Skin Cancer

Surgery

Surgery is an important treatment for many skin cancers. For people, where the cancer has invaded the skin, there is a chance that the cancer may invade deeper structures and spread.

How can I prepare for the surgery? 

Your doctor will explain details of the surgery, general risks and side effects of surgery. Ask your doctor if you have questions. They may recommend:

  • stopping blood thinners (e.g. aspirin) before surgery to reduce the risk of bleeding
  • special stockings to reduce the risk of blood clots
  • early mobilisation (i.e. not staying in bed) to reduce the risk of blood clots and chest infection
  • antibiotics to lower the risk of wound infection.

Before starting treatment, it is important that you consider stopping smoking to reduce the risk of infection and help you fully recovery after your treatment.

Surgical procedures

The different operations that can be used for skin cancer are‚Äč:

LOCAL EXCISION (wide local excision)

This operation involves cutting out the skin cancer with a margin of healthy tissue to ensure all of the cancer is removed. It may require cutting away skin, or other soft tissue and bone. 
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Sentinel lymph node biopsy

This is an investigation that may be done at the time a skin cancer is treated. It is done when there is a high risk of the cancer spreading to lymph nodes, but no nodes are obviously involved. This is most often done in people with melanoma or MCC and rarely done for people with SCC or BCC.
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RECONSTRUCTIVE SURGERY

This may be considered if a large area of tissue is removed. This operation is done by your head and neck surgeon or a surgeon who specialises in reconstructive surgery. Reconstructive surgery may involve:
  • Skin grafting, which is taking skin from another part of your body (such as your thigh) and transplanting it to cover the area where you had surgery.

  • Flap repair, which is taking tissue from another part of your body to rebuild the area where you have had surgery. You can have local flap or a free flap surgery. 

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neck dissection 

This involves removal of lymph nodes from your neck. This is important even when there is no sign of cancer in the lymph nodes on your scan, because there is a risk of microscopic cancer in the lymph glands of the neck.
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Parotidectomy

This is the removal of your parotid glands (pair of major salivary glands located in front of each ear) and the surrounding tissue, because of direct invasion in to the gland or because of spread to lymph nodes lying within the salivary gland.
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facial nerve sacrifice (radical parotidectomy) 

This is the removal of your facial nerve, which controls changes in face or expressions. It is used when a cancer in the parotid gland has spread to the nearby facial nerve.
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Lateral temporal bone surgery

This is the removal of some or all of the bone in the temple and behind the ear. It is used when a cancer in the parotid gland has spread into the nearby bone.
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Orbital exenteration

This involves the removal of the eye or eye lid. It is used when the cancer has spread into the eye socket and cannot be treated any other way.
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Side effects of surgery 

Treatment for skin cancer may lead to late side effects. You may not experience all the side effects, however talk to your doctor if you are concerned.