Skin cancer treatment options

What Are Your Skin Cancer Treatment Options?

Skin cancer treatment options

Treatments for skin cancer depend on the type of cancer, the stage, the size and location of the tumor, and much more.

For basal cell carcinomas and squamous cell carcinomas, surgery (excision) or electrodesiccation and cautery of the cancer is often all that is needed. Mohs surgery is an additional option to reduce scarring.

The treatment of melanoma also includes surgery, but with a wider excision. Depending on the stage, additional treatments such as immunotherapy, targeted therapy, chemotherapy, and radiation therapy may be needed.

A team of doctors will work with you to determine the best skin cancer treatment plan. The team may include specialists such as a surgical oncologist, medical oncologist, radiation oncologist, dermatologist, plastic surgeon, and a pathologist.

Surgery to remove the tumor is the standard treatment, but numerous other options are available as well.

The type of treatment method for nonmelanoma or melanoma cancers depends on how large the lesion is, where it is found on the body, and the specific type. Surgical options include:

Simple excision is done by injecting a local anesthetic and then surgically removing (excising) the cancer and a small area of normal appearing tissue surrounding it. This is frequently done for smaller basal cell and squamous cell skin cancers.

Curettage and Electrodesiccation

Curettage and electrodesiccation is another option that may be used for very small basal cell and squamous cell carcinomas. In this procedure, the skin is numbed locally and a scalpel is used to shave off the lesion (curettage). Cautery (electrodesiccation) burns the surrounding tissue to stop bleeding and create a scab for when the area heals.

Mohs surgery (microscopically controlled surgery) is a highly specialized surgical technique that may be used to excise melanoma-in-situ when the cancer involves an area where sparing tissue is important (e.g. the face).

The surgeon begins by excising visible cancer and sending the sample to the pathologist. The pathologist looks under the microscope to see if any tumor cells are near the margins (edges) of the sample removed. If so, further surgery is done, followed by pathological evaluation until all margins are clear. In some cases, many small excisions of tissue are done before clear margins are found.

The end result of this technique is less scarring than would occur if a surgeon simply took a wider margin of tissue to make sure that no cancer remained.

Surgery for melanoma is more extensive, and many people are surprised at the amount of tissue that is usually removed. A wide excision is recommended whenever possible.

Depending on the location of the melanoma and the size, surgery may be done in the office or in an operating room. For small tumors, a local anesthetic may be injected, but other anesthesia techniques, such as a local nerve block or even general anesthesia may be needed.

A wide elliptical incision is done, paying attention to skin lines. With larger melanomas, or melanomas in challenging areas, a plastic surgeon usually performs the procedure rather than a dermatologist, or the two will work together. For melanoma in situ, a margin of 0.

5 cm (about 1/4 of an inch) beyond the cancer is usually recommended. For other melanomas, a very wide margin (3 cm to 5 cm) was recommended in the past but was not found to increase survival. Today, a margin of 1 cm to 2 cm is usually recommended for tumors that are 1.01 mm to 2.0 mm thick, and a margin of 2 cm for those thicker than 2 mm.

Some surgeons are now using Mohs surgery for melanomas as well.

For smaller melanomas, the incision may be closed after surgery, similar to an incision done for another type of surgery. If a large amount of tissue is removed, closing with skin grafts or skin flaps may be required.

You may be very concerned when your surgeon discusses the amount of tissue that must be removed, but reconstruction for skin cancer has improved dramatically in recent years.

That said, reconstruction may need to be done in stages as healing occurs.

Side effects of any type of surgery for skin cancer may include bleeding or infection, scarring, as well as disfigurement. Again, however, plastic surgery can do wonders in restoring appearance in even very extensive surgeries.

