No one skin-cancer treatment is best for every patient in every situation. There is a need for virtually every type of skin-cancer treatment, depending upon a patient's age, special situations, individual skin types and type of skin cancer. Most importantly, there is very little that is absolute or black and white in medicine and the words "always" and "never" almost never should be used. In a way skin cancer treatment choices are similar to investing, depending upon a patient's "risk tolerance" (if the patient is properly explained the procedure and the options).

There are vast gray zones. For example, there are certain types of melanoma that are much less dangerous than many types of squamous-cell carcinoma. Virtually 100% of well-trained dermatologists and Mohs Surgeons would much rather be diagnosed with a lentigo maligna melanoma that is early and thin, or almost any melanoma that is level one and thin, than with a poorly differentiated squamous-cell carcinoma. Thin melanomas are highly curable, whereas a very abnormal squamous-cell cancer may have already entered the blood stream and moved to another part of the body.

As well, there are many types of basal-cell carcinomas that are much more dangerous to the patient than some forms of squamous-cell carcinomas. Most doctors would be much more concerned about an infiltrating basal-cell carcinoma near my central eyelid than they would be about a superficial (high up or not deep) well differentiated (more like normal tissue) squamous cancer of the shoulder. Of course in almost all cases, skin cancers should be treated.

In summary, nothing is etched in stone when it comes to skin cancer and its treatment. There are many areas of overlap and sometimes it is best to seek two or three opinions before having surgery. The website author believes that the first thing to know is whether the biopsy (pathology or histopathology) was read correctly. Perhaps the glass slide (not just the lab report) should be read by another different reputable lab staffed by Board-Certified DERMATOPATHOLOGISTS before seeking a second surgeon's opinion. It may also be best to seek a final opinion from a nearby Department of Dermatology at a University Medical School.