Non-melanoma skin cancers such as basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the most common types of cancer around the world. Fortunately, they are also the most curable, especially when the tumors are relatively small and thin. The type of cancer treatment chosen depends on the type of skin cancer, the size of the skin cancer, and where it is found on the body.
Melanoma is different from basal cell carcinoma and squamous cell carcinoma in several ways. First, it does not necessarily require much UVR exposure which comes from sun or tanning beds. Of course, the more UVR to which you are exposed, the higher your risks for these skin cancers, including melanoma. Thus, melanoma can be found anywhere on the skin, including places that never have/never will be exposed to UVR.
Your genetic makeup seems to play a prominent role in some melanomas. If you have a lot of moles, or a close relative had melanoma, you are at a significant risk of getting melanoma.
Curettage-electrodesiccation is a combination of two techniques: curettage (scraping the skin away with a curette, a ring-shaped instrument) and electrosurgery or electrodesiccation, in which a high-frequency current is applied to the lesion, destroying the tissue by “drying it out.” Combining this process with curettage has proven highly effective against precancerous and cancerous skin growths.
A local anesthetic is injected under the skin. After scraping away the growth with a long spoon-like instrument called a curette, the provider uses a mild electric current to destroy any remaining abnormal cells. This scraping and the cauterizing process is typically repeated three times, and the wound tends to heal without stitches.
There is little bleeding with this method. Usually, the patient is advised to use a simple dressing for a few days, sometimes with an antibiotic ointment beneath the dressing. The wound requires more time to heal after curettage-electrodesiccation than after excisional surgery, usually two to four weeks. There is no need to have sutures removed post procedure. Postoperative complications are relatively rare.
This method is ideal for treating small or multiple lesions. It can usually be done in the provider’s office under local anesthesia in a very short period of time and has a cure rate of 85-95% for primary lesions.
The cosmetic results may not be as good as those resulting from excisional surgery. Many providers recommend that other techniques be used to remove growths on the face in the areas of the nose, mouth, and eyelids. Although in time the scars left by curettage-electrodesiccation become less conspicuous, they tend to remain lighter in color than the surrounding skin.
Occasionally, enlarged (hypertrophic) scars or very rarely, keloids (raised, reddish nodules) will appear at the treated site. The thickened scars usually subside by themselves in time. Sometimes cortisone injections can hasten this shrinking process. Keloids are more difficult to eradicate. Some positive results have been reported by treating them with repeated injections of steroids.
Simple surgical excision (skin cancer removal) is used to treat both primary and recurrent basal cell carcinomas and squamous cell carcinomas.
Excision is performed in the office under local anesthesia. A local anesthetic is injected under the skin and the procedure is relatively painless. The procedure involves surgically removing the tumor and a certain amount of normal-appearing skin surrounding it (the “margin”): For basal cell and squamous cell carcinomas, margins are often 2 to 4 mm. The excision is sutured together into a fine line. Then the specimen is sent for analysis to a board certified dermatopathologist ensure that the tumor has been completely removed.
Typically most patients do not feel significant discomfort post procedure. One to three weeks after the procedure, the patient will need to return to the office to have sutures removed. In time the excision site will heal into a faint line.
The cure rates following skin cancer excision are 95% and 92% for primary BCC and SCC, respectively, and are dependent on the site, size, and pattern of the tumor.