What is a surgical excision of skin cancer?

A surgical excision, also known as shave excision of a skin lesion, is a skin cancer treatment that surgically removes malignant moles, lesions and tumors from the skin along with a healthy margin around the tumor. 

Surgical excisions can be performed to treat basal and squamous cell carcinomas as well as melanomas. This treatment is an effective option for skin cancer patients, but cure rates are not as high.

When is a surgical excision of skin cancer recommended?

Patients who have melanoma or non-melanoma skin cancers may be candidates for a surgical excision. 

Melanoma 

If you have been diagnosed with melanoma from a skin biopsy, you will likely need a surgical excision to remove the entire cancerous tumor. Most patients with thin melanomas can be cured with a surgical excision.

Low-risk basal cell and squamous cell carcinomas

If you have a low-risk basal cell or squamous cell carcinoma, you may be a candidate for a surgical excision. 

High-risk basal cell and squamous cell carcinomas

Surgical excision is a treatment option for patients with higher risk basal or squamous cell carcinomas, but the cancers are more likely to recur after surgery. If your doctor determines this is the most appropriate treatment for you, he or she will likely remove wide margins of healthy tissue in addition to the malignant tumor. A pathologist may also test the cells during the surgery to ensure your doctor removed all the abnormal cells.

Risks of a surgical excision for skin cancer

Complications associated with a surgical excision include:

  • Scarring - you likely will have a scar after the surgical excision
  • Bleeding or swelling at the affected site
  • Pain
  • Infection 
  • Nerve damage
  • Incision opening after surgery

Benefits of surgical excision for skin cancer

A surgical excision of a skin cancer lesion has comparable cure rates to other skin cancer treatments. The procedure takes less time than other skin cancer treatments.

What to expect during a surgical excision for skin cancer

During a surgical excision for lower risk skin cancers, the affected area is numbed with a local anesthetic. Your doctor will then cut the tumor out in addition to the surrounding healthy skin. The remaining skin will be stitched together. Most patients will have a scar the size of the incision after surgery.

Although surgical excision for lower risk tumors may be performed in a doctor’s office, more complex tumors need to be treated in the hospital under general anesthesia. Some patients will be able to go home the day of the surgery, while others may have to stay overnight. Your doctor will determine the safest option for you based on the type and stage of cancer and your overall health.

Recovery from a surgical excision

The sample will be sent to a laboratory to be examined by a pathologist if your doctor suspects the growth is cancerous. Your Mercy Health care team will give you detailed instructions before leaving the clinic. Instructions will include:

  • Keep excision site dry for 24 hours
  • How to remove or change your bandage
  • Keep the site covered in the sunlight
  • What you can take for pain
  • Apply antibiotic ointment to promote healing

The affected site may be red and inflamed for up to a month but will get lighter over time. If you see signs of infection or experience severe pain, call your doctor.

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