Nonmelanoma Skin Cancer: Surgery

If you have nonmelanoma skin cancer, you may be feeling scared or wondering what can be done to get you back to better health. The good news is that surgery can be a successful option.

Surgery is one of the most helpful and common procedures for nonmelanoma skin cancer. It can remove the cancer with minimal impact on surrounding tissue. This is especially important when the cancer is on the face.

There are different kinds of surgery for nonmelanoma skin cancer. The type you and your healthcare provider choose depends on the cancer’s size, type and location, other treatments you’re receiving, your overall health, and your preferences. You and your provider will explore all options to select the one that fits you best.

Surgery is most often in a healthcare provider's office or a hospital’s outpatient clinic. You’ll be able to go home the same day.

Types of surgery used to treat nonmelanoma skin cancer

Mohs surgery

This type of surgery removes the cancer from the skin one layer at a time. After each layer is removed, it’s looked at under a microscope for cancerous cells. Layers are taken away and analyzed until your provider finds a layer without any cancerous cells. This makes sure that the cancer is gone.

You get medicine (local anesthetic) to numb the treatment area. The provider will begin removing and examining layers. Because this surgery is so detailed, it can take several hours. One benefit of this surgery is it tends to have very little impact on nearby noncancerous tissue.

Mohs surgery might be the best fit for you if:

• Your healthcare provider 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 or in other areas where it is important to reduce the amount of skin removed

Curettage and electrodesiccation

In this procedure, the provider removes the tumor by scraping it with a long, thin instrument ( curette). The area is then treated with an electric needle to stop bleeding and make sure any remaining cancer cells are gone.

You get medicine to numb the area. Your provider then uses the curette to remove the cancer. This process is called curettage.

After curettage, your provider will wave an electric needle with a high frequency over the area to stop bleeding and focus on removing any remaining cancer cells. This is electrodesiccation.

Simple excision

This procedure uses a scalpel to remove the cancer and a small areaof surrounding tissue.

After you get numbing medicine, your provider will use the scalpel to remove the tumor and some of the surrounding skin. This area is called a margin. Removing the margin makes sure the cancer is gone from your body. Depending on the size of the treatment area, you may get stitches or a sterile bandage strip after the procedure to help your body heal.

The removed tumor is also sent to a pathologist. They examine the margins to confirm the area is free of cancer. If the tests show that some of the cancer is still in the margins, you’ll likely need additional procedures to remove it.

Shave excision

Your provider uses a small blade to shave the tumor.

A numbing medicine is put on the area. Your provider will remove the cancer with the blade. This process only affects the top layer of skin. That makes it less invasive than other surgeries. It won’t affect the area surrounding the tumor as much.

This kind of surgery is often recommended for cancer found in the top layers of the skin.

Cryosurgery

This method uses a very cold substance to remove the cancer.

Your provider uses a device that sprays liquid nitrogen onto the tumor. This substance will freeze the cancer cells. The dead skin containing the cells will come off your body.

Afterward, you may have swelling and blistering in the treatment area. You might also see a white scar. The procedure can be done several times to completely remove the cancer.

Laser treatment or dermabrasion

Laser treatment uses a narrow and very precise beam of intense light to remove the cancer cells or cells that are likely to contain cancer in the future. The beam is more precise than a blade (such as a scalpel).

You get numbing medicine. The beam will affect the top layers of skin. It heats the skin until the cancer is removed. The procedure is relatively short. Because of this, healing can be faster and involve less bleeding, swelling, and scarring than other kinds of surgery. Laser surgery can also treat several lesions at once.

What to expect after surgery

It may take weeks or more for your skin to heal after surgery. During this time, you may have some bruising, soreness or aching, redness, and swelling at the site. Your providers will form a treatment plan that helps you heal while keeping you as comfortable as possible. You can treat pain with pain medicine as your healthcare provider advises. Use only approved pain medicine.

You may also see scarring. The size and color of the scar depend on the specifics of the cancer that was removed, such as its size and location, and the kind of procedure you had. Your providers will talk to you about the best course of treatment for the scar to help minimize it.

If you had stitches to help the wound stay closed, they’re usually removed about a week or two after surgery. Healing will continue over time. Your scar may be red or bumpy at first. It takes about a year for the scar to fade.

Your healthcare providers will also give you information on keeping the site clean to avoid infection.

Let your providers know about any side effects you may have, including any changes. Be sure to know who to call during evenings and weekends, too.

Working with your healthcare provider

Talk with your healthcare provider about what kind of surgery is best for you. Ask any questions and address any concerns you may have.