There are a few procedures that are sometimes done or are being explored as alternatives to surgically removing a tumor. Some of these include:

  • Cryosurgery (freezing a skin cancer) is sometimes used to treat very small skin cancers, especially when a large number of precancerous and small cancerous lesions are present. As with surgery, cryosurgery can leave a scar. Cryosurgery may need to be repeated to eliminate any persistent lesions or to treat new precancerous ones.
  • Laser therapy (using a narrow beam of light to “cut out” a tumor) is being evaluated in the treatment of skin cancer. Since this treatment is relatively new, it's still not known how the effectiveness of laser therapy compares with surgery for skin cancer.
  • Dermabrasion (using rough particles to rub away a tumor) is being evaluated as a possible way to prevent the development of skin cancers, but research as to whether this procedure makes a significant difference is still in its early stages. It has reportedly been used for very small skin cancers.
  • Topical chemotherapy with Efudex (topical 5-fluorouracil) is sometimes used to treat small, superficial basal cell carcinomas and small, superficial squamous cell carcinomas. Imiquimod may also be used to treat superficial basal cell carcinoma and superficial squamous cell carcinoma. The treatment of superficial SCC with either Efudex or imiquimod is an off-label use, though these treatments have proven effective in numerous medical studies.
  • The topical cream Aldara (imiquimod) is a type of immunotherapy drug that stimulates a person's own immune system to fight off cancer. It is currently only approved for superficial spreading basal cell carcinoma. In general, surgery is preferred, though imiquimod may be recommended in certain cases. Due to its mechanism of action, it does not scar. The cream is usually applied daily for five to six weeks.

There are a number of treatment options for skin cancers that spread to distant regions of the body. These therapies are also sometimes used if there is no evidence that a skin cancer has spread on exam or imaging studies.

Since intermediate stage melanomas (such as stage II and stage III) frequently recur after surgery, it's assumed that some cancer cells are left behind.

 The chance that this is the case is greater the higher the stage of the tumor and if the tumor has spread to any lymph nodes.

With early-stage melanomas (stage 0 and stage I), only surgery may be needed. Stage II and stage III melanomas have a significant risk of recurrence, and additional treatment with immunotherapy, targeted therapy, and/or chemotherapy may be used to “clean up” any areas of cancer that remain in the body but are too small to be detected by imaging tests.

When treatments are used in this way, they are considered adjuvant therapies.

For stage IV melanomas, surgery alone is insufficient to treat cancer, and a combination of these therapies is needed. 

Immunotherapy (also called targeted or biologic therapy) helps the body's immune system find and attack cancer cells. It uses materials either made by the body or in a laboratory to boost, target, or restore immune function. 

There are several treatments that classify as immunotherapies. With melanoma, there are two major categories (as well as others being evaluated in clinical trials):

  • Immune checkpoint inhibitors: Our bodies actually know how to fight cancer, but cancer cells find a way to hide from or “turn down” the actions of the immune system. These drugs work by, essentially, taking the brakes off the immune system so that it can fight off cancer cells.
  • Cytokines (such as interferon alfa-2b and interleukin-2) work non-specifically to bolster the immune system to fight off any invader, including cancer cells.

Immunotherapy is the standard of care and can be used alone either as adjuvant treatment in localized or in metastatic melanomas. Immunotherapy may also be used in combination with surgery and/or chemotherapy, or as part of a clinical trial. Many other treatments are being tested, including therapeutic vaccines and oncolytic viruses.

Side effects of these treatments vary. They can include fatigue, fever, chills, headache, memory difficulties, muscle aches, and skin irritation. Occasionally, side effects from immunotherapy can include a change in blood pressure or increased fluid in the lungs. 

Chemotherapy is the use of drugs to kill any rapidly dividing cells in the body. This can, obviously, be quite helpful for cancer cells, but several normal cells divide rapidly as well—and they are targeted just the same. This gives rise to common chemotherapy side effects, such as low blood counts, hair loss, and nausea.

Chemotherapy may be given when there is a high risk of cancer recurring (as adjuvant therapy) or when cancer has metastasized. When given for metastatic disease, chemotherapy cannot cure cancer but can often prolong life and reduce symptoms.

