When a skin cancer has been identified through examination or biopsy there may be several options for treatment. While early or less aggressive BCCs and SCCs can be treated non surgically, more advanced lesions require surgical excision to provide the best chance of clearance and minimise recurrence. All melanomas require surgical excision.
Surgical Excisions
Skin Cancer Excision
A skin cancer excision rarely requires hospital admission and general anaesthetic. The vast majority can be done in a primary care setting under local anaesthetic. Sometimes we utilise regional nerve blocks to numb an area of the skin prior to surgery such as the ear, nose and lip. Following successful anaesthetic infiltration we use an approach of margin control, where the lesion and an appropriate margin of normal skin is removed to ensure minimal risk of recurrence. Occasionally we might suggest you see a specialised dermatologist for a procedure called MOHs. This allows for a smaller defect and may be important for cosmetically sensitive areas.
Melanoma
If a lesion is suspected to be melanoma, it may take several excisions to remove. There are several reasons why we take this approach. Firstly, the margin required is based on staging of the lesion and we initially don’t know what stage we have. Secondly, sometimes with more invasive melanomas we need to detect where the area of skin drains to in terms of regional lymph nodes. If we have removed a wide margin initially the remaining skin may drain to a different lymph node and we lose our ability to track the spread. For these two reasons a thin 2mm margin is obtained first and the skin sent to the laboratory for testing.
See attached the skin excision information sheet for more information on what to expect and the risks associated.
Skin Excision
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