If you are faced with skin cancer, you do have choices. There are four possible treatments possible. These consist of:
- Chemotherapy
- Radiation therapy
- Biologic therapy
- Surgery1
In most instances, you will require some form of minor surgery. When this happens, you need to understand your options. Depending upon how far your cancer has advanced and its type, you may need to undergo a specific form of minor surgery. Talking to your doctor will help clarify the situation and explain what can be done to free your body from your specific type of melanoma or non-melanoma skin cancer.
Factors Affecting the use of Minor Surgery
Whenever you are considering surgery, you and your doctor will need to look at certain factors. These generally focus on the different aspects of your life and lifestyle. You need to look at your health. Can you undergo any form of surgery, no matter how minor? You must also consider where the possibly cancerous growth is located. This will affect the type of minor surgery used and the technique.
Surgeons and doctors, even for a simple biopsy, want to remove the least possible skin tissue and cells. They want to make a minor impact on the appearance of the surface of the skin as well. They do not want op leave you with unsightly scars. At the same time, they need to do their job – the removal of adequate tissue to examine and/or eliminate the cancer cells from your body. It can be a tricky balancing act.
Types of Minor Surgery – Biopsy
The most common form of minor surgery is a biopsy. These come in several types. In the case of skin cancer, you can have the non-surgical procedure called needle aspiration biopsy. This is when a hypodermic needle and syringe combine to remove a small piece of tissue. There are also the surgical techniques including excisional and incisional. In the former, the doctor performs a biopsy to remove the entire tumor. In the latter type of biopsy, he or she takes out only a small piece of the suspect tissue.2
Many individuals who are wondering about the existence of cancer must undergo a biopsy first. Frequently it will involve surgery. An incisional biopsy is a minor enough surgery to take place as a simple procedure in your doctor’s office. During a biopsy, your doctor will do the following:
- Clean the area in preparation for the incision
- Provide you with a local anesthetic
- Make a small incision where the skin lesion or tumor, mole or cancer growth is
- Remove a section of the affected skin cells and tissue
- Send the sample off to a laboratory for examination by a pathologist
- Stitch or tape together the small incision
- Send you home with any pain medication. In most instances, this form of minor surgery is considered relatively pain-free3
The exact technique used by the doctor to cut out the piece of diseased tissue will depend upon the size and location of the tumor.4 The favored techniques are:
- Punch – This is a method involving a cookie-cutter like instrument to remove the affected piece. It may be used in an excision biopsy to remove the entire tumor
- Scrape or shave – the physician uses a scraper to shave or scrape small pieces or sections of the affected skin cells
- Incision – This requires the doctor cuts into the tissue and removes a small piece of tissue
The procedure, no matter what the method, is not time consuming. You will return at a later date to talk to your doctor about the pathology results. The tissue sample may indicate the need for further surgery. The next procedure may be another simple operation called a simple excision.
Types of Minor Surgery – Simple Excision
Simple excision is similar to a biopsy that excises material to determine whether it is cancerous.5 However, it differs on several accounts. An excision is a minor surgical procedure. Yet, its purpose is not to remove a sample of the tissue of the tumor. Its intent is to excise (cut out or remove) the entire lump. Moreover, the extent of the removal is to the nearby cells in a greater fashion than that of a biopsy. Yet, the doctor, as in a biopsy, then sends the entire tumor for analysis to the pathologist or possibly a dermatologist.
Simple excision is suitable for handling thin melanoma or other types of skin cancer cells. It is not designed to tackle the larger growths. If it is applied to thicker cancer cell growths, the area of marginal skin excised will also increase. The procedure, like that of an incisional biopsy is simple.
- Apply local anesthetic
- Cut or incise using a scalpel
- Remove the tumor
- Take it out with a small amount of the normal, healthy, non-cancerous skin that is located at the edges (margin) of the tumor. Care is given always to avoid any damage to the blood vessels and any adjacent nerves
- Stitch the wound carefully back together6
This entire procedure will leave a scar. Scarring can be made minimal, however, if the medical professional, cuts the tumor out along a line parallel to a natural skin line. Yet, overall, the average scar from such a minor surgery is thin and hard to see.
A simple excision is more painful than an incisional biopsy. You will require stitches and pain pills. Both, however, help you to discover the extent of your cancer. Both also help you and your physician determine what further steps, if any, you will need to take in the future.
References
1 American Cancer Society (2011). “Treating Skin Cancer – Melanoma TOPICS” www.cancer.org/Cancer/SkinCancer-Melanoma/DetailedGuide/melanoma-skin-cancer-treating-surgery
2 Sarg, M. S. and Gross, A. D. (2007). The Cancer Dictionary Third Edition. New York: Checkmark Books.
3 “Treating Skin Cancer”, American Cancer Society, op.cit.
4 American Cancer Society (2011). “Melanoma Diagnosed.” Retrieved from www.cancer.org/Cancer/SkinCancer-Melanoma/DetailedGuide/melanoma-skin-cancer-diagnosed
5 National Cancer Institute (2011). “Treatment Option Overview”. Retrieved from www.cancer.gov/cancertopics/pdq/treatment/melanoma/Patient/page4#Keypoint18
6 McLanhan, S. and McLanhan D. (2002). Surgery And Its Alternatives. New York: TwinStream Books. (American Cancer Society, 2011)
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