How is surgical skin cancer treatment performed?
There are a number of different ways to treat skin cancer. The skin cancer treatment procedure your medical team decides to use will vary on the basis of which type and stage of skin cancer you have. Your medical team will discuss the options available to you and explain which option they think is the most appropriate for you. Sometimes, your team may be able to remove your skin cancer using a simple procedure at an outpatients appointment. Other times, it may necessary for a more extensive surgical approach. Consequently, the procedure time will vary.
Before you have any type of skin cancer treatment, you will have to give your consent to treatment in writing. You should read the consent form carefully to make sure you fully understand the procedure you are about to have, and the risks that come with it.
If your cancer treatment involves any type of surgery, you will be given an anaesthetic before the procedure. For a simple surgical excision, the surgeon will usually inject a local anaesthetic to numb the treatment area. You will therefore be awake for the procedure but you will not feel any pain. It will take a few hours after the surgery for the numbness to wear off.
For more extensive surgical treatment, a general anaesthetic may be more appropriate for your surgery. In this case, you will meet with the anaesthetist and they will explain how the anaesthetic agent will work. You will be asleep for the surgery and will wake up slowly when it is over. You may feel groggy for a few hours after waking up, but this will wear off. Your memory and concentration may be affected for 1 to 2 days but this will also resolve.
3. Skin cancer removal
The actual surgical technique used to remove skin cancer will vary depending on the type and stage of the cancer. Your surgeon may use one of the following types of skin cancer treatment procedure:
Mohs Micrographic Surgery (MMS)
The Mohs Micrographic surgical technique allows the surgeon to slowly remove layer by layer of skin from the treatment area. They will use a microscope to check if there are any cancerous cells present on the last layer of skin that they remove. They will continue to do this until there are no cancerous cells present on the layer of skin removed. This technique was designed to allow removal of skin cancer while preserving as much healthy tissue as possible. It is most suitable for use in basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs).
Using a scalpel or a razor, your surgeon will cut or shave the cancerous growth from your skin. There are multiple ways in which your surgeon may do this including:
The surgeon will use a scalpel to remove cancerous skin growth and a small area of healthy looking tissue surrounding it. After the procedure, the skin that was removed is sent to a lab to check the grade of the cancer. Depending on the results of this, you may need further treatment.
The surgeon will use a scalpel to remove the cancerous growth and a wider perimeter of healthy looking tissue around it. They may also remove a deeper layer of skin than with a simple excision. The surgeon will then send the skin to the lab to check the grade of the cancer. Depending on the results, you may need further treatment. Surgeons often use this technique to treat malignant melanomas.
The surgeon will use a razor to shave or peel off the cancerous growth. Again, the surgeon will send the skin to the lab to check for the grade of cancer after the procedure. Depending on the results, further treatment may be necessary.
4. Closing of Incisions
Your surgeon will use stitches to close your wound where possible. In some cases with wide excisions, there may not be enough skin available to close the wound and reconstructive surgery using a skin graft may be necessary. Your surgeon will discuss this with you before the procedure if they suspect this will be the case for you. Reconstructive surgery is also a possibility at a later date if you are unhappy with the appearance of your treatment area after surgery.
5. Return home
Generally, you will be able to return home soon after your procedure. Your treatment area may remain numb for a few hours but the effects of the local anaesthetic will wear off with time.
If you have more extensive skin cancer treatment, you may have to stay in hospital overnight.
If you have any more questions about any skin cancer treatment procedure, you can contact your GP or oncologist directly.