Found a suspicious spot and feeling nervous? You’re not alone. Skin cancer comes in different types, and each needs a different plan. Knowing the main options helps you ask the right questions and feel in control.
First, a quick breakdown: basal cell and squamous cell are the most common and usually treatable with local methods. Melanoma is less common but can spread, so doctors treat it more aggressively when needed.
Most non-melanoma skin cancers are treated with simple procedures. Excisional surgery removes the lesion with a small margin of normal skin — it’s fast and usually curative for small tumors. Mohs micrographic surgery spares healthy tissue and checks margins during the procedure; it’s great for spots on the face or places where preserving skin matters.
For very superficial lesions, options include topical creams like 5-fluorouracil or imiquimod, cryotherapy (freezing), curettage with electrodesiccation, or photodynamic therapy. These are less invasive but usually used for thin, well-defined spots. Radiation is an option if surgery isn’t safe for medical reasons or for certain stubborn lesions.
Ask your doctor about expected margins, scarring, and healing time. If you want a less invasive choice, confirm that the tumor type and size make that safe.
If melanoma is found, the first step is usually a wider excision to remove more tissue and reduce recurrence. For tumors of a certain thickness, your surgeon may recommend a sentinel lymph node biopsy — that checks whether cancer reached nearby nodes and guides further treatment.
For advanced or node-positive melanoma, systemic treatments have changed outcomes. If your tumor has a BRAF V600 mutation, targeted pills like dabrafenib plus trametinib can shrink disease quickly. Immunotherapy with PD-1 inhibitors such as pembrolizumab or nivolumab boosts the immune system to fight cancer and has improved survival in large trials over the past decade. These drugs can cause immune-related side effects — skin rashes, colitis, or thyroid issues — so you’ll want clear monitoring plans.
When melanoma has spread widely, options include combining surgery, radiation, targeted therapy, immunotherapy, and clinical trials. Ask about molecular testing of the tumor — it guides targeted and immunotherapy choices.
Follow-up matters. Regular skin checks, monthly self-exams, and sun protection lower risk and catch recurrences early. Ask your provider how often to come back and what signs to watch for.
Practical questions to bring: Do I need a wider excision or Mohs? What are the risks and recovery? Should my tumor be tested for mutations? Are there clinical trials I qualify for? Clear answers help you pick the safest, simplest path that fits your life.
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