< Medical Procedures

Skin Lesion Excision

Skin Cancer: See Spot. See Spot Change. See a Surgeon.

Excision of Skin Lesions

This operation removes a cancerous skin lesion and an area of surrounding tissue called the margin. There are three types of skin cancer: Basal cell cancer is the least invasive with the least amount of margin removed; squamous cell is more aggressive with a wider margin required. Melanoma is the most serious type of skin cancer, occurring in the cells that produce pigment. Many types of benign skin growths may look like malignant tumors and are removed for a biopsy. If a lesion looks precancerous it may be removed as a precaution.

About a million people in the U.S. are diagnosed with skin cancers every year as the most common type of cancer. According to current estimates, forty to fifty percent of Americans who live to age 65 will have skin cancer at least once in their lifetime. Although anyone can get skin cancer, the risks are greatly increased if you have fair skin that freckles easily — often with red or blond hair and blue or light-colored eyes. Fortunately, even though skin cancer is the most common type of cancer, it is not the reason for most cancer deaths. The two most common kinds of skin cancers are basal cell carcinoma and squamous cell carcinoma. (Carcinoma is cancer that begins in the cells that cover or line an organ.) Basal cell carcinoma accounts for more than ninety percent of all skin cancers in the United States. It is a slow-growing cancer that seldom spreads to other parts of the body. Squamous cell carcinoma also rarely spreads, but it does so more often than basal cell carcinoma. However, it is important that skin cancers be found and treated early because they can invade and destroy nearby tissue. Basal cell carcinoma and squamous cell carcinoma are sometimes called non-melanoma skin cancer.


Melanoma is another type of cancer that occurs in the skin in the melanocytes or the pigment cells. Of the three, Squamous Cell, Basal Cell and Melanoma, melanoma is the most aggressive type of skin cancer with metastasis it can result in death from spreading of the cancer. Ultraviolet (UV) radiation from the sun is the main cause of all skin cancers. Even, artificial sources of UV radiation, such as sunlamps and tanning beds have also been linked to causes of skin cancer. The risk of developing skin cancer is affected by where you live. People who live in areas that get high levels of UV radiation from the sun are more likely to get skin cancer. In the United States, for example, skin cancer is more common in Texas where the sun is strong than it is in Minnesota, where the sun is not as strong. Worldwide, the highest rates of skin cancer are found in South Africa and Australia, areas that receive high amounts of UV radiation. And, as you guessed, in fair skin colored people. In addition, skin cancer is related to lifetime exposure to UV radiation. Sun worshipers be aware. Most skin cancers appear after age 50, but the sun’s damaging effects begin at an early age. Therefore, protection should start in childhood, in order to prevent skin cancer later in life. Keep in mind that protective clothing, such as sun hats and long sleeves, can block out the sun’s harmful rays. Also, lotions that contain sunscreen can protect the skin. Sunscreens are rated in strength according to a sun protection factor (SPF), which ranges from 2 to 30 or higher. Those rated 15 to 30 block most of the sun’s harmful rays. Surgery is often used as a treatment for skin cancer. There are several types of surgery depending on the stage and location of cancer. Shave biopsy, simple excision and formal excision of suspicious skin lesions are the first steps for diagnosis and treatment of skin cancers. Management of skin cancers is base on the cell type, location of the tumor and extent of the tumor. Superficial skin cancers can often be “cured” by surgical excision alone. Dysplastic or abnormal appearing moles are sampled using a scalpel. The skin sample is then sent off for a more detailed microscopic control so it can be determined whether all cancer has been removed or not. In some cases where the doctor suspects a cancer that has gone beyond stage 0, samples of the nearest lymph nodes may also be taken using a biopsy. This is to see if the tumor cells have spread to the lymph node, in which case, that lymph node will also have to be removed (at a later stage). The surgery is normally done using local anesthetic. The removed moles or skin samples will later be analyzed in a lab using a specialized microscope and if they prove to be melanoma cancer, it is often necessary to have a second surgical operation to remove the entire melanoma including some of the healthy skin around it to allow for enough safety margin. If there are more tumors, these will be treated using different methods, which will depend on factors such as where they are located and if they have spread. Possible treatments for these melanoma tumors are chemotherapy or radiation in most cases. At least 80-90% of all patients who have been diagnosed with a melanoma cancer can today be cured with a good prognosis. Develop a regular routine to inspect your body for any skin changes. If any growth, mole, sore or skin discoloration appears suddenly or begins to change, see a surgeon. Each of the skin cancer types CAN be treated if detected EARLY.

The ABC’s of skin cancer include any change or development in a mole or skin growth that should prompt you to see a surgeon. These may include: A- Asymmetry – You should notice the general look of your moles or growths, for example, if one half of the mole or growth does not match the other half. B- Border Irregularity – If the edges of the growth are ragged, notched or blurred. C- Color – The pigmentation of the growth is not uniform. Shades of tan, brown and black are present. Dashes of red, white and blue add to the mottled appearance. D- Diameter – If the width is greater than 6 millimeters (about the size of a pencil eraser), it could be an indicator of an abnormal skin growth. Generally, any new mole growth or non healing skin ulcer should be a concern.