Skin Cancer surgery
There are many treatments for skin cancer. Options for treatment depend on may factors including:
- Type of skin cancer.
- Where the skin cancer appears on the body.
- Whether the skin cancer is aggressive.
- Stage of the cancer (how deeply the skin cancer has grown and whether it has spread).
- Patient’s health
After considering the above, we will proceed with the best option for our patients. We do perform the removal of many skin cancers in the office but do refer patients out of the office who require Mohs surgery or more extensive large excisions especially on the face.
Surgical treatment: When treating skin cancer, the goal is to remove all of the cancer. When the cancer has not spread, this is often possible. To remove skin cancer, the following surgical treatment may be used:
- Excision: To perform this, the dermatologist numbs the skin and then surgically cuts out the skin cancer and a small amount of normal-looking skin. This normal-looking skin is called a margin. There are different types of excision. Most excisions can be performed in a dermatologist’s office.
- Mohs surgery: A dermatologist who has completed additional medical training in Mohs surgery performs this procedure. Once a dermatologist completes this training, the dermatologist is called a Mohs surgeon. Mohs surgery begins with the surgeon removing the visible part of the skin cancer. Because cancer cells are not visible to the naked eye, the surgeon also removes some skin that looks normal but may contain cancer cells. This part of the surgery is performed one layer at a time. After removing a layer of skin, it is prepared so that the surgeon can examine it under a microscope and look for cancer cells. If the surgeon sees cancer cells, the surgeon removes another layer of skin. This layer-by-layer approach continues until the surgeon no longer finds cancer cells. In most cases, Mohs surgery can be completed within a day or less. The cure rate for skin cancer is high when Mohs surgery is used.
- Curettage and electrodesiccation: This surgical procedure may be used to treat small basal cell and squamous cell skin cancers. It involves scraping the tumor with a curette (a surgical instrument shaped like a long spoon) and then using an electric needle to gently cauterize (burn) the remaining cancer cells and some normal-looking tissue. This scraping and cauterizing process is typically repeated 3 times. The wound tends to heal without stitches. Sometimes, curettage is used alone.
- Other treatments: Surgical treatment is not right for every case of skin cancer. Some patients cannot undergo surgery and sometimes surgery cannot remove all of the cancer. There other other options that need to be considered when these circumstances arise
Other treatments for skin cancer are:
- Immunotherapy: This treatment uses the patient’s own immune system to fight the cancer. The patient applies a cream (generic name is imiquimod) to the skin as directed by the dermatologist.
- Cryosurgery: The dermatologist freezes the skin cancer. Freezing destroys the treated area, causing the skin and cancer cells to slough off.
- Chemotherapy applied to the skin: The generic name for the medicine used in this treatment is 5-fluorouracil or 5-FU. The patient applies 5-FU to the skin cancer. It destroys the damaged skin cells. When the skin heals, new skin appears.
- Chemotherapy: If the cancer spreads beyond the skin, chemotherapy may kill the cancer cells. When a patient gets chemotherapy, the patient takes medicine. This medicine may be swallowed, injected (shots), or infused (given with an IV). The medicine travels throughout the body and kills the cancer cells. The medicine also destroys some normal cells. This can cause side effects, such as vomiting and hair loss. When chemotherapy stops, the side effects usually disappear.
- Photodynamic therapy: This treatment consists of 2 phases. First, a chemical is applied to the skin cancer. This chemical sits on the skin cancer for several hours. During the second phase, the skin cancer is exposed to a special light. This light destroys the cancer cells.
- Radiation therapy: Radiation may be used to treat older adults who have a large skin cancer, skin cancers that cover a large area, or a skin cancer that is difficult to surgically remove. Radiation therapy gradually destroys the cancer cells through repeat exposure to radiation. A patient may receive 15 to 30 treatments. This treatment is often only recommended for older adults. Many years after a person is exposed to radiation, new skin cancer can develop.
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