Surgery For Non-Melanoma Skin Cancer

Non-melanoma skin cancer is most often treated with surgery. In many cases, the biopsy procedure that is performed to confirm the diagnosis also serves as the treatment, if it is determined that all of the cancerous area has been removed. Further treatment may not be needed in some of these cases. In other cases, nonsurgical treatment is the most appropriate approach.

The type of surgery that is required for non-melanoma skin cancer depends on a number of factors. These include the type of cancer, the size and location of the growth or cancerous area, and whether this is the first instance or a recurrence.

Many of the same surgical procedures are used for both basal cell and squamous cell carcinomas. All have the goal of completely removing all of the cancerous tissue:

• Simple excision - The abnormal growth or area is surgically removed, and the margins (edges) are examined under a microscope to ensure that no cancer cells remain behind. This is determined when the technician can see “clear,” or non-cancerous, tissue along all edges of the tissue sample.
• Mohs surgery - Thin layers of the cancerous growth or area are removed one at a time and examined under a microscope until no further cancer is seen. This surgery is often chosen when the cancer is located in delicate areas, such as the face and neck, because it leaves less scarring.
• Electrodesiccation and curettage - The abnormal area of skin is dried with a high-frequency current, and tissue is removed with a small spoon-shaped instrument (curette).
• Cryosurgery - The abnormal tissue is frozen with a special instrument that contains liquid nitrogen or liquid carbon dioxide. This kills the cancer cells, which then slough off afterward.
• Laser surgery - A device that emits an intense, high-energy beam of light is used to cut away the cancerous tissue. Laser surgery causes very little or no bleeding and less scarring than conventional surgery.

Surgical treatment of skin cancer usually leaves some type of scar. The type and extent of scarring will depend on the size and depth of the area where the surgery was performed. In some cases it may be necessary to perform a skin graft at the surgery site. In this procedure, healthy skin is taken from elsewhere on the body, such as the upper thigh, and grafted onto the surgical site.

Nonsurgical Treatment

In some cases, treatments other than surgery may be used.

This content has been reviewed and approved by Myo Thant, MD.