Introduction
While some forms of early non-melanoma skin cancers (NMSC) can be treated non-surgically, the mainstay of treatment is surgical removal.
Indications
Clinically suspected or biopsy proven skin malignancy should be removed by surgery.
Preoperative Instructions
Most skin cancer surgery is done under local anaesthetic, either in the office or as day surgery in an operating theatre. Depending on how extensive the surgery is, anticoagulant medication may need to be discontinued in consultation with your doctor.
Procedure
Satisfactory removal of skin cancers requires the removal of not just the cancer but a margin of healthy skin at the periphery. The size of this margin depends of the type, size and stage of the skin cancer. Depending on the size and position of the resultant wound, it may be sutured closed in a straight line, or may require a skin graft or a flap of adjacent skin moved around to close the defect.
Postoperative Instructions
Most commonly a dressing will be in place for the first week after which sutures are removed and the pathology removed. Some form of taping or simple dressing is sometimes required for another week or two.
Risks
The main problem that arises after skin cancer surgery is an involved margin – even with surgical magnification, the outline of some skin cancers can be indistinct and the pathology report can raise the possibility that some of the cancer remains. This would require further surgery to ensure a complete removal of the tumour.