Surgical Procedures For Basal & Squamous Cell Skin Cancers
Basal or squamous cell skin cancers may need to be removed with procedures such as electrodessication and curettage, surgical excision, or Mohs surgery, with possible reconstruction of the skin and surrounding tissue.
Squamous cell cancer can be aggressive, and our surgeons may need to remove more tissue. They may also recommend additional treatments for advanced squamous cell cancer, such as medications or radiation therapyenergy beams that penetrate the skin, killing cancer cells in the body.
Basal cell cancer is less likely to become aggressive, but if it does, our doctors may use surgery and other therapies to treat it.
Does Skin Cancer Affect People With Skin Of Color
People of all skin tones can develop skin cancer. If you are a person of color, you may be less likely to get skin cancer because you have more of the brown pigment, melanin, in your skin.
Although less prevalent than in nonwhite people, when skin cancer does develop in people of color, its often found late and has a worse prognosis. If youre Hispanic, the incidence of melanoma has risen by 20% in the past two decades. If youre Black and develop melanoma, your five-year survival rate is 25% lower than it is for white people . Part of the reason may be that it develops in less typical, less sun-exposed areas and its often in late-stage when diagnosed.
What Happens After My Appointment
The tissue removed will be sent to a lab, where a pathologist will examine it under a microscope to confirm that it is cancerous and determine if it is high-risk. According to the NCCN Clinical Practice Guidelines in Oncology, C& E cures between 91% and 97% of low-risk basal cell carcinoma and 96% of low-risk squamous cell carcinoma. In some cases, the procedure might have to be repeated to ensure all the cancerous cells are removed.
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Let’s Talk About Disfigurement
One thing we dont talk as much about is the permanent disfigurement left by skin cancer surgeries. I have several permanently disfigured areas due to skin cancer surgeries. I have a dip in my lower leg where a good portion of tissue was removed. I also have the same thing on one of my thighs. Those areas dont really bother me.
What Is The Outlook For People With Skin Cancer
Nearly all skin cancers can be cured if they are treated before they have a chance to spread. The earlier skin cancer is found and removed, the better your chance for a full recovery. Ninety percent of those with basal cell skin cancer are cured. It is important to continue following up with a dermatologist to make sure cancer does not return. If something seems wrong, call your doctor right away.
Most skin cancer deaths are from melanoma. If you are diagnosed with melanoma:
- The five-year survival rate if its detected before it spreads to the lymph nodes is 99%.
- The five-year survival rate if it has spread to nearby lymph nodes is 66%.
- The five-year survival rate if it has spread to distant lymph nodes and other organs is 27%.
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There’s One Thing That Really Bothers Me
The area that does bother me, though, is a result of two separate surgeries to remove skin cancer. About six years ago, I had a major skin cancer surgery to remove multiple cancerous areas. During that surgery, I had 23 areas removed. Ten of those areas required stitches. One of the areas that required stitches was right above my lip. I thought perhaps I’d be left with a standard skin cancer scar.
Healing Your Scrapes And Burns
After a scrape or burn, it usually heals within three to seven days. A large scrape may take up to two weeks to heal, while a deep scrape may take up to one to two weeks to heal. A doctor will scrape a little above the edge of the cancer to aid in the removal of all cancerous cells. The wound is then covered with an ointment and a bandage. scabs can form on the skin over time. It could take three to six weeks for the wound to heal completely. If you have an allergic reaction to bandaid, make sure your wound is always moist and apply Vaseline every now and then .
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How Dermatologists Diagnose Basal Cell Carcinoma
When you see a board-certified dermatologist, your dermatologist will:
Examine your skin carefully
Ask questions about your health, medications, and symptoms
If your dermatologist finds a spot on your skin that could be any type of skin cancer, your dermatologist will first numb the area and then remove all of it. This can be done during an office visit and is called a skin biopsy. This is a simple procedure, which a dermatologist can quickly, safely, and easily perform.
Having a skin biopsy is the only way to know for sure whether you have any type of skin cancer. After your dermatologist removes the spot, a doctor, such as your dermatologist or a dermatopathologist, will examine it under a high-powered microscope. The doctor is looking for cancer cells.
If the doctor sees cancerous basal cells, the diagnosis is BCC.
After the doctor examines the removed skin under a microscope, the doctor writes a report. Called a biopsy report or a pathology report, this document explains in medical terms what was seen under the microscope.
If the diagnosis is any type of skin cancer, the information in this report will tell your dermatologist the key facts needed to treat the cancer, including:
The type of BCC you have
How deeply the cancer has grown
Your dermatologist will carefully consider your health and the findings in the report before choosing how to treat the cancer.
Mohs Micrographic Surgery: For Trickier Cancers
During a Mohs procedure, a specially trained dermatologist or surgeon removes a very thin layer of skin containing the tumor.
