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Surgery for Skin Cancer

Skin Cancer Surgery: What You Need to Know

  • Skin cancers can be life threatening, but they are easily treated if caught early.

  • Surgery is a common treatment for skin cancer.

  • Surgical options for skin cancer vary according to the location, type and size of the cancerous tissue, as well as the stage of the disease.

  • Surgery for skin cancers can often be performed using local anesthetic in the case of smaller less complicated tumors. Larger or more complicated tumors require operation.

Skin Cancer Surgery Options

Cryosurgery

Cryosurgery is the process of using an instrument to spray liquid nitrogen onto the skin to freeze and destroy tissue. This technique can be used on malignant and benign tissue. Over the course of approximately 30 days, the tissue forms a scab and falls off, taking cancerous cells with it. The procedure is typically used in cases of skin cancer that are isolated to a small area.

Cryosurgery is less invasive than other surgical options and therefore results in a shorter recovery time as well as minimal pain and bleeding. Since the cancer is treated at the surface level, microscopic cancer spread may not be detected. However, additional cancer treatments can be used in conjunction with this treatment option.

Curettage and Electrosurgery

Curettage is the process of using a round blade to scrape away cancerous skin tissue.

Electrosurgery, or burning of tissue with an electric current, is used after the curettage process to control bleeding and destroy any remaining cancer cells. The procedure is considered to have a high cure rate, particularly for small well-defined skin cancers.

Mohs Micrographic Surgery (MMS)

Invented by Dr. Frederick Mohs, this technique is used to treat some skin cancers. The procedure is unique because microscopic examination of the cancerous tissue happens during, rather than after surgery. The process takes more time than other surgical options because the surgeon will remove one layer of skin at a time until the margins of the area are cancer-free. However, proponents of the technique state the precise nature of the technique results in preservation of normal skin.

Wide Local Excision

Typically used for the treatment of larger skin cancers, wide local excision involves removing the cancerous tissue and margin of surrounding healthy tissue. This technique is used to treat melanoma. It can also be used to treat basal and squamous cell carcinomas.

Skin Grafting and Skin Flaps

If a large portion of cancerous skin is removed during surgery, your surgeon may use a skin flap or skin graft to repair the skin. The skin grafting process includes repairing the affected area using skin from another part of your body, such as your thigh or groin.

Skin flaps are similar to skin grafts in that they include repairing the area using skin from another part of the body. Often the surgeon will try to reconstruct the defect with tissue that is adjacent to the defect. This will transfer tissue of like color and texture. One advantage with the use of skin flaps, is that tissue that is retrieved comes with its own blood supply. Flaps may be used when the area that is missing skin does not have a good supply of blood due to the location or damage to the vessels. In the head and neck the use of adjacent tissue flaps gives a more aesthetic result.

The option for a skin flap can be more complicated but has better cosmetic results. In some cases, additional cosmetic procedures may be required to improve appearance.

Lymph Node Removal

Before skin cancer surgery, your doctor will examine the lymph nodes near the cancerous skin for warning signs of metastasis, the spread of cancer from one part of the body to another. This may involve the use of CAT scans, MRI or ultrasound. If your doctor finds cancer cells in your lymph nodes, you may require additional surgery to remove them. The lymph nodes act as “filters” for your body. They are designed to catch tumor cells and limit their spread to other parts of the body. This lymphadenectomy procedure (removal of lymph nodes) is typically performed by a plastic surgeon who specializes in the surgical management of cancers.

Lymph node removal can results in the following side effects:

  • Lymphedema, or swelling of the limb close to the lymph node

  • Infection, which is usually treated with antibiotics

  • Seroma (fluid buildup at the site of the surgery): As stated earlier, the lymph nodes are filters, and their removal will require your body find a new way to filter this fluid that is normally found in your body.

  • Numbness or tingling in the area of your surgery

Skin Cancer Surgery Risk Factors

Patients who undergo surgery for skin cancer may experience some of the following side effects:

  • Pain

  • Swelling

  • Bleeding

  • Scarring

  • Crusting

  • Cancer recurrence

  • Allergic reaction to the anesthesia

  • Wound infection

  • Loss of the skin graft

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Make a Health Promise

Skin cancer accounts for nearly half of all cancer cases. Protecting your skin from the sun is vital. It’s also important to examine your skin on a regular basis. Become familiar with moles or other skin conditions in order to better identify changes. If you or your family has a history of skin cancer, visit a dermatologist regularly for routine skin checkups.

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Avoiding Wound Infection

Infection can occur with the first 30 days of surgery. Signs of infection can include increasing redness or heat, swelling, pain and tenderness, and discoloration of the surrounding tissue. To help avoid infection, your doctor may prescribe antibiotics. You can take additional measures to reduce the likelihood of infection, including:

  • Not removing your bandage for the first 24 hours after surgery

  • Keeping the surrounding area clean

  • Showering and washing the area with a liquid antibacterial soap (when cleared by your physician to do so): You should not immerse or soak the wound in water until the sutures are gone and you are cleared by your physician to do so, so hold off on swimming and taking baths.

Dry skin around the wound can also delay healing. You can apply a thin film of any petroleum-based ointment to help keep the wound moist and avoid scabbing and scarring.

More Information About Skin Cancer Surgery from Johns Hopkins Medicine

Dad and daughter playing in a pool

Summer Skin Safety

Using a broad-spectrum, water resistant sunscreen, and protective clothing can shield your skin from harmful UV rays.

Learn more of the top tips for protecting your skin, and the latest advancements in skin cancer research.

Read more.

Recovery from Skin Cancer Surgery

After your skin cancer surgery, you may need additional treatment to prevent the recurrence of cancer. These postsurgical treatments, often referred to as adjuvant therapy, could include further surgery, chemotherapy, radiation, immunotherapy, or targeted therapy.

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