Chemotherapy may be given in a number of different ways:

  • Topically: Topical 5-fluorouracil for is used for extensive basal cell carcinoma.
  • Intravenously: Chemotherapy can be delivered through the bloodstream targets cancer cells wherever they happen to be and is a mainstay for cancers that have metastasized to a number of different areas.
  • Intrathecally: For skin cancer metastases to the brain or spinal cord, chemotherapy may be injected directly into the cerebrospinal fluid. (Due to the presence of a network of tight capillaries known as the blood-brain barrier, intravenous chemotherapy does not often penetrate into the brain).
  • Intraperitoneal: For melanomas that have spread within the abdomen, chemotherapy may be given directly into the peritoneal cavity.
  • Into a limb: For cancers present in an arm or leg, a tourniquet may be applied and a higher dose of chemotherapy injected into the arm or leg that would otherwise be possible if given through a vein (isolated limb perfusion, ILP and isolated limb infusion, ILI).​

Targeted therapies are drugs that zero in on specific molecular pathways involved in the growth of cancer cells. In this way, they do not “cure” cancer, but may halt its progression for some people. Since these treatments have specific cancer (or cancer-related) targets, they often—but not always—have fewer side effects than traditional chemotherapy.

There are two primary categories of drugs now used (with others in clinical trials) including:

  • Signal transduction inhibitor therapy: These drugs target cellular communication pathways between cancer cells that are needed for the growth of some melanomas. Zelboraf (vemurafenib) and Taflinar (dabrafenib) may be effective for people who have tumors that test positive for changes in BRAF. The targeted drugs Mekinist (trametinib) and Cotellic (cobimetinib) may also be used.
  • Angiogenesis inhibitors: In order for tumors to grow and spread, new blood vessels must be formed (a process referred to angiogenesis). Angiogenesis inhibitors work by preventing the formation of new blood vessels, essentially starving a tumor so it cannot grow. Side effects can sometimes be serious and include problems such as high blood pressure, bleeding, and rarely, bowel perforation.

Radiation therapy is the use of high-energy X-rays or other particles to kill cancer cells. The most common type of radiation treatment is external-beam radiation therapy, which is radiation given from a machine outside the body. Radiation may also be given internally via seeds that are implanted in the body (brachytherapy).

With melanoma, radiation may be given when cancer has spread to lymph nodes, after a lymph node dissection (with or without chemotherapy or immunotherapy). It is used most commonly as a palliative therapy to reduce pain or prevent fractures due to bone metastases, rather than to treat skin cancer directly.

There are many clinical trials in progress that are looking for newer and better treatments for skin cancer, and the National Cancer Institute currently recommends that everyone diagnosed with melanoma consider the possibility of joining one. 

The treatment of cancer is changing very rapidly. The immunotherapy and targeted therapies currently used for melanoma were unheard of a decade ago, and even a few short years ago were only available in clinical trials.

Some people have had what oncologists call a “durable response” to treatment with these drugs, essentially—and cautiously—suggesting their effectiveness as a cure. This is true even for people with very advanced stage metastatic melanomas.

Though these individuals remain the exceptions and not the norm, this is promising.

Oftentimes, the only way a person can receive a newer treatment is by being enrolled in a clinical trial. There are many myths about clinical trials, and many people are nervous about taking part in one.

It may be helpful to understand that, un clinical trials of the past, many of these treatments are designed very precisely to target abnormalities in melanoma cells.

Because of this, they are much more ly to be of benefit to a person receiving them as part of a research study than in the past.

We do not currently have any alternative cancer treatments that work to treat skin cancer, but some of these integrative therapies for cancer may be helpful in reducing the symptoms of cancer and cancer treatments. Options such as meditation, yoga, prayer, massage therapy, acupuncture, and more are now offered at many of the larger cancer centers.

Source: https://www.verywellhealth.com/skin-cancer-treatment-3010859

Squamous Cell Carcinoma Treatment – The Skin Cancer Foundation

Skin cancer treatment options

Using a scalpel, the surgeon removes the entire tumor along with a “safety margin” of surrounding normal tissue. The margin of normal skin removed depends on the thickness and location of the tumor.

Typically, the patient goes home after the surgery, and the excised tumor goes to the lab. If the lab finds cancer cells beyond the margins, the patient may need to return for more surgery until margins are cancer-free.

When it’s used

For small, early SCCs that have not spread, excisional surgery is frequently the only treatment required.

