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Skin Cancer Treatment: Surgery and its Side Effects

By Dr. Sajjan Rajpurohit in Cancer Centre

Apr 28 , 2023 | 6 min read

Skin cancer is one of the most common forms of cancer, affecting millions of people worldwide each year. It can be caused by a variety of factors, including exposure to ultraviolet (UV) radiation from the sun or tanning beds, genetics and environmental factors. While prevention and early detection are critical in managing skin cancer, surgical intervention is often necessary to remove cancerous tissue and prevent its spread to other parts of the body. Skin cancer surgery involves the removal of cancerous cells and tissue through a variety of techniques, including excision, Mohs surgery and lymph node biopsy. Although surgery can be a daunting prospect for some, it is often the most effective way to remove skin cancer and prevent its spread. With advances in surgical techniques and technologies, skin cancer treatment through surgery has become more precise, less invasive and with faster recovery times than ever before.

Exploring Surgical Options For Skin Cancer Treatment

When skin cancers are detected early and have not spread, surgery is often recommended as a primary treatment option to remove the entire tumour. In cases where the doctor suspects that cancer cells may have spread to nearby lymph nodes, the removal of these nodes may also be required. There are several surgical procedures available for skin cancer treatment, each with its own unique benefits and considerations. Common surgical procedures used to treat skin cancer include:

Cryosurgery

Cryosurgery is a form of treatment that involves the use of extreme cold to destroy abnormal tissue. During cryosurgery, liquid nitrogen or argon gas is applied directly to the affected area, causing the tissue to freeze and die. The procedure is generally quick, easy to perform and does not require anaesthesia. Additionally, cryosurgery leaves little to no scarring, making it a popular option for treating skin cancers located on the face or other visible areas of the body.

Curettage And Electrosurgery

Curettage and electrosurgery are most effective for treating small, non-melanoma skin cancers that have not spread beyond the top layers of skin. This procedure involves the use of a curette, a sharp instrument with a circular cutting edge, to scrape away the cancerous tissue. The wound is then treated with electrosurgery, which uses an electrical current to cauterise the area and stop any bleeding. The procedure is relatively quick and can usually be completed in under an hour.

Mohs Surgery

Mohs surgery, also known as Mohs micrographic surgery, is a highly precise surgical technique used for skin cancer treatment, particularly basal cell carcinoma and squamous cell carcinoma. During Mohs surgery, the surgeon removes cancerous tissue layer by layer, examining each layer under a microscope until only healthy tissue remains. This ensures that all of the cancerous cells are removed while preserving as much healthy tissue as possible.

Wide Local Excision

Wide local excision is a commonly used surgical technique to treat early-stage skin cancers like basal cell carcinoma and squamous cell carcinoma. The procedure involves removing the cancerous tissue along with a margin of healthy skin tissue around it. The removed tissue is sent to a laboratory for microscopic examination to confirm that all cancerous cells have been eradicated. If the results reveal cancerous cells in the margins, further surgery may be required.

Skin Grafting And Skin Flaps

Skin cancer can also be treated with skin grafts and skin flaps. A skin graft is where a patch of skin from one area of the body (donor site) is transplanted to cover the wound caused by cancer. For larger wounds, a skin flap can be used instead. This is where a piece of skin is taken from a nearby area and moved to the affected area while still attached to the blood supply.

Lymph Node Removal

During a lymph node removal procedure, the surgeon will make an incision in the skin and carefully remove the lymph nodes. The nodes will then be sent to a laboratory for examination under a microscope to determine whether they contain any cancer cells. This information is used to determine the stage of cancer and to guide further treatment decisions.

Risk Factors Associated With Skin Cancer Surgery

Like any surgical procedure, skin cancer surgery carries certain risks. Understanding the risk factors associated with skin cancer surgery can help patients and healthcare providers make informed decisions about treatment options and minimise potential complications. Some of the common risk factors include:

Pain

Skin cancer surgery can cause varying degrees of pain and discomfort, depending on the size and location of the tumour, as well as the type of surgical procedure used. Pain can be managed with medications and other therapies, but it's important to discuss pain management options with the doctor before undergoing surgery.

Swelling

Swelling is a common side effect of skin cancer surgery, particularly in the area around the surgical site. The extent of swelling can vary depending on the size and location of the tumour and can be managed with ice packs, the elevation of the affected area and compression bandages.

Bleeding

Bleeding is a potential risk factor associated with skin cancer surgery, particularly for larger tumours or those located in areas with a rich blood supply. The doctor will take steps to minimise bleeding during surgery and may provide specific instructions for wound care to help prevent bleeding after the procedure.

Scarring

Scarring is an inevitable outcome of skin cancer surgery, but the extent and visibility of scars can vary depending on the location and size of the tumour, as well as the surgical technique used. Scar management strategies such as the use of topical ointments or silicone sheets will help minimise scarring.

Wound Infection

Wound infectioncan occur if the wound is not properly cared for after the procedure. Signs of infection include redness, swelling and warmth around the surgical site, as well as drainage or pus. The doctor will provide specific instructions for wound care to help prevent infection and may prescribe antibiotics if needed.

Preventing wound infection after skin cancer surgery

After undergoing skin cancer surgery, preventing wound infection is a crucial factor in achieving successful treatment outcomes. Wound infections can delay the healing process, cause additional pain and discomfort and in severe cases, lead to systemic infections that require hospitalisation. While the doctor will take steps to minimise the risk of infection during the surgical procedure, it's important to continue good wound care practices after the surgery. One must keep the surgical site clean and dry, use sterile dressings, avoid touching the wound with dirty hands, and wait until the doctor approves before exposing the wound to water. Following these guidelines can help minimise the risk of complications and promote a speedy recovery.

Frequently Asked Questions

Q.1) How Successful Is Skin Cancer Surgery?

Skin cancer surgery can be highly successful, with cure rates exceeding 90% for most types of skin cancer, especially when detected early. The success of the surgery can depend on several factors, such as the type and stage of cancer, the patient's overall health and the expertise of the surgeon.

Q.2) How Painful Is Skin Cancer Surgery?

The level of pain experienced during skin cancer surgery can vary depending on the type of procedure and the location of the tumour. However, local anaesthesia is typically used during the surgery to numb the area and reduce pain.

Q.3) What Happens After Surgery For Skin Cancer?

After skin cancer surgery, the surgical site will be covered with a dressing or bandage, which should be kept clean and dry. The doctor will provide specific instructions on how to care for the wound, as well as any pain managementor activity restrictions.

Q.4) Does Cancer Spread Quickly After Surgery?

Cancer can potentially spread after surgery, but the likelihood of this happening depends on several factors, such as the type and stage of cancer, how much of the cancer was removed during the surgery and whether any cancer cells were left behind. The doctor will monitor the patient’s recovery and provide specific instructions on how to minimise the risk of cancer recurrence or spread.