For skin cancers detected early, surgery is often the best option.

The Duke Cancer Institute's team of highly experienced surgeons performs everything from simple excisions and re-excisions to innovative techniques such as intraoperative lymphatic mapping and sentinel lymph node biopsies.

Sentinel lymph node biopsies allow surgeons to remove a single lymph node from a regional nodal basin to determine whether melanoma has spread from its primary site on the skin.

Our surgeons are also experienced in performing Mohs micrographic surgery to remove the growth layer by layer until only healthy tissue remains, a technique that has the highest cure rate of all skin cancer treatment methods.

Surgery for Basal Cell and Squamous Cell Cancers

Many basal cell and squamous cell cancers can be cured with surgery. With squamous cell cancers, sometimes surgery will be combined with radiation.

Several different types of surgery may be used, depending on the type and stage of the tumor.

• Mohs micrographic surgery. The surgeon removes the tumor in layers until no more cancer is left. Each layer is examined under a microscope to look for cancer after removal, so as much normal tissue as possible is preserved. Learn more about Mohs surgery.
• Simple excision. The surgeon cuts away the tumor and some normal tissue around it. Simple excision may be used to treat larger tumors.
• Shave excision. A blade is used to shave off the abnormal area or cancerous cells.
• Electrodessication and curettage. A blade is used to scrape away layers of cells, and an electric needle is used to destroy remaining cancer cells. Electrodessication and curettage can be used for treating small or thin basal cell or squamous cancers.
• Cryosurgery. To treat some small, surface tumors, liquid nitrogen is sprayed onto the skin to freeze and kill the cancer cells. A small part of the surrounding skin may blister and come off to be replaced by new skin.
• Laser surgery. To treat surface tumors, a laser beam is used in place of a knife to cut away a surface tumor and some surrounding skin.
• Dermabrasion. The top layer of skin cells are rubbed away using small, rough particles or a rotating instrument.
• Skin grafting and reconstructive surgery. When large tumors have been removed, the surgeon may use a skin graft (skin removed from some other part of the body) to cover the wound, help it heal, and make the skin look as normal as possible.

Surgery for Melanoma

For many people with melanoma, surgery may be the sole treatment. Other treatments may be used in combination with surgery.

• Local excision. While the patient is under local anesthesia, the surgeon removes the cancer and a small amount of normal tissue surrounding it. Local excision may be the only treatment required for some small, early melanomas. This procedure is also called simple excision.
• Wide local excision. This surgery removes larger tumors and a larger amount of surrounding tissue. Wide local excision may be combined with lymph node dissection.
• Lymph node dissection. If the cancer has spread to the lymph nodes, one or more of them may be removed. Your surgeon may perform a sentinel node biopsy, in which the lymph node likely to receive drainage from the cancer first is removed and examined for cancer. If that node is cancer free, there is no need to remove additional lymph nodes.
• Skin grafting. When large tumors have been removed, the surgeon may use a skin graft (skin removed from some other part of the body) to cover the wound, help it heal, and make the skin look as normal as possible.

Appointments

Learn how to make an appointment at the Duke Cancer Institute.