Mohs surgery is performed during a single visit, in stages. The surgeon removes the visible tumor and a very small margin of tissue around and beneath the tumor site. The surgeon color-codes the tissue and draws a map correlated to the patient’s surgical site.

In an on-site lab, the surgeon examines the tissue under a microscope to see if any cancer cells remain. If so, the surgeon returns to the patient and removes more tissue exactly where the cancer cells are. The doctor repeats this process until there is no evidence of cancer.

Then the wound may be closed or, in some cases, allowed to heal on its own.

Superficial versus minimally invasive

Superficial SCCs have not penetrated (or invaded) below the topmost layer of the skin (the epidermis), while minimally invasive SCCs have just barely invaded the second layer of skin (the dermis) and have no high-risk characteristics.

The physician scrapes or shaves off the SCC with a curette (a sharp instrument with a ring-shaped tip), then uses heat or a chemical agent to stop the bleeding and destroy remaining cancer cells.  The procedure may be repeated a few times during the same session until no cancer cells remain.

Treating advanced SCCs

More extensive treatment is necessary for SCCs that have spread, are large in size, have penetrated the skin deeply and caused severe local damage or have resisted multiple treatments and recurred. Find out more about these treatment options here.

Reviewed by:Elizabeth K. Hale, MD

C. William Hanke, MD

Last reviewed: May 2019

Source: https://www.skincancer.org/skin-cancer-information/squamous-cell-carcinoma/scc-treatment-options/

Skin Cancer Treatment Options

Skin cancer treatment options

Most skin cancers are detected and cured before they spread. Melanoma that has spread to other organs presents the greatest treatment challenge.

Standard treatments for localized basal cell and squamous cell carcinomas are safe and effective.

Small tumors can be surgically excised, removed with a scraping tool (curette) and then cauterized, frozen with liquid nitrogen, or killed with low-dose radiation.

Applying an ointment containing a chemotherapeutic agent called 5-fluorouracil — or an immune response modifier called imiquimod — to a superficial tumor for several weeks may also work. Larger localized tumors are removed surgically.

In rare cases where basal cell or squamous cell carcinoma has begun to spread beyond the skin, tumors are removed surgically and patients are treated with chemotherapy and radiation. Sometimes disfiguring or metastatic (spreading) basal cell skin cancers that are not able to be treated by surgery or radiation are treated orally with sonidegib (Odomzo) or vismodegib (Everidge).

Melanoma tumors must be removed surgically, preferably before they spread beyond the skin into other organs. The surgeon removes the tumor fully, along with a safe margin of surrounding tissue. There is controversy whether removing nearby lymph nodes is valuable in certain cases.

Neither radiation nor chemotherapy will cure advanced melanoma, but either treatment may slow the disease and relieve symptoms. Chemotherapy, sometimes in combination with immunotherapy — using drugs interferon-alpha and interleukin-2– is generally preferred.

If melanoma spreads to the brain, radiation is used to slow the growth and control symptoms.

Immunotherapy is a relatively new field of cancer treatment that attempts to target and kill cancer cells by manipulating the body's immune system. Some of the most promising developments in the field of immunotherapy have sprung from efforts to cure advanced melanoma.

Some researchers are treating advanced cases with vaccines, T-VEC (Imlygic), a genetically modified herpes virus used to infect and kill cancer cells.

and other drugs such as interferon, interleukin-2, ipilimumab (Yervoy), nivolumab (Opdivo) or pembrolizumab (Keytruda) in an effort to stimulate immune cells into attacking melanoma cells more aggressively.

Genetic manipulation of melanoma tumors may make them more vulnerable to attack by the immune system. Each of these experimental treatment approaches aims to immunize a patient's body against its own cancer — something the body cannot do naturally.

There are also drugs that target specific gene changes within normal cells that cause them to become cancerous. Often called targeted therapy, these drugs include dabrafenib (Tafinlar), trametinib (Mekinist), and vemurafenib (Zelboraf).

People who have had skin cancer once are at risk for getting it again. Anyone who has been treated for skin cancer of any kind should have a checkup at least once a year. About 20% of skin cancer patients experience recurrence, usually within the first two years after diagnosis.

