Curettage and Electrodesiccation
Curettage and electrodesiccation (C&E) is a procedure used to treat low-risk tumors and precancerous lesions. C&E treats tumors by scraping away the cancerous tissue and destroying remaining cancer cells with an electric needle. This procedure is quick and inexpensive. It can be performed in your doctor’s office. It can be used to treat several tumors in one visit.
Curettage and electrodesiccation cures 91% to 97% of low-risk basal cell carcinoma (BCC) and 96% of low-risk squamous cell carcinoma (SCC).1,2 Experienced doctors have the best cure rates. Cure rates are lower when C&E is used on high-risk tumors.
This procedure may also be called desiccation and curettage. The abbreviations ED&C or EDC may also be used.
How is curettage and electrodesiccation performed?
C&E is an office-based procedure. The area around the tumor will be injected with a medication to numb it. You will feel a pin prick from the needle.3 It stings as the medication is injected.
A curette is a long, thin instrument with a loop on one end. Tumor tissue is soft and can be scraped away easily with a curette. The first tissue that your doctor scrapes off will be sent to a lab for examination.4 Your doctor will use an electric needle, called an electrode, to cauterize any remaining cancer cells. Cauterizing means burning a wound. This is done to destroy the tissue and stop the bleeding. (Another word for cauterize is desiccate, which is where the procedure gets its name.) C&E minimizes damage to healthy skin.5
Your doctor will repeat the process of scraping and cauterizing. The process will be repeated up to 3 times until the doctor reaches firm dermis tissue.1 You will not need stitches to repair the wound.
A pathologist will look at the first sample of tumor tissue under a microscope. This exam will confirm whether or not the lesion was cancerous. It will also reveal any high-risk features. The pathologist’s report will not be available until days after the C&E. If the tumor turns out to be high-risk, you may need a second procedure. Re-treatment is necessary to be sure that all the cancer cells are gone.1 The pathologist will not be able to assess the edges (margin) from the sample.1
For what types of skin cancer is C&E used?
C&E is used to treat low-risk BCC and SCC.1,2 Low risk tumors are small and have clear borders. They are primary tumors (initial tumor), rather than tumors that have returned (recurred). Your doctor will decide whether a tumor is low-risk based on an examination of the lesion and your medical history.1,2 Information from the biopsy will confirm or change the risk assessment.
C&E can also be used to treat actinic keratosis.2 Actinic keratosis is a precancer, which forms when cells in the epidermis begin to grow abnormally. Up to 10% of actinic keratoses become SCC.5 For this reason, your doctor might recommend treating actinic keratosis.
C&E can be used to treat Kaposi sarcoma lesions, when there are only a few to remove.6 Lesions may grow back (recur) in the same spot.6
C&E is not used for areas that have hair, such as the scalp, beard, or armpits.1 If the tumor has grown into a hair follicle, C&E might not be enough to remove it.1
What should I expect before, during, and after?
The procedure is quick and can be performed in your doctor’s office. Because you are given a numbing medication (local anesthetic), you will not feel anything during the procedure. Your doctor may scrape and burn the area up to 3 times. You may notice an unpleasant smell when the wound is cauterized.3 Your doctor will probably cover the wound with a bandage.7 You will be instructed on how to care for the wound.7,8 Most patients are able to drive themselves home after C&E.8
Risks of curettage and electrodesiccation
The wound can take 2 to 3 weeks to heal.7 C&E leaves a scar, which is typically flat and round.5,7,9
Possible risks of C&E include:8
- Need for re-treatment based on pathology report
- Cancer recurrence
Questions to ask
- What options do I have for treating this lesion?
- Why do you think C&E is a good option for this lesion?
- What characteristics suggest that this is a low-risk tumor?
- What will you do if the tumor is deeper than you thought?
- What are the recurrence rates for this type of lesion after C&E?
- How many of these procedures have you done?
- What type of anesthesia will you use during the procedure?
- What do you expect the scar will look like?
- How can I minimize scarring?
- How long does it usually take for the wound to heal?
- What should I expect for my recovery?
- How often should I have follow-up exams with my dermatologist to check for cancer recurrence or a second skin cancer?