Skin Cancer Treatments:

Skin cancer is most commonly treated by surgical methods. These procedures include:

Surgical Excision:
Surgical excision is the most common treatment method for skin cancer. It is used primarily for removal of easy-to-treat skin cancers that are not located in cosmetically sensitive areas, such as the arm, leg, or trunk. Surgical excision is performed using a scalpel. It is usually performed as an outpatient procedure. At this time, surgical excision is the preferred method of treatment for malignant melanoma.

Surgical excision requires the surgeon to estimate where the edges of the tumor are located and then add several additional millimeters of normal skin to try and remove the entire tumor. This may lead to an excessively large surgical wound due to the estimation of the tumor margins. When treating skin cancers on the face or other cosmetically sensitive areas it is important to keep the surgical wound as small as possible so as to have the best appearance after sewing up the wound.

After the tissue sample is removed, it is sent to a pathology lab to check for complete removal of the tumor. This step requires several days to one week. If tumor is present in the edges of the tissue sample, then tumor is still present in the patient. The patient must then return for further surgery.

One disadvantage of surgical excision is that not all of the tissue edges are checked when using routine pathology; therefore, some of the tumor may remain and lead to recurrence of the skin cancer. However, Moh's surgery allows the doctor to check all the edges to give the highest cure rate and the smallest chance for recurrence. (See About Mohs Micrographic Surgery for more information about this procedure.)

Electrodesiccation & Curettage:
Also known as "scrape and burn" this method removes skin cancer by using a curette and electric needle. The curette scrapes away tumor, since tumor cells are less cohesive than normal cells. The area is then treated with an electric needle to further burn the area. This process is repeated three times.

This method is commonly used and successful in many instances. The surgical margins are not checked, however, and after the procedure is completed the surgeon does not know whether the tumor has been completely removed. An open wound is also left to heal on its own, which often results in a sub-optimal cosmetic outcome. This wound takes several weeks to heal. The method does allow quick and simple treatment often on the same day as a skin biopsy when the diagnosis is almost certain.

Cryotherapy:
The tumor is frozen with liquid nitrogen. This method of cancer surgery is not common practice, but can be very effective in experienced hands.

Mohs Micrographic Surgery:
The most precise method for skin cancer (basal cell and squamous cell carcinoma) removal with the highest cure rates. With this method the surgeon checks the tissue while you wait. Further surgery can be performed immediately, and repair of the surgical wound can usually be completed the same day. Mohs surgery is a cost efficient outpatient procedure using local anesthesia.

Non-Surgical Methods Include:
Radiation Therapy: X-rays are used to kill the cancer cells. This method also requires an estimate of the extent and size of the tumor.

Photodynamic Therapy: An investigational technique where light and chemicals are combined to kill cancer cells.