Skin Cancer, Nonmelanoma: Surgery

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Surgery

Surgery is the most common and most successful method of treating nonmelanoma skin cancer. The goals of surgery are to:

• Remove the entire skin cancer and a margin of healthy skin tissue around the cancer to reduce the chance of recurrence.
• Preserve nearby skin tissue that is free of cancer and minimize scarring after surgery.

Surgery Choices

The main types of treatment for nonmelanoma skin cancer include:

• Complete excision. Excision removes the skin cancer along with some healthy skin tissue around it (margin).
• Curettage and electrosurgery. Curettage uses a spoon-shaped instrument (curet) to scrape off the skin cancer. Electrosurgery with an electric current may be done after curettage to burn the skin tissue to control bleeding and destroy any remaining cancer cells.
• Mohs micrographic surgery. The Mohs procedure removes skin cancer one layer at a time and examines these layers under a microscope immediately after they are removed. This method allows for a close examination of each layer of skin to identify skin margins that are free of cancer during the surgery. Mohs surgery is also advised for certain skin cancers when the highest cure rate is needed while sparing as much healthy tissue as possible.⁶
• Cryosurgery. Cryosurgery destroys the skin cancer by freezing it with liquid nitrogen.
• Laser surgery, which is not commonly used. Lasers destroy surface (superficial) nonmelanoma skin cancers and actinic keratoses with an intense beam of light. The laser beam can also be used as a scalpel to remove (excise) a skin cancer. Currently, laser surgery is an expensive form of treatment.

Each type of treatment has advantages and disadvantages. Discuss your options with your doctor.

What To Think About

If squamous cell carcinoma has spread to the lymph nodes, surgery to remove the affected lymph nodes (lymphadenectomy) may be done. Radiation or chemotherapy may be recommended after surgery.

Last updated:	October 14, 2008
Author:	Bets Davis, MFA
Reviewed By:	Kathleen Romito, MD - Family Medicine, Alexander H. Murray, MD, FRCPC - Dermatology
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC