Surgery for small skin cancers

Your GP might be able to remove your non melanoma skin cancer in their GP surgery. 

They can do this if they have specialist training. It is mainly for basal cell carcinoma (BCC) or actinic (solar) keratosis.

To remove a large skin cancer you might need a bigger operation.

Excisional biopsy

What is an excisional biopsy?

An excisional biopsy is when your doctor removes the affected area of skin and a small amount of the surrounding healthy tissue. You might have an excisional biopsy to both diagnose and treat a skin cancer at the same time. 

How you have it

You usually have an excisional biopsy with an injection of medicine to numb the area (local anaesthetic).

Once the area is numb your doctor removes the whole cancer by cutting it away. They also remove an area of healthy tissue from around it. This is the healthy margin. They remove the healthy margin to make sure that they have taken away all the cancer. 

The doctor sends the cancer and the surrounding tissue to the laboratory. A specialist doctor (pathologist) looks at the tissue under a microscope. They tell your doctor what type of cancer it is and give them other detailed information about it. They also look at the healthy tissue surrounding the cancer to make sure it is large enough. 

You usually have stitches to close the skin up afterwards. 

After you have it

You might need further surgery to make sure they have removed all the cancer with a large enough healthy margin. 

You’ll need the stitches removing after one to two weeks if you have non-dissolvable stitches. Make an appointment at your GP surgery to see the practice nurse, who can take them out.

You might have a small amount of pain when the local anaesthetic wears off. Taking simple painkillers such as paracetamol will help.

Cryosurgery

What is cryosurgery?

Cryosurgery uses extreme cold (with liquid nitrogen) to remove the cancer.

How you have it

The doctor puts liquid nitrogen onto your skin to freeze the cancer. They usually spray the liquid nitrogen on. But they can use a metal probe or sometimes a cotton bud.

The liquid nitrogen feels very cold. A scab forms over the next few days. This then drops off within the next couple of weeks taking the cancer cells with it. You can't have cryosurgery on skin areas near sensitive organs such as the eye.

The treated area will look white from freezing. It only takes a few minutes for your skin to return to its previous colour.

Your doctor might repeat the process during your appointment. Or they might organise for you to come back again.

After you have it

Some of the side effects include:

Pain and discomfort

You might feel a small amount of pain and discomfort while you have the treatment. You don’t usually need painkillers. But if you do, simple painkillers such as paracetamol can help. 

Redness, inflammation and ooze

The area usually gets red and inflamed. This goes away after about 2 to 3 days as a scab will start to form. You might also see a watery liquid leak from the site. This is normal and happens for a short time.

Blisters

The treated area might develop blisters. These usually get better after a few days as a scab starts to form. But sometimes they don't and they may be filled with blood. Contact the doctor or GP who did the operation.    

Curettage and electrocautery (electrodesiccation)

What is curettage and electrocautery? 

Your doctor cuts away the cancer and uses an electric needle to kill any cancer cells in the surrounding tissue. This is also sometimes called curettage and cautery (C and C).

This isn't a common treatment.

How you have it

You have an injection of medicine to numb the area (local anaesthetic).  Your surgeon uses either a small spoon shaped tool or ring shaped blade (curette). They scoop out or scrape away the cancer and the tissue around it, layer by layer.

In case there are any cancer cells left behind, they use an electric needle to kill the cells immediately around the wound. This also stops any bleeding.

You might need curettage and cautery 2 or 3 times to make sure all the cancer is gone. Or you might only need it once if you have a very small cancer.