Surgical Treatment

Surgery is one of the most common treatments for skin cancer, including melanoma, basal cell carcinoma and squamous cell carcinoma. Surgical treatments use any of a number of tools to excise abnormal tissue from the skin. Skin cancer surgery works best for smaller, more localized lesions.

Simple Excision

Some skin cancer lesions can be removed with simple excision. Simple excision involves the removal of the mole or lesion, along with some surrounding skin. This small perimeter is removed because the skin around the lesion may also contain cancerous cells. If the skin cancer removal is not complete, any remaining cells can grow to form additional or recurring tumors.

Mohs Micrographic Surgery

Mohs micrographic surgery is a highly effective method of surgical skin cancer removal. Mohs surgery is most often used to remove basal cell or squamous cell carcinoma. It involves careful removal of a lesion, one layer at a time. This procedure serves a dual purpose; it ensures removal of all cancerous cells, while removing as little healthy tissue as possible. Mohs surgery also reduces the risk of scarring, and is therefore commonly used on the face.

The surgery begins with removal of a thin layer of the lesion and a small amount of surrounding skin. This tissue is then examined for cancerous cells under a microscope. Subsequent thin layers are removed from the deeper layers of the skin; these are also examined for cancer cells. The process continues until a sample is removed that contains no abnormal cells, indicating clear margins. This helps to reduce the risk of cancer recurrence.

Cryosurgery

In cryosurgery, liquid nitrogen or argon gas is used to kill skin cancer cells. These materials are applied directly to the lesion with a spray or swab. Cryosurgery is effective for early-stage squamous cell or basal cell carcinoma. It is also used for precancerous lesions, such as actinic keratosis (also called carcinoma in situ).

Electrodessication and Curettage (EDC)

EDC uses a sharp, spoon-shaped tool called a curette to remove a skin cancer lesion. This process is followed by electrodessication, in which an electric needle burns the surrounding skin to stop bleeding and kill remaining cancer cells. EDC is commonly used to remove basal cell carcinoma lesions.

Other Surgical Treatments

In dermabrasion, an instrument equipped with a rotary attachment abrades, or shaves off, the outer layers of skin. Like some other surgical methods, dermabrasion is best for early-stage or precancerous lesions that extend only through the skin’s surface layers. In laser therapy, a laser (a thin beam of light) acts like a knife to excise cancerous tissue.

Closing Surgical Incisions

Methods of closing the incision also vary depending on the amount of tissue removed, and the location of the incision. For example, lesions removed from the face may be best treated with the help of a plastic surgeon, as many small stitches can minimize scarring. When large amounts of skin must be removed, reconstruction or skin grafting may be necessary.

Resources

Fox Chase Cancer Center. (n.d.). Skin cancer treatment options (nonmelanoma). Retrieved July 11, 2010, from http://www.fccc.edu/cancer/types/skin/nonmelanoma/treatment.html

Mayo Clinic. (2009). Basal cell carcinoma. Retrieved July 11, 2010, from http://www.mayoclinic.com/health/basal-cell-carcinoma/DS00925

National Cancer Institute. (2009). What you need to know about skin cancer: treatment. Retrieved July 11, 2010, from http://www.cancer.gov/cancertopics/wyntk/skin/page9