Once skin cancer is diagnosed, the only acceptable treatment is medical care. Alternative approaches may be useful in cancer prevention and in combating nausea, vomiting, fatigue, and headaches from chemotherapy, radiation, or immunotherapy used to treat advanced skin cancer. Be sure to discuss any alternative treatments you are considering using with your cancer doctor.

Skin experts know that the mineral zinc and the antioxidant vitamins A (beta-carotene), C, and E can help repair damaged body tissue and promote healthy skin.

Now, researchers are trying to determine whether these and other nutrients might protect skin from the harmful effects of sunlight.

To test the theory, selected skin cancer patients are given experimental supplements of these vitamins in the hope of preventing cancer recurrence. As of now, there is no convincing evidence that these agents are helpful.

SOURCES:

News release, FDA.American Cancer Society.National Cancer Institute.

American Academy of Dermatologists.

© 2019 WebMD, LLC. All rights reserved.

Source: https://www.webmd.com/melanoma-skin-cancer/detection-treatment-skin-cancer

Skin cancer (non-melanoma) – Treatment

Skin cancer treatment options

Surgery is the main treatment for non-melanoma skin cancer, although it may depend on your individual circumstances.

Non-surgical treatments, such as freezing (cryotherapy), anti-cancer creams, photodynamic therapy (PDT), radiotherapy and electrochemotherapy, are also used in certain circumstances. 

Overall, treatment is successful for at least 9 10 people with non-melanoma skin cancer.

If you have skin cancer, your specialist care team may include a dermatologist, a plastic surgeon, a radiotherapy and chemotherapy specialist (an oncologist), a pathologist (a specialist in diseased tissue) and a specialist nurse.

If you have non-melanoma skin cancer, you may see several (or all) of these specialists as part of your treatment.

When deciding which treatment is best for you, doctors will consider:

  • the type of cancer you have
  • the stage of the cancer (its size and how far it's spread)
  • your general health

Your cancer team will recommend what they think is the best treatment option, but the final decision will be yours.

Before visiting hospital to discuss your treatment options, you may find it useful to write a list of questions you'd to ask.

For example, you may want to find out what the advantages and disadvantages are of particular treatments.

Surgical excision is an operation to cut out the cancer along with surrounding healthy tissue to ensure the cancer is completely removed.

Surgical excision may be done in combination with a skin graft, which involves removing a patch of healthy skin, usually from a part of the body where any scarring cannot be seen, such as your neck, abdomen or upper thigh. It's then connected (grafted) to the affected area.

In most cases, surgery is enough to cure non-melanoma skin cancer.

Mohs micrographic surgery (MMS) is a specialist form of surgery used to treat non-melanoma skin cancers when:

  • it's felt there's a high risk of the cancer spreading or returning
  • the cancer is in an area where it would be important to remove as little skin as possible, such as the nose or close to the eyes

MMS involves surgical excision of the tumour and a small area of surrounding skin.

The edges are immediately checked under a microscope to make sure all the tumour has been completely removed.

If it has not, further surgery is done, usually on the same day. This minimises the removal of healthy tissue and reduces scarring while ensuring that the tumour has been completely removed.

Curettage and electrocautery is a similar technique to surgical excision, but it's only suitable in cases where the cancer is quite small.

The surgeon will use a small spoon-shaped or circular blade to scrape off the cancer before burning (cauterising) the skin to remove any remaining cancer cells and seal the wound.

The procedure may need to be repeated 2 or 3 times to ensure the cancer is completely removed.

Cryotherapy uses cold treatment to destroy the cancer. It's sometimes used for non-melanoma skin cancers that are at an early stage.

Liquid nitrogen is used to freeze the cancer, and this causes the area to form a scab.

After about a month, the scab containing the cancer will fall off your skin. Cryotherapy may leave a small white scar on your skin.

Anti-cancer creams are also used for certain types of non-melanoma skin cancers, but are only recommended when the tumour is contained within the top layer of the skin, such as early basal cell carcinoma and Bowen's disease.

