When we hear the term “malignant,” it is difficult not to panic. Skin cancer can range from an excellent prognosis with minimal excision as the only treatment to the life-threatening melanoma. Surgical excision is the first line of treatment for any malignant mole, and it can sound a bit intimidating. In reality, it is something frequently done in your doctor’s office under local anesthetic.
What to Expect From a Surgical Excision for a Malignant Mole
Surgical excision is a skin cancer treatment to surgically remove malignancies such as moles, lesions, and tumors from the skin. A healthy margin is also removed around the tumor to make sure all malignancy is removed.
The procedure is generally well-tolerated and done with a local anesthetic that numbs the area. Risk factors include:
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Scarring—this is common after a surgical excision
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Bleeding or swelling—minimal bleeding and some swelling are not uncommon, but you should contact your doctor if you experience persistant bleeding or significant swelling.
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Pain—pain should be minimal, and you can take over-the-counter pain relievers such as Tylenol to help with any discomfort
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Infection—infection is uncommon after a surgical excision. If you notice signs of infection such as redness, swelling, seepage, or increasing pain, then contact your health care professional right away.
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Nerve damage—Depending on the location of the malignancy and how deep the excision must be, it is possible to experience some nerve damage.
Skin Cancer Malignancies Treated with Excision
Melanoma
Melanoma is usually diagnosed with a skin biopsy. If the biopsy finds melanoma, surgical excision is usually the first line of treatment to remove the entire cancerous area. Patients with thin melanoma or melanoma caught early, may be cured with surgical excision.
Low-risk squamous cell or basal cell carcinomas
Each of these types of low-risk skin cancers are good candidates for curative surgical excision of the cancerous mole or area of skin.
High-risk squamous and basal cell carcinomas
Surgical excision is a treatment option for high-risk carcinomas, but the cancers have a high likelihood of returning after surgery. If your doctor determines it is an appropriate treatment, wide margins will be removed. A pathologist may test the excised skin during surgery to ensure that all the abnormal cells were removed.
When Should I Be Concerned About a Mole?
Your dermatologist, or primary care provider, should perform regular full-body skin examinations to track any potential cancerous changes to the skin or any moles. In addition, you should do frequent self-exams of any moles. Examine your skin every month or so to look for changes.
When examining moles, it is essential to remember the ABCDE’s of melanoma. These are:
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A—Asymmetry. Both halves of the mole should look identical. If they do not, this is called asymmetry and should be evaluated by your doctor.
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B—Borders. A mole with irregular, poorly defined borders can be of concern.
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C—Color. A mole with multiple shades of color is more concerning than moles with a uniform color throughout.
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D—Diameter. A doctor should evaluate moles that are larger than a pencil eraser.
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E—Evolving. Watch for moles that are changing in shape, size, color, or borders.
You should also watch any new moles that develop or moles that suddenly start to itch or bleed. A suspicious mole should be checked right away by your doctor, so contact them and describe the changes to the mole.
Other Signs of Skin Cancer
Skin cancer is often easily treated if caught early, hence the importance of full-body skin evaluations. Remember to check hard to see areas in a mirror. These include under the armpits, between the toes and fingers, and underneath your fingernails. Women will need to raise their breast to check underneath. You should also use a hand-mirror to check between your buttocks, in the genital region, and any other hard to see places.
When doing a self-exam, potential signs to be alert for include:
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Changes to any moles as detailed above
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A sore that bleeds or does not heal after several weeks
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Rough or scaly red patches, which may crust or bleed
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Spots on the skin that are new, changing in size or shape, or suddenly become irritated
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A wart-like growth that appears suddenly
Not all of these things will be skin cancer, but they are worth bringing to the attention of your health care provider. Skin cancer can manifest in many different ways, so it is important to make a note of any changes to your skin and have them evaluated at your next appointment.
