Surgery for Non-Melanoma Skin Cancer

When you hear the phrase “skin cancer,” you might think first of melanoma, the most serious type. Yet the most common types of skin cancer are basal and squamous cell, and they rarely spread through your body.

Your treatment for non-melanoma cancers may include radiation or chemotherapy, but surgery to remove the tumor is used most often.

Mohs Surgery (Mohs Micrographic Surgery)

During this procedure, a surgeon removes skin tissue in very thin layers, carefully looking at each layer under a microscope to see if it’s cancerous and he needs to remove more. He stops once he sees a layer of cancer-free tissue.

This precise approach helps you keep as much healthy skin as possible, and it’s especially useful for treating cancers near sensitive areas like your eyes, nose, or mouth.

What to expect: Mohs surgery usually is done in your doctor’s office, but it can take a long time because you have to wait for the lab results for each layer. In most cases, you won’t be put to sleep. Instead you’ll get local anesthesia so you won’t feel any pain. The surgery wound may heal on its own, but you may need stitches or a skin graft if a lot of tissue is taken out.

Surgical Excision

This isn’t as complex as Mohs surgery, but it’s less exact. Your surgeon will cut out the cancerous tissue as well as some of the surrounding healthy skin to make sure the entire tumor is removed. The tissue is then sent off to a lab for testing.

What to expect: This is also outpatient surgery. You’ll be numbed first with a local anesthetic. You’ll probably need stitches to close up your wound.

If the tests show that no cancer cells remain, your treatment is done. But if some cancer cells are still there, you may need to have the procedure again.

Cryosurgery

Also known as cryotherapy, this destroys cancer cells by freezing them with liquid nitrogen, which is sprayed or swabbed directly onto your skin.

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What to expect: You’ll feel a brief burning sensation when your doctor puts on the liquid nitrogen. The frozen skin will form a scab as it heals, which should fall off in about a week.In some cases, you may need the treatment again to make sure all the cells are destroyed.

When you’ve healed completely, you may notice that your skin is hairless or appears lighter in color. In rare cases, the surgery can make you lose feeling in the area.

Electrodesiccation and Curettage

This type of surgery usually isn’t recommended for cancers that are deep below your skin’s surface. During this quick procedure, your doctor scrapes away cancerous tissue with a tool called a curette, which looks a little like a pen but has a sharp loop at one end. Afterward, she’ll use electricity to kill any remaining cancer cells and help stop bleeding. The tissue isn’t sent to a lab afterward, so you won’t know for sure if the entire tumor was removed.

What to expect: You won’t need more than a topical anesthetic, and the wound usually heals on its own, without stitches.

Laser Surgery

Instead of a scalpel, your surgeon will use a laser to destroy the cancer with heat. Because a laser beam is much more precise than a knife blade, this can treat cancer in sensitive areas of your body.

What to expect: The laser’s heat also seals the wound as it cuts, so there’s less bleeding and pain, and less scarring. Your healing time also will be shorter, compared with traditional surgery.

Sometimes, the laser isn’t able to kill all the cancer cells, though. If that happens, you may need to have the treatment again.

WebMD Medical Reference Reviewed by Sabrina Felson, MD on October 12, 2019

Sources

SOURCES:

American Cancer Society: “What is melanoma skin cancer?”

National Cancer Institute: “Skin Cancer Treatment: Patient Version.”

Mayo Clinic: “Mohs Surgery.”

Skin Cancer Foundation: “Basal Cell Carcinoma Treatment Options.”

American Cancer Society: “Surgery for Basal and Squamous Cell Skin Cancer.”

National Cancer Institute: “Cryosurgery in Cancer Treatment.”

Skin Cancer Foundation: “Squamous Cell Carcinoma Treatment Options.”

NYU Langone Medical Center: “Surgical Procedures for Basal and Squamous Cell Skin Cancer.”

American Cancer Society: “Lasers in cancer treatment.”

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