Treatment of skin cancer depends on the
- type of skin cancer
- its stage and location and the
- individual's age and overall health
People with small basal cell carcinomas, for instance, may need only simple treatment. That's because basal cell cancers rarely spread to other parts of the body and seldom are fatal. Squamous cell carcinomas have a greater tendency to spread, and may require more treatment. Malignant melanoma may require complicated treatment because of its high risk for spreading.
Skin cancers are usually treated by a dermatologist, a doctor who specializes in skin diseases. Treatment often can be done in the doctor's office. Most require only a local anesthetic. The patient goes home after treatment, and can soon resume regular activities.
Some tiny skin cancers are completely removed and cured during the biopsy. No more treatment is needed. However, most require additional treatment to eliminate all of the cancer cells.
Three kinds of treatment are used for most skin cancers. They re:
- Surgery: Taking out or destroying the cancer.
- Chemotherapy: Giving drugs to kill the cancer cells.
- Radiation therapy: Using powerful energy from x-rays or other sources to destroy the cancer cells.
In addition to these, there are other treatment options.
Surgery is the most common treatment. The doctor may use any of several surgical methods:
- Simple excision involves cutting out the
tumorwith a margin of surrounding normal skin to be sure it is completely removed.
- Cryosurgery (cryo = "cold") freezes and kills the cancer cells. It uses liquid nitrogen, which has a temperature of 196 degrees below zero centigrade. The extreme cold instantly kills the tumor, which falls off like a scab after the area thaws. Cryosurgery itself is painless. However, the treated area may become swollen and painful after it thaws. Cryosurgery is used mainly for small or superficial skin cancers, and to remove
precancerousgrowths. Curettageand electrodessicationcombines two methods. In one, the doctor uses a curette, a sharp, spoon-shaped instrument, to scoop out the tumor. The area is then treated with electrodessication, applying electrical current produced by a special machine. It controls bleeding, and dehydrates and kills any cancer cells remaining near the edge of tumor area.
- Micrographic surgery (or Mohs surgery) attempts to remove all of the tumor and as little surrounding normal tissue as possible. The doctor removes one layer of tumor, and examines it with a microscope. If cancer cells are present he removes another layer, and examines that. The process continues until all cancer cells have been removed.
Lasersurgery uses the highly focused beam of light from a laser to destroy cancer cells. It is seldom used for cancers that have not grown beyond the outer layer of the skin.
Modern ways of doing surgery reduce the amount of scar tissue that forms afterward. Nonetheless, skin cancer surgery will leave a visible scar. Its size usually depends on the size of the cancer and the amount of tissue removed during surgery.
- Cryosurgery for a small tumor usually leaves a faint, white scar that is barely visible.
- Treatment of large cancers may require a skin graft to close the defect. Grafting involves removing skin from another part of the body and moving it to the area where the cancer was removed. Scars often fade and become less visible with time.
Nice To Know:
Micrographic surgery has an advantage aside from leaving the smallest possible scar: It has a very high cure rate. It is generally used for larger, high-risk cancers.
Systemic chemotherapy also may be given in a pill, injected into a muscle, or intravenous form through a needle in a vein. This body-wide, or systemic, chemotherapy can kill cancer cells that have spread outside the skin. It may cause nausea and other side effects in some individuals. Side effects are common, but can generally be controlled. This treatment is generally used only for metastic cancer.
Treatment is painless and does not make the body radioactive. Several treatments may be needed to kill all of the cancer cells.
Radiation therapy may cause:
- Rash, redness, or dryness in the area. Those changes are temporary and disappear.
- Other changes in skin texture or color may develop after radiation therapy. They may become more noticeable years later.
For further information about radiation therapy, go to Radiation Therapy.
Several other treatments may be used for skin cancer, including:
Photodynamic therapyuses drugs that collect inside a tumor. The doctor then focuses a special light on the tumor. The light triggers a chemical reaction in the drug that destroys tumor cells, but does not harm surrounding normal tissue.
- Biological therapy tries to use the body's own natural defenses to attack and destroy cancer cells. It sometimes is called biological response modifier (BRM) therapy or immunotherapy. In one form of biological therapy, disease-fighting white blood cells are removed. The cells are grown in a laboratory and exposed to substances that boost their disease-fighting ability. The activated cells then are injected back into the body to attack the tumor. Biological therapy is used mainly for advanced forms of cancer that cannot be treated with other methods. It is available in clinical trials, studies conducted in medical centers to determine its safety and effectiveness.
Experimental Treatments for Skin Cancer
People with severe forms of skin cancer sometimes can choose between standard therapy and experimental therapy. Standard therapy is the traditional treatment used by most doctors. Most standard treatments have been in use for years. Standard therapy, however, may not work for all patients. It may not cure the disease, or it may cause too many side effects.
In such cases, people with serious cancer may benefit from experimental therapy. These are brand new treatments that scientists are studying inclinical trials. Clinical trials are experiments in new treatments that are tested on people. They are designed to find better ways of treating people.
Clinical trials do give cancer patients access to the newest and most hopeful scientific discoveries. Experimental treatment, however, may prove less effective than the traditional therapy. For instance, it may have hidden side effects. However, experimental therapies may also prove to be more effective than traditional treatments.
Talk with the doctor to decide whether a
For a list of clinical trials: (http://www.clinicaltrials.gov.)