Hi everyone. With the number of people diagnosed with skin cancer continuing to increase, I think it is important for everyone to be prepared to be told that they have skin cancer and/or precancerous lesions. Because many people find the word “cancer” to be overwhelming, I want to help you be prepared and form the best questions to ask your dermatologist if you are diagnosed with skin cancer.
First, and most importantly, do not panic Skin cancer is very common and the vast majority of diagnosed skin cancer is cured surgically in the outpatient setting with only mild disruption to your daily routine. In fact, many patients are back to work within hours of skin cancer surgery.
Always ask your dermatologist if the pathologist who interpreted your biopsy is a board certified dermatopathologist. This is an important point as dermatopathology is a subspecialty and you should be sure the diagnosis is coming from an appropriately trained physician. This is usually not an issue as there are many dermatopathologists around the country. One should always be sure to get the exact diagnosis, and not settle for knowing it is “skin cancer” but rather find out if it is basal cell carcinoma or melanoma, for example.
Once you receive the diagnosis, try to focus on how to best treat your skin cancer and then how to prevent future skin cancers from forming. Ask your dermatologist what the treatment options include as several superficial skin cancers can be treated with topical creams rather than with surgery in certain situations. If your cancer will be treated with a surgical procedure, ask your dermatologist if the procedure will be a “destructive” procedure or a surgical “excision” requiring stitches. This is an important point as the destructive treatments do not include a specimen to be again sent to the pathologist to make sure that all cancerous cells have been removed. For some basal cell and squamous cell carcinomas (the two most common skin cancers), it is appropriate to have the cancer treated destructively even though you will not know for sure that the cancer is completely removed. Discuss these differences with your dermatologist and allow him/her to explain why one treatment type may be preferable.
If the decision is for surgical excision, ask your dermatologist if Mohs surgery would apply to your case. Mohs surgery is used on sensitive areas, such as the nose and ears or for several more invasive cancers. Also ask your dermatologist about surgical excision, including the duration of the procedure (usually about 30 minutes) and what to expect after the procedure. This includes what types of activity you should avoid while you have stitches in place and how much pain to expect.
Now that the recently diagnosed cancer has a treatment plan, ask your dermatologist about future skin checks. Ask him/her how often you should be seen (such as every 3 or 6 or 12 months). Remember, many skin cancers are related to sun exposure so many people with one skin cancer are diagnosed with a second cancer within several years as these people usually have had excessive sun exposure in the past. Be sure to get on a good skin care regimen including daily sun protection and also ask for a brochure that describes different skin cancers so you can check your skin at home for suspicious lesions. Also remember to educate your friends and family about skin cancer to allow them to learn from your experience.
After your skin cancer is treated, be sure to let any dermatologist you see in future know of the type of skin cancer, location of skin cancer, and how it was treated. The scar must be monitored for recurrence of the cancer and any suspicious lesion near the scar should be monitored closely or biopsied. Hopefully, no more skin cancers arise but remember that the best time to diagnose a skin cancer is as early as possible.
I hope this information allows you to clearly set up a plan with your dermatologist regarding your skin cancer. Any fears and questions you have should be addressed in order to make you feel comfortable and confident that your cancer is being treated appropriately.
Kevin Berman is a dermatologist in Roswell, Georgia and is affiliated with multiple hospitals in the area, including North Fulton Regional Hospital and Northside Hospital. He wrote for HealthCentral as a health professional for Skin Cancer.