Surgery for Nonmelanoma Skin Cancer

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

Surgery is one of the most effective and common procedures for nonmelanoma skin cancer. It can remove the cancer with minimal impact on nearby tissue.

There are different kinds of surgery for nonmelanoma skin cancer with the goal of removing the cancer completely. 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.

Which surgeries treat nonmelanoma skin cancer?

There are a few kinds of surgeries that might be an option. Ask your provider for any additional information on the following types.

Mohs surgery

What is it?

Mohs surgery (also called Mohs micrographic surgery) is a type of surgery to remove the cancer from the skin 1 layer at a time. After each layer is removed with a scalpel, it’s checked under a microscope for cancerous cells. Layers are taken away and analyzed by an on-site lab until your provider finds a layer without any cancerous cells. This ensures that the cancer was completely removed.

How does it work?

You get a local anesthetic to numb the treatment area. The provider will begin removing and checking layers. Because this surgery is so detailed, it can take a few hours. One benefit of this surgery is it tends to have very little impact on nearby noncancerous tissue. Your provider will decide on the best way to close the surgical site opening or will keep it open if it is small enough to heal on its own.

Mohs surgery might be the best fit for you if:

• Your provider is not sure of the exact depth and shape of the tumor

• The tumor is in a place other types of surgery might not access so easily

• The cancer is in a sensitive part of your body, such as your face or where tissue is thin

• The cancer has returned

• The cancer is large

Curettage and electrodesiccation

What is it?

In this procedure, the provider removes the cancer by scraping it with a long, thin, sharp tool with a loop or scoop at 1 end (curette). The area is then treated with an electric needle to stop bleeding and make sure any remaining cancer cells are gone. This may be used for low-risk skin cancers and precancers.

How does it work?

You get a local anesthetic 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.

This process is often used for cancer on the top layer of skin.

Excisions

Simple excision

What is it?

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

How does it work?

After you get a local anesthetic, 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. If the opening is large, a skin graft from another part of the body may be needed to cover the wound to help healing.

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 (cryotherapy or cryosurgery)

What is it?

Your provider uses a small blade to shave the tumor.

How does it work?

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 multiple times to completely remove the cancer.

Laser treatment

What is it?

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).

How does it work?

You get a local anesthetic. The beam will impact 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 multiple lesions at once. It is more often advised for pre-cancer lesions.

What can I expect after surgery?

It may take a few 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 to help minimize the scar.

If you had stitches to help the wound stay closed, they’re usually removed about 1 or 2 weeks 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 new changes. Be sure to know who to call during evenings, holidays, and weekends, too.