Surgery for skin cancer

Surgery is the most common treatment for skin cancer. The type of surgery you will have depends on the size and position of the cancer.

Many small skin cancers are removed by a surgeon or dermatologist using simple surgery. They will remove the cancer and some normal-looking skin around the area. Most operations will be done under local anaesthetic and you will be able to go home the same day. The hospital staff will tell you how to look after the area when you go home.

A specialised type of surgery called Mohs micrographic surgery is available at some hospitals. The surgeon removes the cancer in layers until all the cancer cells have gone. This type of surgery can be useful for some skin cancers, such as skin cancers on the face or larger skin cancers.

Some people have surgery using curettage and electrocautery. This involves scraping the cancer cells away, using heat or electricity to stop the bleeding. It is usually used for small skin cancers. It usually gives good cosmetic results.

What is surgery for skin cancer?

Surgery is the most common treatment for skin cancer. How it is done depends mostly on the size of the cancer and where it is.

If you have a small cancer, the doctor can usually remove (excise) it under local anaesthetic. Or they may use a technique to destroy the cells known as curettage and electrocautery.

A larger cancer is more likely to be removed while you are under a general anaesthetic. The skin is replaced with a skin graft or skin flap, if needed. A type of surgery called Mohs micrographic surgery (or margin-controlled excision) is used in some hospitals in the UK.


Excision

Most small skin cancers are removed by simple surgery. The surgeon or dermatologist will remove the cancer and some normal-looking skin around it. The normal-looking skin is checked to make sure that the cancer has completely gone. You will have stitches that may need to be removed 5 to 14 days after your operation. Sometimes surgeons use dissolvable stitches that do not need to be removed.

Most operations are done under local anaesthetic and you can go home on the same day. The wound will be covered by a dressing. The staff at the hospital will explain how to take care of the area and the dressing. If necessary, hospital staff can arrange for a district nurse to change your dressings at home. Or they may advise you to go to your GP surgery or return to the hospital for help with dressing the wound.


Mohs micrographic surgery

This is specialised surgery, also known as margin-controlled excision, and is only available at a few hospitals in the UK. Your specialist will refer you to one of these centres if they think you might need this technique. Mohs surgery is particularly useful for:

  • skin cancers that have come back in the same place
  • when the doctor thinks that the cancer has begun to spread into the surrounding area
  • skin cancers on the face (to minimise the effects of surgery)
  • large skin cancers.

During Mohs surgery, the surgeon removes the cancer in thin layers. The tissue that has been removed is looked at under a microscope during the surgery. The surgeon continues to remove more layers until no cancer cells are seen in the tissue. This technique makes sure that all the cancer cells are removed and only a very small amount of healthy tissue is removed.

Mohs surgery is often done under local anaesthetic. You are usually allowed to go home the same day.

If you are having a large cancer removed, you may also need to have a skin graft or skin flap to cover the wound.

After surgery, you will have to take things slowly to build up your strength. I was 61, and I know of others who are older who have come through this.

Christine


Curettage and electrocautery

Occasionally, people have treatment using curettage and electrocautery. This involves scraping away the cancer and using heat or electricity to stop any bleeding. It is usually only used for skin cancers that are small.

First, the doctor or nurse will give you a local anaesthetic. Once the area is numb, the doctor will scrape away the cancer using an instrument called a curette. They then use an electrically heated loop or needle to stop any bleeding (cauterise the wound) and destroy any remaining cancer cells.

This treatment usually gives good cosmetic results. A few people may develop some scarring, which may be more noticeable if they have pale skin.

Back to Surgery

Who might I meet?

A team of specialists will plan your surgery. This will include a surgeon who specialises in your type of cancer.

Skin grafts and skin flaps

You may need to have skin taken from another area of the body to cover the area where the skin cancer was removed.