While the patient waits, the sample is examined under a microscope to see if there are any cancer cells.
The procedure is repeated, with the doctor removing one thin layer at a time, until a tissue sample is cancer-free. The process can take several hours.
The Mohs technique is considered the gold standard for treating many squamous cell cancers, basal cell cancers, and some melanomas, says the SCF.
It has the highest cure rate and spares as much healthy skin surrounding the tumor as possible, leaving the smallest possible scar.
As with other skin cancer surgeries, it is typically done on an outpatient basis in a doctors office with local anesthesia.
But because it is so complex and time-consuming, skin cancer experts have devised guidelines for when it is the best option.
Its often used when theres a high risk of recurrence, the extent of the cancer is hard to determine, or the cancer is in a part of the body where appearance or function are high priorities, such as near the eye, the middle of the face, the ears, or the fingers, notes the American Cancer Society .
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What Should I Expect Before During And After
The procedure is quick and can be performed in your doctors office. Because you are given a numbing medication , you will not feel anything during the procedure. Your doctor may scrape and burn the area up to 3 times. You may notice an unpleasant smell when the wound is cauterized.3 Your doctor will probably cover the wound with a bandage.7 You will be instructed on how to care for the wound.7,8 Most patients are able to drive themselves home after C& E.8
How Long Does Curettage Take To Heal
Curettage is a medical procedure in which the inside of a wound or lesion is scraped with a curved instrument called a curette. The curette is also used to remove any foreign material, such as dirt, dead tissue, or cancerous cells. Curettage usually takes less than 30 minutes to perform, and the wound typically heals within 7-10 days.
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How Is Skin Cancer Diagnosed
First, your dermatologist may ask you if you have noticed any changes in any existing moles, freckles or other skin spots or if youve noticed any new skin growths. Next, your dermatologist will examine all of your skin, including your scalp, ears, palms of your hands, soles of your feet, between your toes, around your genitals and between your buttocks.
If a skin lesion is suspicious, a biopsy may be performed. In a biopsy, a sample of tissue is removed and sent to a laboratory to be examined under a microscope by a pathologist. Your dermatologist will tell you if your skin lesion is skin cancer, what type you have and discuss treatment options.
For What Types Of Skin Cancer Is C& e Used
C& E is used to treat low-risk BCC and SCC.1,2 Low risk tumors are small and have clear borders. They are primary tumors , rather than tumors that have returned . Your doctor will decide whether a tumor is low-risk based on an examination of the lesion and your medical history.1,2 Information from the biopsy will confirm or change the risk assessment.
C& E can also be used to treat actinic keratosis.2 Actinic keratosis is a precancer, which forms when cells in the epidermis begin to grow abnormally. Up to 10% of actinic keratoses become SCC.5 For this reason, your doctor might recommend treating actinic keratosis.
C& E can be used to treat Kaposi sarcoma lesions, when there are only a few to remove.6 Lesions may grow back in the same spot.6
C& E is not used for areas that have hair, such as the scalp, beard, or armpits.1 If the tumor has grown into a hair follicle, C& E might not be enough to remove it.1
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Surgery For Basal And Squamous Cell Skin Cancers
Surgery is a common treatment for basal cell and squamous cell skin cancers. Different surgical techniques can be used. The options depend on the type of skin cancer, how large the cancer is, where it is on the body, and other factors. Most often the surgery can be done in a doctors office or hospital clinic using a local anesthetic . For skin cancers with a high risk of spreading, surgery sometimes will be followed by other treatments, such as radiation or chemotherapy.
My First Open Wound Care Experience Didn’t Go Too Badly
Overall, I think I did a pretty good job with limited instruction. The wound healed pretty well with some scarring as was expected. I wish I had asked more questions prior to the surgery because that open wound was a shock to my system. Knowing what to expect would have helped me be more prepared. Hopefully, you will be a better patient than I was.
What are some of your tips for open wound care?
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Are There Effective Ways To Remove Moles At Home
A number of websites offer do-it-yourself tips for removing a mole at home. These methods are not proven to work, and some may be dangerous. You should talk with your doctor about your options before you try any home remedies for mole removal.
Some of these unproven methods include:
- burning the mole off with apple cider vinegar
- taping garlic to the mole to break it down from the inside
- applying iodine to the mole to kill the cells inside
- cutting off the mole with scissors or a razor blade
Other home remedies that claim to remove moles include applying:
- a mixture of baking soda and castor oil
Pharmacies and online stores also sell mole removal creams. To use these creams, you first scrape off the top part of the mole. Then you rub the cream into the mole. The products claim that within a day after applying the cream, a scab will form. When the scab falls off, the mole will go with it.
That said, you should never remove a mole at home. Mole removal should be done by a medical professional like a dermatologist, who can send it to a lab to be evaluated for cancer.
