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If the doctors think he will get through the surgery alright that is half the battle.
Do know that he will probably decline due to the anesthesia. It is not a "death sentence" but you never know how much the anesthesia will effect him. He may be fine, it may take a week to get back to "baseline" or a month or he may not return to his pre surgery cognition.
So as much as I am normally for minimizing medical procedures I think in this case I would opt for the surgery.
Recovery will be difficult mainly because he is going to want to not keep his hands off the area. And it will look worse before it gets better and that may upset him as well.
Source: https://www.yalemedicine.org/conditions/squamous-cell-carcinoma#:~:text=Although%20squamous%20cell%20carcinoma%20can,grow%20rapidly%20and%20invade%20deeply.
You don't say where the lesion is, but sounds like it may be on his face. Close to his brain and lymph nodes? Has any of his doctors checked to see if it has spread? If not, why not? If so and it's only that lesion, then there may be other treatment options.
Options include:
Excisional surgery.
Mohs surgery.
Cryosurgery.
Curettage and electrodesiccation (electrosurgery)
Laser surgery.
Radiation.
Photodynamic therapy (PDT)
Topical medications.
"In June 2020, pembrolizumab (Keytruda®) was approved by the FDA for the treatment of recurrent or metastatic SCC that is not curable by radiation or surgery. In July 2021, the FDA expanded this approval to include SCC that is locally advanced and not curable by radiation or surgery."
Source: https://www.skincancer.org/skin-cancer-information/squamous-cell-carcinoma/advanced-scc/#:~:text=Treatment%20overview&text=In%20June%202020%2C%20pembrolizumab%20(Keytruda,curable%20by%20radiation%20or%20surgery.
Adhesive...I can not wear the old white stuff. There is paper tape and hypo-allergetic tape.
https://healthsea.com/squamous-cell-carcinoma/
You probably should go with the surgery knowing that there may be some delerium and decline. In his case his pain needs to be taken care of. Hope for the best!
So, yes, anaesthesia will likely cause some progression of his dementia, but treatment would bring him some relief.
There is always a risk of death when undergoing anaesthesia, even for a young and healthy person. In my early 40s, I stopped breathing during surgery and was at risk of not waking up. The alternative to surgery was becoming paralyzed. The risk was worth it.
There is risk with so many things in life; they can't all be avoided.
If it were my decision to make, I would opt for my parent to have the surgery and have a chance of being comfortable in their last years. There is no comfort or peace to be had with a painful, weeping cancerous wound.
"Squamous cell cancer cannot turn into melanoma since each type of cancer arises from different types of cells in the skin. It is possible, however, to have both squamous cell skin cancer and melanoma skin cancer at the same time."
Source: https://www.emedicinehealth.com/does_squamous_cell_cancer_turn_into_melanoma/article_em.htm
It sounds like a fairly major surgery. I don’t have first hand knowledge, however I’ve heard that can really be a set back with Alzheimer’s and what you lose you don’t get back.
See if surgery is the only way to alleviate pain or if Dr can suggest something else.