Skin Cancer Surgery

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.