Skin Cancer Surgery

If an Atypical Mole is at risk of transforming, or if it’s status is in doubt the lesion is surgically removed.

If melanoma is detected in an Atypical Mole, some of the surrounding tissue may also be removed to make sure that all of the cancerous cells are cleared.

Excision Treatment Process - After careful administration of local anaesthetic, the Doctor uses a scalpel to remove the entire growth, along with surrounding apparently normal skin as a safety margin. The wound around the surgical site is then closed with sutures (stitches).

Excision Treatment Recovery - For a few days post excision there may be minor bruising and swelling. Scarring is usually minimal. Pain or discomfort is minor. Typically, where sutures are used, they are removed soon afterwards.

Surgical Excision Prognosis - A histopathological report is generated for any Atypical Mole that is removed and once clearance is confirmed there is effectively no chance of this Mole causing any problem in the future.

Non-melanoma skin cancers are almost always surgically removed under local anaesthetic and this is the safest form of treatment due to the potential of Squamous Cell Carcinomas to spread. This approach offers:

Excision Treatment Process - After careful administration of local anaesthetic, the Doctor uses a scalpel to remove the entire growth, along with surrounding apparently normal skin as a safety margin. The wound around the surgical site is then closed with sutures (stitches).

Excision Treatment Recovery - For a few days post excision there may be minor bruising and swelling. Scarring is usually minimal. Pain or discomfort is minor. Typically, where sutures are used, they are removed soon afterwards.

Surgical Excision Prognosis - Studies indicate the cure rate for primary tumours with this technique is around 92 percent. Clearance rates for recurrent Squamous Cell Carcinomas are lower around 77 percent. A repeat excision may be necessary on a subsequent occasion if evidence of skin cancer is found in the specimen.

Mohs Micrographic Surgery Treatment Process - Using a scalpel or curette (a sharp, ring-shaped instrument), a Mohs Surgeon removes the visible Squamous Cell Carcinoma with a very thin layer of tissue around it. While the patient waits, this layer is sectioned, frozen, stained and mapped in detail, then checked thoroughly under a microscope.

If cancer is still present in the depths or peripheries of this excised surrounding tissue, the procedure is repeated on the adjacent area of the body which still contains tumour cells until the last layer viewed under the microscope is cancer-free.

Mohs Micrographic Surgery Treatment Recovery - After tumour removal, the wound may be allowed to heal naturally or may be reconstructed immediately.

Mohs Micrographic Surgery Prognosis - The cosmetic outcome is often excellent.

It is often used on tumours that have recurred, are poorly demarcated, or are in hard-to-treat, critical areas around the eyes, nose, lips, ears, neck, hands and feet. After tumour removal, the wound may be allowed to heal naturally or may be reconstructed immediately. The cosmetic outcome is usually excellent.

It can be time-consuming and expensive.

Because most treatment options involve cutting, some scarring from the tumour removal should be expected. This is most often cosmetically acceptable with small cancers, but removal of a larger tumour often requires reconstructive surgery, involving a skin graft or flap to cover the defect. Mohs Surgeons are trained in reconstructive surgery, so visit to a Plastic Surgeon is usually unnecessary.

In more advanced skin cancers, some of the surrounding tissue may also be removed to make sure that all of the cancerous cells are cleared.

Excision Treatment Process - After careful administration of local anaesthetic, the Doctor uses a scalpel to remove the entire growth, along with surrounding apparently normal skin as a safety margin.

The wound around the surgical site is then closed with sutures (stitches).

Excision Treatment Recovery - For a few days post excision there may be minor bruising and swelling. Scarring is usually quite acceptable. Pain or discomfort is usually minor.

Typically, where sutures are used, they are removed soon afterwards.

Wide-Area Local Excision - A second excision is usually performed on the site after the melanoma has been diagnosed on excisional biopsy. The desired safety margins are determined by the type of melanoma to be between 5mm and 20mm based on the level of invasion and a second excision known as a wide-area local excision is performed to achieve this amount of safety margin around the melanoma excision site. In cases of superficial spreading melanoma the desired margin is 5 mm to the side and deep, and highly invasive melanomas may require up to 20mm margins to the side and deep to reach the lowest risk of spread or local recurrence.

The curette may also be used to scrape off the base of the lesion. Bleeding is stopped with an electrocautery needle or by applying trichloroacetic acid (TCA). Local anesthesia is required.

This method is most often used to remove superficial actinic keratoses on the face, especially when other techniques have failed.

Usually a biopsy is sufficient to determine the stage of a Basal Cell Carcinoma. In the rare case of suspected metastatic Basal Cell Carcinoma, lymph nodes may be examined by the Doctor to see if the cancer has spread or by the use of imaging technologies like ultrasound, CT, or PET scanning.