There are 2 main types of anti-cancer creams:

  • chemotherapy creams – these contain a medicine called 5-fluorouracil
  • immune stimulating creams – these contain a medicine called imiquimod

For non-melanoma skin cancer, chemotherapy creams containing 5-fluorouracil are used.

The cream is applied to the affected area for several weeks.

As only the surface of the skin is affected, you will not experience the side effects associated with other forms of chemotherapy, such as being sick or hair loss. However, your skin may feel sore for several weeks afterwards.

Immune stimulating creams containing imiquimod is used to treat basal cell carcinomas with a diameter of less than 2cm. It's also used to treat actinic keratoses and Bowen's disease.

Imiquimod encourages your immune system to attack the cancer in the skin and is used over several weeks.

Common side effects of 5-fluorouracil cream and imiquimod include redness, flaking or peeling skin and itchiness. Less common and more serious side effects include blistering or skin ulceration.

Photodynamic therapy (PDT) is used to treat basal cell carcinoma, Bowen's disease and actinic keratoses. It involves using a cream that makes the skin highly sensitive to light.

After the cream has been applied, a strong light source is shone on to the affected area of your skin, which kills the cancer.

PDT may cause a burning sensation and may leave scarring, although there is usually less scarring than with surgery.

Radiotherapy involves using low doses of radiation to destroy the cancer. The level of radiation involved is safe. However, your skin may feel sore for a few weeks after radiotherapy.

Radiotherapy is sometimes used to treat basal cell and squamous cell carcinomas if:

  • surgery would not be suitable
  • the cancer covers a large area
  • the area is difficult to operate on

Radiotherapy is sometimes used after surgical excision to try to prevent the cancer coming back. This is called adjuvant radiotherapy.

Electrochemotherapy is a possible treatment for non-melanoma skin cancer.

It may be considered if:

  • surgery is not suitable or has not worked
  • radiotherapy and chemotherapy have not worked

The procedure involves giving chemotherapy into the tumour or sometimes directly into a vein (intravenously). Short, powerful pulses of electricity are then directed to the tumour using electrodes.

The electrical pulses allow the medicine to enter the tumour cells more effectively and cause more damage to the tumour.

The procedure is usually done using general anaesthetic, where you're unconscious, but some people may be able to have local anaesthetic, where you're conscious but the area being treated is numbed.

Depending on how many tumours need to be treated, the procedure can take up to an hour to complete.

The main side effect is pain where the electrode was used, which can last for a few days and may require painkillers.

It takes around 6 weeks for results to appear and the procedure usually needs to be repeated.

Your specialist can give you more detailed information about electrochemotherapy.

Source: https://www.nhs.uk/conditions/non-melanoma-skin-cancer/treatment/

Skin Cancer & Treatments

Skin cancer treatment options

According to the American Cancer Society, skin cancer is now the most common of all cancers in the United States. The good news is that skin cancer is highly curable when diagnosed and treated early by a skilled dermatologist.

In almost all cases, treatment can be performed on an outpatient basis under a local anesthesia.

We offer our patients today’s most advanced technology and surgical techniques for treating basal cell carcinoma, squamous cell carcinoma and melanoma.

What is squamous cell carcinoma?
Squamous cell carcinoma (SCC) is a skin cancer that occurs in the uppermost layers of the skin, or the epidermis.

SCCs often look scabs, with a crusty patch growing on top of inflamed, red skin.

Primarily caused by years of UV exposure, SCCs are most commonly found on areas of the body that are exposed to the sun, but they can also develop on the inside of the mouth, nose, and genitalia.

What is basal cell carcinoma?
Basal cell carcinoma (BCC) is the most common form of skin cancer, affecting cells of the deepest layer of the epidermis. BCCs are abnormal growths that resemble a waxy bump, sore, or scar.

The result of long-term exposure to the UV rays of the sun (or tanning beds), BCCs often occur on areas that have been most exposed, such as the face and neck. BCCs are slow growing and rarely metastasize.

However, if they are not treated, they have the potential to become disfiguring and invade healthy surrounding tissue.

What is melanoma?
Melanoma is the most serious form of skin cancer, and can be fatal if left untreated. It can occur anywhere on the body when the skin cells that produce pigment mutate and grow rapidly, forming a tumor that resembles a mole, or develops from a mole.

