Surgery for skin cancer
Surgery is the most common treatment for skin cancer. The type of procedure you have will depend on the size and position of the cancer.
Most small skin cancers are removed by a GP or a dermatologist. A surgeon may treat more complex cases.
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The doctor will inject a local anaesthetic to numb the affected area, then cut out the skin cancer and some nearby normal-looking tissue (margin). A pathologist checks the margin for cancer cells to make sure the cancer has been completely removed. The results will be available in about a week. If cancer cells are found at the margin, you may need further surgery or radiation therapy.
Mohs surgery, or microscopically controlled excision, is usually done under local anaesthetic by a dermatologist.
It is used to treat skin cancers that have begun to spread deep into the skin or come back (recurred). It can also be used for cancers in areas that are hard to treat, such as near the eye or on the nose, lips and ears.
This procedure is done in stages. The doctor removes the cancer little by little and checks each section of tissue under a microscope. They keep removing tissue until they see only healthy tissue under the microscope, and then close the wound with stitches or, sometimes, a skin flap or graft (see below). Mohs surgery reduces the amount of healthy skin that is removed while making sure all the cancer is taken out.
Mohs surgery costs more than other types of surgery. Special equipment is needed so it’s available only at some hospitals or clinics.
If you have a large skin cancer removed, the wound is covered with a skin flap or skin graft.
For a skin flap, nearby loose skin or fatty tissue is moved over the wound and stitched. For a skin graft, a thin piece of skin is removed from another part of the body and stitched over the wound. These procedures may be performed in the doctor’s office but are sometimes done as day surgery in hospital under a local or general anaesthetic.
Podcast: Making Treatment Decisions
Prof Diona Damian, Dermatologist, The University of Sydney at Royal Prince Alfred Hospital, and Associate, Melanoma Institute of Australia, NSW; Dr Annie Ho, Radiation Oncologist, Genesis Care, Macquarie University, St Vincent’s and Mater Hospitals, NSW; Rebecca Johnson, Clinical Nurse Consultant, Melanoma Institute of Australia, NSW; Shannon Jones, SunSmart Health Professionals Coordinator, Cancer Council Victoria; Liz King, Skin Cancer Prevention Manager, Cancer Council NSW; Roslyn McCulloch, Consumer; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Paige Preston, Policy Advisor, Cancer Prevention, Health and Wellbeing, Cancer Council Queensland; Dr Michael Wagels, Plastic and Reconstructive Surgeon, Princess Alexandra Hospital, QLD.
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