When skin cancer is detected, it must be removed with an excision. Surgery starts with the surgeon using a marking pen to circle around the skin that is cancerous. This will include some edges of healthy skin as it is impossible to determine how far a tumor spreads. The surgeon then applies a local anesthetic to ensure that the procedure is as painless as possible. He then cuts along the marked lines. This takes about half an hour if the lesions are small in size.
Once the cancerous skin is excised, the surrounding skin that was cut is reconnected with multiple stitches. Sizable incisions are often closed with a flap or a skin graft as stitches alone will not suffice. Although infrequent, scars can occur as a result of skin cancer excision surgery. If there is significant scarring that the patient is uncomfortable with, reconstructive surgery can be performed.
Aside from conventional skin cancer excisions, there is also the option of Mohs micrographic surgery. During Mohs surgery, cancerous skin is removed during a multi-step process instead of all at once. Several layers of the impacted skin are removed one by one. Once each layer is removed, it is immediately examined and analyzed beneath a microscope. While traditional excisions work best to eliminate squamous cell and basal cell carcinomas, Mohs microscopic surgery allows the vast majority of the healthy skin around the cancerous skin to be spared. Mohs surgery is also better than standard excisions when it comes to removing cancerous skin on certain body sites like the face.
Once surgery is completed, the margins of the skin by the cancerous area that was removed will be analyzed to determine if any cancerous cells still remain. Recovery times will differ by patient but they usually only take a week or two. Other factors include the amount of skin that is cut and the body site where the operation took place. Side effects include scars, bleeding, slowly healed skin grafts, pain, infections and a remaining margin with cancer cells.
Most skin cancer excisions are quite successful. Standard skin cancer excisions to remove basal cell carcinoma of .8 inches in width or less have a success rate of 95% when performed with .2 inch margins. Standard excisions performed to remove squamous cell carcinoma has a success rate of around 92%. Mohs microscopic surgery has an even higher success rate than standard excision procedures.