The first 2 weeks after a skin cancer diagnosis, step by step.
Ask the office that did your biopsy for the full written report, since a phone summary leaves out details. The report belongs in your own files, and every doctor you see later will want it. Note the name of the lab and the case number printed at the top, because other doctors use them to request your slides.
Skin cancer is a group of diseases, and the plan depends on which one you have. For basal or squamous cell cancer, ask about the subtype and whether the report lists any high-risk features. For melanoma, ask for the Breslow thickness in millimeters, whether ulceration is present, and the stage so far. Write the answers down word for word.
A biopsy often removes only part of a cancer. Ask whether the report shows cancer cells at the edges of the sample and what procedure comes next, such as a standard excision, Mohs surgery, or a wider excision with a lymph node biopsy for some melanomas. Ask who will perform it and how soon it should happen.
Pathologists agree closely on clear-cut cases, but the middle ground is harder. In a BMJ study (Elmore and colleagues, 2017), 187 pathologists read the same melanocytic biopsies, and diagnoses ranging from moderately atypical moles to early invasive melanoma often differed from one reader to the next. A review of your slides by a dermatopathologist is a common request, and doctors rarely take offense. Your dermatologist's office or the original lab can send the slides.
Stress makes it hard to absorb new information. A relative or friend can take notes, ask follow-up questions, and help you recall what the doctor said. Many offices also allow you to record the visit if you ask first.
Put the 3 questions that matter most at the top of the list in case time runs short. Common ones include how deep or how far the cancer has gone, whether more tests are needed before treatment, whether you should see another specialist, and what follow-up will look like. Leave space on the page for the answers.
Call your insurer to learn which dermatologists, surgeons, and cancer centers are in your network and whether a referral or prior approval is required. The National Cancer Institute notes that many health plans pay for a second opinion, and some require one before surgery. Keep your pathology report, clinic notes, photos of the spot, and any scan results together in 1 folder, on paper or on your phone.
One skin cancer raises the chance of another, so daily sun protection and regular skin checks begin now. After a melanoma diagnosis, let your parents, siblings, and children know. About 1 in 10 people with melanoma have a family history of the disease, according to the American Cancer Society, and close relatives can ask their own doctors about skin exams.
What your stage means and what happens next.
A line-by-line guide.
Help for patients and families.
