Nonmelanoma Skin Cancer: Surgery
Surgery is the most common way to treat nonmelanoma skin cancer. There are many methods of surgery than can be used to remove the cancer. The goal is to completely remove the cancer while trying to limit harm to healthy tissue. This is especially important when the cancer is on the face.
This procedure removes the cancer and as little normal tissue as possible. It’s done in sensitive areas such as the face. During Mohs surgery, you’re given a local anesthetic to numb the area being treated. The cancer is removed from the skin one layer at a time. Each layer is checked under a microscope for cancer. If cancer cells are seen, another layer of skin is removed. Layers are removed until the doctor doesn’t see any more cancer. The procedure is done at one time, but it may take several hours, depending on how many layers need to be removed. After this surgery, the cancer is fully removed and the wound can be repaired. Mohs surgery may be a good option if:
Your doctor is not sure of the exact depth and shape of the tumor
The tumor is very large
The tumor is located in a hard-to-treat place
The skin cancer has come back
The skin cancer is on the face
Curettage and electrodesiccation
This procedure removes tissue and cauterizes the area. You are given a local anesthetic to numb the area. Your doctor then uses a sharp spoon-shaped instrument called a curette to remove the cancer. This is called curettage. After curettage, your doctor passes an electric needle over the surface of the scraped area to stop bleeding, and destroy any remaining cancer cells. After it heals, a flat, white scar may remain.
This is done to cut the cancer from the skin, along with some of the healthy tissue around it. You are given a local anesthetic. Then, your doctor uses a scalpel to remove the tumor from the skin. The doctor may also remove some of the normal skin around the tumor. This is called a "margin." Depending on the size of the incision, stitches or a sterile bandage strip may be used to close the wound. The tissue that was removed is sent to a pathologist for analysis. If the report reveals that not all the cancer was removed, you’ll likely need another procedure to remove the rest of the cancer.
This method is used for cancer that is only in the top layers of the skin. You are given a local anesthetic. Then, your doctor uses a small blade to shave off the tumor. The goal is to remove the tumor at its base.
This method uses cold to destroy the cancer cells. This method is best for very small cancers near the skin’s surface. Your doctor uses a device that sprays liquid nitrogen onto the tumor. This freezes the cells and destroys them. The dead skin then falls off. You may have some swelling and blistering in the area after treatment. A white scar is usually left behind. The procedure may need to be repeated.
Laser treatment or dermabrasion
Laser therapy uses narrow beam of intense light is used to remove cancer cells. Dermabrasion removes the top layer of skin with a rotating wheel or small particles that rub away skin cells. These types of surgery are not as common. It’s not possible to see if all the cancer cells were removed with these methods. These kinds of surgery also don’t give produce a tissue sample for a pathologist to check.
Pain after surgery
Temporary pain in the area of the surgery is a common side effect. You may feel pain in the first few days to a week after surgery. You can treat pain with pain medicine as your health care provider advises. Only use approved pain medication.
Scarring after surgery
Any skin surgery leaves scars. The same is true for surgery to remove skin cancer. The size and color of the scar depend on the size of the cancer, its location, the type of surgery, and how well your skin heals. Your doctor will use methods to hide the scar as much as possible.
If stitches were used to hold the wound closed, they are usually removed about a week after surgery. Healing continues over time after that. Early on, the scar may be red or bumpy. It takes about a full year for a scar to fade. Be sure to speak with your doctor about ways to aid healing. Most often, though, your body's natural healing abilities are the best and simply take time.
In some cases, a skin graft may be needed to close an opening in the skin left by surgery and to leave the area looking more like the surrounding skin. To do skin graft surgery, the surgeon numbs and removes a patch of healthy skin from another place on the body. This is called the graft. The graft may be taken from the upper thigh or abdomen. The graft is then used to cover the wound. If you have a skin graft, you will be given special instructions about how to care for it while it heals.
Your treatment plan
The method of surgery your doctor will advise for you depends on factors such as:
The type of cancer
The size of the tumor
The location of the tumor
If the area of the tumor is visible, such as on your face
If the tumor has spread
Your overall health
Whether cancer is likely to occur again
If the area has been treated before and the cancer has come back
Talk with your doctor about what kind of surgery is an option for you.Ask any questions and address any concerns you may have. You may still need other types of treatment before or after surgery. Surgery is most often in a doctor's office or a hospital’s outpatient clinic. You’ll be able to go home the same day.