The diagnosis of skin cancer is alarming. Thankfully, with major advancements in the medical field, there are a variety of treatments available to you that are successful in eliminating and preventing further malignant growth. Use this guide to give you a broad knowledge of the various treatments, from minor and non-invasive to more serious therapies for more advanced growths.
The kind of treatment that a doctor may recommend is determined by a few factors: the type of skin cancer, the location of the growth, the development of the cancer and the overall health of the patient. There are three types of skin cancer that are the most prevalent: basal cell carcinoma and squamous cell carcinoma are the most common, and melanoma is the most deadly because of its tendency to spread to other parts of the body. The development of the skin cancer can go from precancerous growths (actinic keratosis) that can be removed quickly and non-invasively to cancers that have invaded other parts of the body and will require multiple kinds of treatments over a longer period of time.
If your doctor finds a precancerous growth, (called an actinic keratosis) or a small, early-stage or superficial growth, you can have the spot frozen. This is called “cryosurgery”, cryo meaning “cold.” Your doctor will use a spray or a cotton-tipped applicator to apply liquid nitrogen to the growth. The liquid nitrogen freezes and kills the tissue, which eventually crusts and falls off. This method only causes some discomfort and eliminates the need for cutting the precancer or carcinoma (cancerous growth).
In excisional surgery, the doctor cuts out (excises) the carcinoma and some surrounding tissue to ensure all of the cancerous cells are removed. This type of surgery can be used for any type of skin cancer and is typically used for early-stage carcinomas that have not spread beyond the margin of the growth. Usually, an excision is an outpatient procedure that may require stitches. Additionally, your doctor will send the excised tissue to a lab to make sure all of the cancerous cells were removed.
Mohs is known to be the gold standard for removing skin cancer growths. It has been time-tested, having been around for decades, and is the treatment with the highest cure rate and lowest rate of recurrence of skin cancer. Not only is Mohs effective for treating skin cancer, but its precise method allows it to be minimally invasive, making Mohs the preferred treatment for carcinomas in highly visible areas like the face and areas where the tissue is particularly thin or sensitive. Mohs is typically used for basal cell carcinoma and squamous cell carcinoma, although it is increasingly becoming more common for removing melanoma. Mohs is also the preferred method for skin cancers that have returned after previous treatment. Mohs is an outpatient procedure that usually takes a few hours, depending on the size and progression of the skin cancer. The area being treated will be numbed, and then the doctor will remove the visible carcinoma. The next step is for the doctor to carefully shave layers of skin from the area of the growth and take the removed skin to an on-site lab, where it is microscopically examined for cancerous cells. The doctor will continue to remove layers of skin until no cancer cells remain. As a patient, you can be assured that no healthy tissue was unnecessarily removed and that all of the margins of the skin cancer are gone. The wound may be left open to heal, be closed up with stitches, require a minor skin graft, or receive later treatment by a plastic surgeon.
This is a simple and quick procedure that is used to remove actinic keratoses (precancerous growths), basal cell cancer, and thin squamous cell cancers. For the procedure, the doctor will numb the area with local anesthesia. Then, using an instrument with a circular blade (a curette), the doctor will scrape away the carcinoma. Finally, the doctor will use electrodesiccation, which involves using either heat from an electric needle or liquid nitrogen to destroy remaining cancer cells from the base of the lesion.
Laser surgery is used to treat superficial and precancerous growths. It can also treat skin cancers that have not responded to other treatments, like topical medications. A doctor may use an ablative laser to vaporize the lesion if control over the depth of tissue treated is necessary or a non ablative laser that converts light energy to heat and kills the cancer cells.
Photodynamic, or light therapy, is for treating actinic keratoses, superficial basal cell carcinomas and squamous cell carcinomas. During the procedure, a topical agent is applied to the skin that makes the skin on and around the lesion sensitive to light. After an hour or so when the skin has absorbed the chemical agent, the doctor will expose the skin to a blue or red light or a laser, activating the topical agent and killing the cancer cells underneath. You may be left with peeling, flaking, and swollen skin.
If the cancer cannot be completely removed through surgery, your doctor may recommend radiation therapy. You also may be pointed to radiation therapy if you are over the age of 60 or are in poor health. Radiation therapy uses low-energy, X-ray beams focused on the skin cancers to kill the malignant cells. The beams can also help keep new cancerous cells from growing. Usually, it is necessary to do several treatments over a few weeks or daily treatments for a month. Cure rates for radiation therapy are around 90%.
There are a variety of medications used to treat skin cancer. Many are used in conjunction with surgery. Some of the medications are topical, while others are taken orally. The therapies included under the umbrella of medication are: immunotherapy, chemotherapy and targeted therapy. Immunotherapy uses medication to help the patient’s immune system find and destroy cancer cells. Chemotherapy is not as widely used as it was because of the development of other therapies, but includes the use of topical creams or lotions and orally or injected medications. Chemotherapy will kill cancer cells, but will also kill healthy cells in the process. Targeted therapy employs drugs that target and kill cancer cells. This therapy can be used to shrink tumors, and is typically for melanoma.
Early detection is the key to successful treatment of skin cancer. The less developed the cancer, the greater likelihood of eliminating the tumor without recurrence. You should do a monthly skin cancer check on yourself so that you can catch any abnormalities that may warrant the attention of a dermatologist. You should also see a dermatologist once a year for a skin cancer screening. With monthly and yearly skin cancer checks and diligent preventative measures being practiced, you are on your way to maintaining your skin’s health.
Make an appointment with one of the board-certified dermatologists at Vanguard Dermatology, located in the greater New York City area. At Vanguard, you can get a skin cancer screening, a mole evaluation, or treatment for precancerous and malignant growths.