Scrape And Burn Healing
The scrape and burn healing process is a two-step process that involves first removing the dead tissue from the wound and then applying a heat treatment to the area to promote new tissue growth. This method is often used for treating large or deep wounds that have not responded to other forms of treatment.
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Basal Cell And Squamous Cell Carcinomatreatments
Numerous treatment options are available for basal cell and squamous cell carcinoma. Your therapy will depend upon the type of skin cancer you have and its stage.
- Surgery Many skin cancers can be cut from the skin quickly and easily. In fact, the cancer is sometimes completely removed at the time of the biopsy, and no further treatment is needed.
- Curettage and Electrodesiccation Doctors commonly use a type of surgery called curettage. After a local anesthetic numbs the area, the cancer is scooped out with a curette, an instrument with a sharp, spoon-shaped end. The area is also treated by electrodesiccation. An electric current from a special machine is used to control bleeding and kill any cancer cells remaining around the edge of the wound. Most patients develop a flat, white scar.
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Do I Need To Take Any Precautions While Using Imiquimod
When using this medicine, you should:
Keep all appointments with your dermatologist. These follow-up visits allow your dermatologist to determine if the medicine is working for you. You should never use your own judgment to determine this. Your dermatologist considers many factors, not only whether your skin is clearing. If the medicine does not work, you may need to use a different treatment to prevent the disease from progressing.
Protect your skin from the sun. This helps reduce your risk of developing new AKs and skin cancers. To do this, you should seek shade when outdoors wear long sleeves, pants, a wide-brimmed hat, and sunglasses and use a sunscreen. Be sure to use sunscreen that is broad-spectrum, SPF30+, and water-resistant.
Avoid sexual activity while the medicine is on your skin. Even if you use a condom or other type of protection, this may not prevent the imiquimod from spreading to your partner.
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Targeted Therapy: Targeting Cancer Mutations
Targeted therapy, another revolutionary new category of treatment, focuses on characteristics of skin-cancer cells that make them different from normal cells, such as gene changes.
For instance, about one-half of all melanomas have mutations in the BRAF gene that cause out-of-control cellular growth.
Oral drugs that target this mutation are called BRAF inhibitors. These include Zelboraf and Taflinar . BRAF inhibitors are often combined with medication that targets a protein called MEK. Two such drugs are Mekinist and Cotellic .
Why Does Skin Cancer Occur In More Non
Scientists dont fully know why people of skin with color develop cancer in non-sun-exposed areas, such as their hands and feet. They think that the sun is less of a factor though. However, dermatologists still see plenty of UV sunlight-induced melanomas and squamous cell skin cancer in people of color, in skin tones ranging from fair to very dark.
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Effective Options For Early And Advanced Bcc
When detected early, most basal cell carcinomas can be treated and cured. Prompt treatment is vital, because as the tumor grows, it becomes more dangerous and potentially disfiguring, requiring more extensive treatment. Certain rare, aggressive forms can be fatal if not treated promptly.
If youve been diagnosed with a small or early BCC, a number of effective treatments can usually be performed on an outpatient basis, using a local anesthetic with minimal pain. Afterwards, most wounds can heal naturally, leaving minimal scarring.
After Curettage And Desiccation
Your surgeon will schedule a follow up appointment after Curettage and Desiccation has been performed. At that time, you can discuss a maintenance or skin care plan to promote healing and reduce the chances of recurrence. If it is appropriate your dermatologist may recommend an adjusted schedule for regular skin checks, certain skin care products, or a visit with a medical esthetician for after care. It is imperative to follow the instruction of your surgeon after skin cancer treatment.
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How Is The Electrodesiccation And Curettage Performed
The area to be treated is sterilized then anesthetized, typically with lidocaine. A semi-sharp instrument called a curette is used to scrape the area until healthy skin is encountered. Because basal cell carcinomas are often softer than normal skin, they often scrape away easily. Squamous cell carcinoma in situ is often harder and rougher than normal skin, so a dermatologist can often tell when hard or rough skin is no longer present, leaving only healthy skin remaining. After scraping the area with the curette, an electrocautery device is used to apply small amounts of electricity to the treated surface. This can thermally injure any remaining cancerous cells and can sometimes loosen cancerous cells. The procedure is then typically repeated. This increases the cure rate by helping to eliminate any cancerous roots or cells. The wound is then dressed with ointment and a bandage and left to heal in over a couple weeks.
How Long Does It Take For A Scar To Morph Into Cancer
Typical malignant change may occur over decades in these cases, says Dr. Tung.
Signs that may alert you that your scar is no longer just a scar include pain, redness, bleeding or skin breakdown.
Scars and skin which has been persistently inflamed can turn into a type of skin cancer called squamous cell carcinoma.
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