Blog #SCC

When patients come to me holding a pathology report, the word “cancer” has already triggered fear. At that stage, most of them don’t really read what’s written - they just see the word and stop.

So let’s talk about the two most common types of tumors I operate on: BCC and SCC.

Yes - both are skin cancers.

No - they are not the same.

First: BCC — Basal Cell Carcinoma

This is by far the most common tumor. About 8 out of 10 cases I see are BCC.It is a slow‑growing tumor. It almost never spreads to other organs.

But - it does invade deeply.

A small BCC on the nose can, over years, reach the cartilage.

On the eyelid - it can extend into the eye socket and even into nerves.In some cases, this tumor can infiltrate surrounding tissue with almost no external sign other than a slight change in skin color or texture.

Classic sign:  A shiny pink sore that keeps returning, bleeds, doesn’t heal, and slowly grows.

Sometimes it can be brown or black in parts, and it often appears in places where the patient assumes it came from trauma (glasses, scratches, etc.).

Second: SCC — Squamous Cell Carcinoma

This tumor is less common and behaves differently.

SCC can spread - to lymph nodes, and in rare cases to distant organs.Not always, not with high probability, but this is a major difference from BCC.

In some cases, this tumor is dangerous and even life‑threatening.

There are several subtypes - some more aggressive, some less, some deep, some superficial.

Classic sign:  A rough, scaly lesion - sometimes ulcerated, sometimes fleshy and nodular - usually on sun‑exposed areas: face, ears, lips, hands.

Why Mohs Surgery Is the Preferred Treatment for Both?

Because in Mohs surgery, unlike standard excision, we examine all tumor margins immediately under the microscope.

We don’t take “wide margins” as a safety measure - we take exactly what is needed, confirm that everything is clear, and then close.

Result:  Maximum cure rates with minimal damage to healthy tissue.

Bottom Line

For BCC - it’s important to treat, maybe slightly less urgent, but we do not wait.

For SCC - we definitely do not wait. Treatment should be done promptly and thoroughly.

If you received a report with one of these names - contact us.

We’ll explain exactly what’s going on and what the next step is.

When I performed my first mole surgery in the early 2000s, I arrived at the operating room with a protocol, equipment, theoretical knowledge acquired during my training in San Diego, and clinical experience acquired during my extensive plastic surgery residency. What I didn't know yet was what only surgery after surgery teaches.

Ten thousand surgeries later, I can say that much of what I know today is not found in any textbook.

What the data doesn't tell:
A 99% cure rate in Mohs surgery for BCC tumors — that's a real number. But behind every percentage are people. A 72-year-old man who came in with a "small pimple on his nose" that turned out to be a tumor that had penetrated the cartilage. A 58-year-old woman who postponed surgery for a year and a half "because it didn't seem important." A 17-year-old boy whose tumor was discovered during a routine checkup.
Every case taught me something.

What surprises patients the most:
Most of them think that Mohs surgery is “major surgery.” They come with anxiety, with someone accompanying them, with questions about general anesthesia.
In reality: Most surgeries are performed under local anesthesia only, in the clinic's operating room. You arrive in the morning, return home at noon. The scar, in most cases, is almost invisible after six months.

What still worries me
Patients who arrive too late.
Not too late in the dramatic sense — but too late in the sense of "I knew something was wrong a year ago, but I thought..., I waited until..." Every month of waiting with BCC or SCC on the face is another millimeter of growth, another tissue that will have to be removed, another risk of complications and aesthetic damage that will be difficult to repair.

If you have a lesion that doesn't heal, a wound that recurs, a spot that changes — come. Even if it turns out to be completely benign in the end. A visit that rules out a tumor is better than a visit that proves you've been nurturing a large and dangerous tumor.

What hasn't changed:
Every surgery, from the first one until now, begins at that moment: when I explain to the patient about the surgery and what's going to happen and I see the anxiety go down their face. That hasn't changed. That won't change.

For questions or to schedule an appointment: WhatsApp/SMS to 050-5633002 or email to 5633033@gmail.com