis, this cancer can cause significant disfigurement by invading surrounding tissues.Like basal cell carcinoma, squamous cell carcinoma (SCC) usually occurs in sun-exposed areas but may also occur in immunosuppressive patients, such as solid organ transplant patients. SCCs can also involve the anus, cervix, esophagus, lungs and urinary bladder. Like BCCs, SCCs often appear on the skin as a reddish papule that slowly grows and ulcerates. A SCC will often arise from a premalignant pink, scaly lesion called an actinic keratosis. SCC occurrences on the scalp, ears, and lips have the highest rates of metastasis and should be treated expediently, as they have a twenty to fifty percent chance of spreading to the nerves or lymph nodes. 

Treatment Options for Basal Cell and Squamous Cell Carcinoma

BCCs and SCCs are generally treated by electrodessication and curettage (ED&C), radiation, surgical excision, or Mohs Surgery.

  • Electrodessication and Curettage (ED&C)
    • ED&C is a useful treatment mainly for the superficial BCC on the trunk. This treatment requires scraping and burning the lesion, often leaving a scar, but has approximately a 90% cure rate.
  • Radiation
    • Radiation has about a 90% cure rate, and is reserved for inoperable or disfiguring large tumors. Ultimately, the location and size of the cancer will warrant the treatment option.
  • Surgical Excision
    • Surgical excision is cutting out the tumor with a scalpel, often taking wide enough margins to try and prevent leaving any cancer behind. The problem with wide excision is that, although it removes the cancerous tissue, it can often remove a lot of healthy tissue as well. Surgical excision has a 92% cure rate.
  • Mohs Surgery
    • Mohs Surgery was developed to remove cancers from delicate areas such as the face, ears, hands and genitalia. Mohs surgery is a “tissue sparing and margin controlled” surgery, that allows the dermatological surgeon to make the excision as small as possible, while also examining 100% of the surgical margins. Mohs Surgery has a 99% cure rate.

Moving Forward With Treatment for BCC and SCC

Receiving a diagnosis of basal or squamous cell carcinoma can be unsettling. At Advanced Dermatology & Skin Surgery, we provide the highest level of care for you and your loved ones. Our team of Fellowship-Trained Mohs Surgeons, Board-Certified Dermatologists, plus Certified Physician Assistants and Advanced Registered Nurse Practitioners specially trained in Dermatology, partner with you to ensure you feel confident in the course of treatment you choose for your particular diagnosis.  

Dr. Cvancara sees patients at our Coeur d’Alene and Spokane Valley locations. If you have additional questions or concerns about basal cell or squamous cell carcinoma or possible treatment options, please contact us at 509.456.7414.