Atypical moles (or dysplastic nevi) can sometimes mimic the appearance of melanoma, so schedule an examination to be sure. Be diligent about self-checking your moles and look for the ABCDE signs of melanoma, especially if you have ever experienced a sunburn or have a family history of this cancer.

Melanoma is serious and can spread quickly to other parts of the body.

Skin Cancer Treatments

The good news is there are many effective treatments for eliminating skin cancer. Early forms of basal cell and squamous cell skin cancer may be treated non-surgically using liquid nitrogen (cryosurgery) currettage, light-based treatments, laser treatments and topical creams.

Surgical removal is also used to eliminate these cancers, by excision or by performing Mohs micrographic surgery. For patients who are poor surgical candidates, superficial radiation therapy may be recommended.

If melanoma is diagnosed, and is in its earliest stages, a dermatologist may choose to surgically remove it in their office. However, if the melanoma has spread beyond the top layer of the skin, more extensive treatment will be needed.

This often requires having the melanoma removed by a general surgeon or surgical oncologist, and may also include radiation, chemotherapy and/or immunotherapy treatments.

Cryosurgery

Cryosurgery is a simple, non-invasive procedure in which liquid nitrogen is used to freeze and destroy growths on the surface of the skin. It’s an effective treatment for precancerous skin lesions (actinic keratoses) as well as a range of skin conditions, including warts, skin tags, and moles.

Applying liquid nitrogen to skin lesions and growths allows our specialists to specifically target the damaged areas and destroy them at the cellular level.

After freezing, the affected area will scab over and should heal within three to six weeks. Our team uses cryosurgery to treat a wide range of conditions.

It offers a number of advantages: it’s a simple, affordable outpatient procedure, it’s mildly uncomfortable, and it has a low risk of infection.

Mohs Surgery

Mohs surgery is widely accepted as the most effective method for removing certain types of skin cancer, with a cure rate of 98 to 99 percent for basal and squamous cell carcinomas.

Mohs surgery is performed by a skilled dermatologist, who removes the cancer in stages, layer by layer, while preserving as much healthy surrounding tissue as possible.

Each thin layer of skin is examined under the microscope as it is removed in order to detect any remaining cancerous cells. If cancer cells are present, the surgeon removes another thin layer of the skin. This layer-by-layer approach continues until the cancer cells can no longer be found, removing the cancer down to its roots.

SRT-100 Vision™ is the next generation of innovation in our team’s advanced technology for treating nonmelanoma skin cancer and keloid scarring. This treatment is ideal for patients 40 and older considering non-surgical treatment for their skin cancer or looking to minimize their keloid scarring.

This evolved technology’s high frequency ultrasound image guidance and other enhancements now enable our team and certified radiation therapist to:

View the area being treated while it’s being treated. This “see and treat” capability allows basal and squamous cell carcinomas, as well as keloid tissue, to be thoroughly assessed and targeted even more precisely.

Examine and assess each of our patient’s lesions at the micron level.Define each lesion’s boundaries and margins to optimize patient treatment plans.

Identify the field size to be treated, improving our patient’s cure rates.

Determine and deliver beam depth as well as ensure precise positioning.

Source: https://mydermspecialists.com/skin-cancer-treatments/

Nonmelanoma skin cancer: What are the best treatments?

Skin cancer treatment options

If you’ve just been diagnosed with nonmelanoma skin cancer, be glad you and your doctor caught it. Most of the time it’s curable, especially when it’s found and treated early. And you have a number of treatment options to choose from, depending on what type it is.

But you need to talk to your doctor about the pros and cons of each one before you decide what is right for you.

For precancers, very small skin cancers or those at the top layer of your skin, treatment could be pretty simple. There are a number of methods that don’t require cuts or unnecessary strain to other parts of your body.
Gels and creams.

Chemotherapy drugs target and kill cancer cells, while immune response drugs tell your body’s own defenses to attack a certain area. There are several topical forms available of both that you can apply to the affected area of your skin.

