There are a few kinds of procedures that might be a choice. Ask your doctor for any additional information on the following types.
Mohs surgery
What it is: Mohs surgery (also called Mohs micrographic surgery) is a type of surgery to remove the cancer from the skin one 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 doctor finds a layer without any cancerous cells. This ensures that the cancer was completely removed.
How it works: You get a local anesthetic to numb the treatment area. The doctor 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 doctor 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 doctor 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 it is: In this procedure, the doctor removes the cancer by scraping it with a long, thin, sharp tool with a loop or scoop at one 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 it works: You get a local anesthetic to numb the area. Your doctor then uses the curette to remove the cancer. This process is called curettage.
After curettage, your doctor 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 it is: This procedure uses a scalpel to remove the cancer and a small area of surrounding tissue.
How it works: After you get a local anesthetic, your doctor 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
What it is: Your doctor uses a small blade to shave the tumor.
How it works: Your doctor will use a local anesthetic to numb the area and then use a small scalpel to shave or remove the tumor on the outer layers of skin. Usually, stiches are not needed. The doctor may use a small electrical current to cauterize blood vessels or use a medicine to stop any bleeding.
Cryotherapy (or cryosurgery)
What it is: Your doctor uses a device that sprays liquid nitrogen onto the tumor.
How it works: The substance that is sprayed onto the tumor 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 it is: 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 it works: 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 surgery. Laser treatment can also treat multiple lesions at once. It is more often advised for precancer lesions.