When a lesion on the skin might be skin cancer, there are several surgical procedures that are used to either diagnose or treat the area. In many instances, surgical intervention is the only form of treatment needed for certain types of skin cancer that are not aggressive.
Although a punch biopsy is intended to be a diagnostic tool, it can also be a treatment for some small skin cancer lesions. A punch tool contains a thin, circular blade that, when pushed into the skin, allows the doctor to take out a small piece of the lesion. The skin is anesthetized for the procedure and a suture may be used to close the area afterward. Once the sample is taken, it is sent to the pathology lab to determine whether it is cancerous or benign and whether the sample has clear margins. If it is determined to be a form of skin cancer, such as small cell or basal cell skin cancer, and it has clear margins, there may be no further treatment needed. Samples determined to be melanoma will need additional treatment since this form of skin cancer is more aggressive.
An excision is slightly more invasive than a punch biopsy and may be done after the sample from a punch biopsy was sent to the lab. In some instances, an excision may be the first treatment if the lesion is larger and the doctor wants to attempt to remove it all in one treatment session. The lesion is removed with a surgical blade and the doctor is careful to remove a small border around the lesion. Since the doctor is making the determination about what is a healthy border based on visual inspection, there are no guarantees whether the border is large enough. Based on the type of cancer and how the borders look, the doctor will determine how to proceed. Some people may need more extensive surgical intervention, whereas others only need to wait for the excision to heal and have no further treatments.
Mohs surgery is a more extensive form of excision. If a lesion is larger and is on an important area of the body, such as the face, it is best to go straight to Mohs surgery to preserve as much tissue as possible. Mohs surgery is much like an excision because the goal is to remove the cancerous lesion and achieve clear borders. It is different because each sliver of tissue removed is immediately inspected under the microscope so the doctor knows whether to remove more tissue next or whether all the cancerous tissue has been removed so they can stop the procedure. With the Mohs procedure, less healthy tissue is unnecessarily removed and if plastic or reconstructive surgery is needed later, the surgeon has more tissue to work with.
Some form of surgery is used for all skin lesions that are suspected to be cancer. Whether the procedures are diagnostic or a type of treatment will depend on the type of cancer and staging of the lesion. To learn more, contact a company like Gateway Dermatology PC.