Skin Cancer: What Happens Next After Diagnosis

Basal Cell Carcinoma (BCC) & Squamous Cell Carcinoma (SCC)

A diagnosis of skin cancer can be overwhelming. The next steps depend on the type of cancer, its location, size, depth, and behavior, as well as individual patient factors. This page explains how basal cell carcinoma and squamous cell carcinoma are evaluated and treated, and how care is coordinated at International Vein & Skin Institute (IVSI).

This page focuses on surgical treatment planning and referral decisions following a confirmed diagnosis of basal cell carcinoma or squamous cell carcinoma.

OVERVIEW OF COMMON SKIN CANCERS

Basal Cell Carcinoma (BCC)

Basal cell carcinoma is a non-melanocytic skin cancer arising from basal cells of the epidermis. It is the most common skin cancer in humans.

BCC grows slowly
It rarely metastasizes
If left untreated, it can become locally invasive, causing tissue destruction and disfigurement

Squamous Cell Carcinoma (SCC)

Cutaneous squamous cell carcinoma is an invasive skin cancer arising from keratinocytes.

It is the second most common skin cancer
It may develop from actinic keratoses or arise de novo
SCC carries a higher risk of local invasion and metastasis than BCC

BASAL CELL CARCINOMA (BCC): TYPES & BEHAVIOR

Several clinical variants of basal cell carcinoma are recognized. Each differs in appearance, growth pattern, and aggressiveness.

Common BCC Variants

Nodular BCC – Most common; often appears as a pearly or translucent papule
Pigmented BCC – Contains brown or black pigment; may resemble a mole
Superficial BCC – Thin, red, scaly patch; often on trunk or extremities
Micronodular BCC – More aggressive growth pattern; margins may be less apparent
Morpheaform (Sclerosing) BCC – Infiltrative growth with indistinct borders; higher recurrence risk

Some subtypes (micronodular, morpheaform, infiltrative) are more difficult to completely remove and often require specialized surgical approaches.

WHY LOCATION MATTERS — HEAD & NECK CONSIDERATIONS

Basal cell carcinoma occurs most frequently on the head and neck.

If neglected or advanced, BCC may infiltrate:

Eyelids or orbit (affecting vision)
Nose, ears, or facial cartilage
External auditory canal or temporal bone
Base of the skull or cranial nerves
Calvaria or deeper facial structures

In rare advanced cases, this can result in functional impairment, neurologic symptoms, or major reconstructive needs. Early diagnosis and appropriate treatment are critical to prevent these complications.

SQUAMOUS CELL CARCINOMA (SCC): KEY FEATURES

Squamous cell carcinoma is invasive by definition.

Commonly occurs on sun-exposed areas (face, scalp, ears, hands)
Often arises in a background of sun-damaged skin
Early SCC may resemble a thickened actinic keratosis
Advanced lesions may ulcerate, bleed, or grow rapidly

Because SCC has a greater potential to spread, timely and adequate treatment is essential.

GOAL OF TREATMENT

The goal of treatment for both BCC and SCC is:

Complete elimination of the tumor with maximal preservation of function and physical appearance

Treatment selection balances:

Cancer control
Anatomic location
Functional structures
Cosmetic outcome
Patient-specific risk factors

GENERAL TREATMENT OPTIONS (OVERVIEW)

Depending on cancer type, size, depth, and location, treatment options considered in general may include:

Surgical excision
Mohs micrographic surgery
Radiation therapy
Destructive techniques (limited cases)
Topical therapies (selected superficial cases only)

Not every option is appropriate for every patient or every tumor.

TREATMENT OFFERED AT IVSI

Surgical Excision (When Appropriate)
Dr. Tryzno performs conservative surgical excision with appropriate margins for selected basal cell and squamous cell carcinomas.

Performed in-office under local anesthesia
Incision performed using a surgical CO₂ laser in cutting mode
Margins selected based on tumor type and location
Tissue submitted for pathology
Sutured closure to support healing

While surgical excision is highly effective, no excision guarantees 100% clearance. If margins are involved or deeper structures are affected, additional treatment may be required.

WHEN MOHS SURGERY IS RECOMMENDED

Mohs micrographic surgery offers the highest cure rates and greatest tissue preservation.

Mohs is typically recommended for:

Infiltrative, morpheaform, or micronodular BCC
Recurrent tumors
Tumors with poorly defined borders
High-risk locations (nose, eyelids, lips, ears)
SCC with aggressive features

➡ Mohs surgery is not performed at IVSI.
Patients who require Mohs are referred to a qualified Mohs surgeon.

RADIATION THERAPY (SELECT CASES)

Radiation therapy may be considered when:

Surgery is not an option
Patients are not surgical candidates
As adjunct therapy when margins are positive

Radiation is not appropriate for all patients and is avoided in certain genetic conditions.

TOPICAL THERAPY (LIMITED ROLE)

Topical treatments (such as 5-fluorouracil) may be used in very select superficial cases.

Important limitations:

Does not confirm complete tumor eradication
No histologic margin control
Not appropriate for invasive or aggressive tumors

MELANOMA — DIFFERENT PATHWAY

Melanoma is managed differently from BCC and SCC.

At IVSI:

Suspicious lesions are evaluated and biopsied
Initial excision may be performed when appropriate
Definitive melanoma treatment and staging are coordinated with oncology and surgical specialists

Melanoma care requires a multidisciplinary approach.

NEXT STEPS AFTER DIAGNOSIS

After a diagnosis is established:

Pathology results are reviewed with you in person by Dr. Tryzno
The diagnosis and its implications are explained clearly
When appropriate, surgical excision is scheduled
Referrals are made when specialized or multidisciplinary care is required
Follow-up and long-term surveillance are planned based on individual risk

Learn more about Skin Surgery & CO₂ Laser Procedures at IVSI.

SCHEDULE A CONSULTATION

If you have been diagnosed with basal cell carcinoma or squamous cell carcinoma and need guidance on next steps:

📞 Call (847) 518-9999 to schedule a consultation with Dr. Jozef Tryzno

MEDICAL DISCLAIMER

This information is provided for educational purposes only and does not replace individualized medical evaluation. Treatment recommendations depend on pathology, tumor characteristics, anatomic location, and patient-specific factors.