When do you know they got "enough" during skin cancer surgery?

Mohs surgery. The gold standard is mohs micrographic surgery a process by which the tissue can be examined immediately under the microscope to check all margins to ensure that all the skin cancer is removed. Fellowship trained mohs surgeon can be found thru the american college of mohs surgery (acms): http://www.Mohscollege.Org/acms/.
Margin Control. It depends on how the skin cancer is removed. With tradtional surgical excision an appropriate margin is added to the size of the lesion and the tissue removed is sent to a lab for the margin to be checked and ensure the cancer is all gone. With mohs microgrpahic surgery the specimen is checked while the patient remains in the office. It is sectioned horizontally as well (as opposed to vertically with a traditional excision) which allows nearly 100% of the peripheral and deep margins to be checked.
Frozen or permanent . Intra operatively there are methods used by. The dermatologist or pathologist to examine the wound edges of the resected specimen to determine if any cancer has been left behind. While generally accurate these frozen section techiques are not considered as accurate as permanent preparation analysis which may take a few days. Mohs technique is where surgeon acts as pathologist and surgeon.
Dermatologic surgeon. Can use a technique called moh's chemosurgery, a painstaking shaving and instant analysis of the "margins" to assure that they are clear. Used mostly with basal and squamous tumors, controversially and occasionally in melanoma. We used to compete in basal; they make the diagnosis. We get few referrals.
Pathology. The specimen removed is examined by the pathologist to determine clear margins. Different cancers require different minimal distances from the excised tumor to comfortably determine free and safe margins. This pathology exam can be checked after the specimen is removed and wound closed or at the same time as the excision.
Skin cancer. There are different techniques to remove skin cancer. The technique that has the highest cure rate and that spares the most normal tissue is called mohs micrographic surgery. This method allows the cancer to be traced out under the microscope by examining the entire periphery of the excised tumor. If any roots are seen the excision and microscopic checking continues until tumor free plane obtained.
Pathology report. Depending on the type of skin cancer (melanomas require a larger margin) - the pathologist will use a microscope to look at the edges (margins) of the area removed.
Pathology report. After a skin cancer is excised or cut out of the skin, the specimen is sent to a dermatopathologist. It is analyzed under the microscope to make sure that the edges or margins are clear. This is how your physician knows that the cancer has been fully removed. In addition, for skin cancers on the face, mohs surgery can be done so each skin specimen is analyzed while you wait until margins are clear.
Skin Cancer Treatment. It really depends upon the treatment chosen. For excisions (when the cancer is cut out), a margin of normal appearing skin is removed as well and the tissue is sent to the lab for evaluation under the microscope. For mohs' surgery, all of the margins are immediately evaluated under the microscope to ensure complete tumor removal. For curettage and desiccation, there is no evaluation performed by a lab.
Microscopic analysis. There are different ways to do it, but when you remove a skin cancer, the surgeon will send the removed skin to the pathologist to have them look at it to assess the tissue. If there is still cancer present on the edges (margins) of the removed skin, your surgeon will need to remove more skin to get all the cancer.

Related Questions

Does it take more than one shot for skin cancer surgery?

Depends. When removing skin for skin cancer, the skin that is removed needs to be checked ny a pathologist under the microscope to make sure all the cancer is removed. If skin cancer remains, a second surgery is necessary to remove the residual cancer. A second surgery is required about 5% of the time. Read more...
Don't let it stop u. It may indeed take multiple shots of numbing medicine to remove a skin cancer, but it certainly is worthwhile. Discuss with your surgeon...It may be feasible to perform the skin cancer removal under anesthesia or with some adjunctive medications to help with anxiety. If you have a skin cancer, don't let a needle phobia keep you from getting appropriate treatment, it could save your life! Read more...
Sometimes. Depends on cancer and technique. If u do mohs surgery for basal cell then the answer is one and done. If it is for melanoma or you don't do mohs then it may be more. Read more...
It can. Skin cancers can spread superficially or deep. All the cells or roots need to be removed in order to prevent further spread. Mohs is the only procedure that can ensure that all the skin cancer is removed with one procedure. All other procedures might require multiple attempts. Read more...
Skin cancer. There are different techniques to remove skin cancer. The technique that has the highest cure rate and that spares the most normal tissue is called mohs micrographic surgery. This method allows the cancer to be traced out under the microscope by examining the entire periphery of the excised tumor. If any roots are seen the excision and microscopic checking continues until tumor free plane obtained. Read more...
Depends. The size of the lesion dictates how many shots of local anesthesia are needed. Read more...
Depends. If there is a small area being treated, it can be injected though one site usually. Larger excisions need multiple injections to numb fully. However, as the initial injection works, the other injection sites may not be felt. Read more...

Anyone had skin cancer surgery and end up with a lot more skin removed?

All the time. If you are diagnosed with melanoma by a small biopsy, you will need more skin removed. Read more...
Yes... Most skin cancer excisions are done with some means of checking the margins....Meaning the surgeon will continue to remove skin until the margins are all clear (and no more cancer remains). Larger tumors, recurrent cancers, and tumors in the central face tend to be the ones which can turn out to require a much bigger resection that one might guess before the surgery starts. Read more...
Yes. Standard treatment for melanoma requires taking wide margins determined by the depth of the lesion. The margins or amount of skin can be quite large depending on the invasiveness of the melanoma determined by breslow or clark's staging and can result in a very large scar. Read more...
Yes. Some skin cancers have poorly defined borders and thus only show up on a microscope. Thus more tissue is removed till all cancer is gone even if it wasn't visible to naked eye. Read more...
Yes. It is common to require more skin removed after the initial biopsy. Often what appears on the surface may only be the "tip of the iceberg" especially if the skin cancer has been present for a long time. Read more...
Skin cancer. There are different techniques to remove skin cancer. The technique that has the highest cure rate and that spares the most normal tissue is called mohs micrographic surgery. This method allows the cancer to be traced out under the microscope by examining the entire periphery of the excised tumor. If any roots are seen the excision and microscopic checking continues until tumor free plane obtained. Read more...
Skin cancer cure. Skin cancer like all other cancers can become deadly. To ensure complete removal sometimes a lot more skin has to be removed than what you see on the surface. This is done with the help of microscopic examination of the boundaries. So the amount of skin removal is directly related to the amount of skin cancer found under the microscope. Read more...

Would intensive cancer surgery (not skin cancer) be attempted if the person has not been off warfarin for at least 5 days?

Unlikely. Generally any elective surgery (even cancer surgery) is done off of Coumadin (warfarin). Sometimes your doctor will take you off of Coumadin (warfarin) and put you on a shorter acting injectable blood thinner like Lovenox. Read more...