Skin Cancer Treatments

There are treatments for all patients with skin cancer. Three kinds of treatments are used:

  • Surgery (taking out the cancer)
  • Chemotherapy (using drugs to kill cancer cells)
  • Radiation therapy (using x-rays to kill cancer cells)

Surgery is the most common treatment for skin cancer. Your doctor may remove the cancer using one of the following:

  • Electrodessication and curettage burns the lesion and removes it with a sharp instrument
  • Cryosurgery freezes the tumor and kills it
  • Simple excision cuts the cancer from your skin along with some of the healthy tissue around it
  • Mohs Micrographic Surgery removes the cancer and as little normal tissue as possible. During this surgery, the doctor removes the cancer and then uses a microscope to look at the cancerous area to make sure no cancer cells remain.

Surgery may leave a scar on your skin. Depending on the size of the cancer, skin may be taken from another part of your body and put on the area where the cancer was removed. This is called a skin graft. New ways of doing surgery and grafting may reduce scarring.

Radiation therapy uses x-rays to kill cancer cells and shrink tumors. Radiation therapy for skin cancer comes from a machine used outside the body.

Chemotherapy uses drugs to kill cancer cells. In treating skin cancer, chemotherapy is often given as a cream or lotion placed on the skin to kill cancer cells (topical chemotherapy). Chemotherapy may also be taken by pill, or it may be put into the body by a needle in a vein or muscle. Chemotherapy given in this way is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells outside the skin. Systemic chemotherapy is being tested in clinical trials.

Biological therapy tries to get your own body to fight cancer. It uses materials made by your own body or made in a laboratory to boost, direct, or restore your body's natural defenses against disease. Biological therapy is sometimes called biological response modifier (BRM) therapy or immunotherapy.

TREATMENT BY TYPE
Treatment for skin cancer depends on the type and stage of your disease, your age, and your overall health.

BASAL CELL CARCINOMA
Your treatment may be one of the following:

  • Mohs micrographic surgery
  • Simple excision
  • Electrodessication and curettage
  • Cryosurgery
  • Radiation therapy
  • Topical chemotherapy

SQUAMOUS CELL CARCINOMA

  • Your treatment may be one of the following:
  • Mohs micrographic surgery
  • Simple excision
  • Electrodessication and curettage
  • Cryosurgery
  • Radiation therapy
  • Topical chemotherapy

MALIGNANT MELANOMA

Four kinds of treatments are used to treat melanoma:

  1. Surgery
  2. Chemotherapy
  3. Radiation therapy
  4. Biological therapy

Surgery (excision) is the primary treatment for all stages of melanoma. Your doctor may take out the melanoma using one of the following operations:

Conservative re-excision is an operation to take out any cancer that remains following biopsy, along with a small amount of skin around it (usually less than one-half of an inch).

Wide surgical excision takes out the cancer and some of the skin around the tumor. You may need to have skin taken from another area of the body and put on the place where the cancer has been taken out. This is called grafting.

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in the vein or muscle. Chemotherapy is called a systemic treatment because the drugs enter the bloodstream, travel through the body, and can kill cancer cells throughout the body. If the melanoma occurs on an arm or leg, chemotherapy may be given with a technique called isolated arterial perfusion. In this method, chemotherapy drugs are put directly into the bloodstream of the arm or leg where the melanoma is found. This allows most of the drug to reach the tumor directly. However, chemotherapy has not been shown to be effective in treating melanoma. Clinical trials are being done to find chemotherapy drugs that are effective.

When a physician removes all the cancer that can be seen at the time of the surgery, chemotherapy may be given after the procedure to kill any cancer cells that are left. Chemotherapy given after an operation to a person who has no cancer cells that can be found is called adjuvant chemotherapy. Adjuvant therapy has not been shown to be effective in treating melanoma. Clinical trials are being done to find adjuvant chemotherapy drugs that are effective.

Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy).

Biological therapy tries to get your own body to fight cancer. It uses materials made by your own body or made in a laboratory to boost, direct, or restore your body's natural defenses against disease. Biological treatment is sometimes called biological response modifier (BRM) therapy or immunotherapy. Biological therapy has not been shown to be effective in treating melanoma. Clinical trials are being done to find biological therapies that are effective.

TREATMENT BY STAGE

Treatments for melanoma depend on the stage of disease, age, and general health.

STAGE I MELANOMA
Your treatment may be one of the following:

  • Conservative re-excision after biopsy.
  • Wide surgical excision. Skin grafting may be done to cover the wound. Sometimes lymph nodes around the tumor may also be removed.

STAGE II MELANOMA
Your treatment may be one of the following:

  • Wide surgical excision.
  • Wide surgical excision of the tumor and removal of nearby lymph nodes. Clinical trials are evaluating whether removal of lymph nodes improves outcome.
  • Wide surgical excision followed by adjuvant systemic chemotherapy or biological therapy.
  • Wide surgical excision followed by chemotherapy given directly into the arm or leg where the melanoma was (isolated arterial perfusion).

STAGE III MELANOMA
Your treatment may be one of the following:

  • Wide surgical excision. Skin grafting may be done to cover the wound. Nearby lymph nodes may be taken out if they contain cancer.
  • Wide surgical excision followed by chemotherapy given directly into the arm or leg where the melanoma was (isolated arterial perfusion). Nearby lymph nodes may be taken out if they contain cancer.
  • Wide surgical excision followed by adjuvant systemic chemotherapy or biological therapy. Nearby lymph nodes may be taken out if they contain cancer.

STAGE IV MELANOMA

Your treatment may be one of the following:

  • Surgery to remove lymph nodes that contain cancer or tumors that have spread (metastasized) to other areas of the body.
  • Radiation therapy to relieve symptoms.
  • Systemic chemotherapy and/or biological therapy.
  • Biological agents injected directly into the tumors that have spread.

RECURRENT MELANOMA

Your treatment depends on many factors, such as the treatment you received before, and where the cancer came back. Since there is no accepted treatment for recurrent melanoma, your treatment may be a clinical trial of systemic chemotherapy or biological therapy.

American Academy of Dermatology
American Society for Dermatologic Surgery

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Northeast Dermatology Associates
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