Depending on which kind you use, your treatment could last from 2 days to 3 months, and cause mild to severe irritation to your skin.
Liquid nitrogen. Your doctor may suggest freezing off the cancerous skin tumor.

He might have to do it a couple of times, but it eventually kills the cancerous cells. Your skin will blister and crust up, but once it heals all you’ll be left with is a scar.

Basal cell and squamous cell skin cancers are the two most common nonmelanoma skin cancers. Surgery is often used to treat them. These procedures usually take a matter of minutes to an hour and only require local anesthetic.
Excision.

Your doctor will use a blade to remove the cancer, as well as some cancer-free skin. This is a quick process that often requires stitches and will leave a scar.
Electrodessication and Curettages.

This procedure gets its name from the scoop-shaped tool called the curette. After your doctor removes the cancerous cells, he’ll use an electric needle to probe the skin around the area to kill any leftover cancer cells.

You may repeat the process a couple of times during your visit, and you’ll probably end up with a scar.
Mohs surgery. During this surgery, your doctor will remove thin layers of skin from the affected area and review them under a microscope to look for cancerous cells.

It usually takes hours because your doctor repeats the procedure, removing a thin layer of skin and putting it under the microscope, until he no longer sees any cancer cells. Mohs is common for cancers found on the face.

If you’re trying to avoid surgery or if your cancer is too large, radiation might be an option. It uses high-energy rays (such as X-rays) or particles (such as photons, electrons, or protons) to kill your cancer cells.

To treat skin cancer, external radiation is focused on the cancerous tumor to kill or stop its growth. To help limit some of the side effects, your doctor will ly use a type of radiation called electron beam radiation because it doesn’t go deeper than your skin.

Your doctor might also use internal radiation – putting radioactive materials inside the affected area — to go with other treatments, especially if your cancer has metastasized, meaning spread to other parts of your body, such as your lymph nodes.

The side effects of radiation therapy include:

  • Skin irritation
  • Changes in skin color and texture
  • Hair loss to the treatment site
  • Damage to saliva-making glands and teeth (when treating near those areas)

Photodynamic therapy (PDT), also called phototherapy, might be an option if you have:

With PDT, your doctor uses a special light along with a drug to kill cancer cells. The drug goes on as a cream that your doctor rubs onto your skin over the cancer.

Then, you need to wait at least 3-6 hours for your skin to absorb the medicine. In some cases, you may need to wait as long as 14-16 hours. When your doctor turns on the light, it kicks the drug into action to destroy the cancer.

You can't get PDT for cancers that go deep into your skin because the light can't reach that far. It's mainly used for cancer that covers a large section of skin or that's clustered in one area.

PDT tends to work just as well as other treatments surgery and radiation, but there are no long-term side effects, and it doesn't leave a scar.

Your doctor might suggest other treatments the type of skin cancer you have, whether it continues to happen , and your overall health. These could include less common treatments, non-FDA-approved procedures, or even clinical trials. Talk to your doctor about your specific goals and concerns.

Once your treatment is complete and the affected area is healed, you need to protect your skin. Many of these treatments can make your skin more sensitive to the sun. Talk to your doctor about the side effects of your treatment to know if you need to stay the sun and for how long.

Also, your odds for getting skin cancer again go up if you’ve had it before. So it’s now more important than ever to perform regular skin checks, know what things raise your odds of skin cancer, and take all necessary steps to prevent it from coming back. Your doctor may even recommend twice-a-year check-ups going forward.

SOURCES:

American Cancer Society: “Cancer Facts & Figures 2016,” “What are basal and squamous cell skin cancers?” “Photodynamic Therapy.”

National Cancer Institute: “Skin Cancer Treatment.”

Mayo Clinic: “Nonmelanoma skin cancer.”

Canadian Cancer Society: “Photodynamic Therapy for Non-melanoma skin cancer.”

Macmillan Cancer Support: “What Is Photodynamic Therapy for Skin Cancer?”

Cancer Research UK: “Photodynamic Therapy (PDT).”

© 2018 WebMD, LLC. All rights reserved.

Source: https://www.webmd.com/melanoma-skin-cancer/skin-cancer-guide/nonmelanoma-treatments

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