Skin Cancer

How is skin cancer treated?

Once a skin cancer is discovered, there are several treatment options which are based on on several factors:

  • The type of cancer (basal cell, squamous cell, melanoma, or other)
  • The size of the cancer—treatments that may be effective for small cancers may not be optimal for larger cancers
  • The location of the cancer (face vs. trunk)
  • Your past history and family history of skin cancers

What are the various types of treatment?

Cryosurgery—A small amount of liquid nitrogen is used to “freeze” away the lesion.  Cryosurgery is usually reserved for treating small pre-cancers such as actinic keratoses.

Topical therapy—is best for pre-cancers (actinic keratoses) and some physicians may recommend it for non-aggressive forms of skin cancer such as superficial basal cell carcinoma. Examples of topical therapies are Efudex cream (5-fluourouracil) and Aldara cream (imiquimod). The primary advantage of using topical therapy is avoidance of surgical procedures. However, topical therapies have lower cure rates than surgery and often require application of creams that irritate the skin for weeks or months. Another potential problem is that topical therapy may only remove the superficial portion of the tumor and mask deeper tumor roots.  Its use is strictly limited to very superficial forms of non-melanoma types of skin cancer (superficial basal cell carcinomas).

Curettage-electrodessication—a procedure where the tumor is scraped off using a sharp-edged device called a curette. The surrounding skin is then cauterized (heated) to prevent bleeding and further remove the tumor. This destruction technique is best for non-aggressive types of skin cancer that are very thin or superficial or for non-aggressive forms of skin cancer on the arms or trunk.

Excision—The tumor is surgically removed along with a small portion of surrounding skin. This usually requires stitches to control bleeding and close the wound.

Mohs surgery—This is an advanced, state-of-the-art procedure in which the physician serves as surgeon, pathologist and reconstructive surgeon. It relies on the accuracy of a microscope to trace and ensure removal of skin cancer down to its roots. The cure rate for Mohs micrographic surgery is the highest of all treatments for skin cancer -- up to 99 percent even if other forms of treatment have failed. This procedure, the most exact and precise method of tumor removal, minimizes the chance of regrowth and lessens the potential for scarring or disfigurement.   Mohs surgery is indicated when:

  • the cancer was treated previously and recurred
  • scar tissue exists in the area of the cancer
  • the cancer is in an area where it is important to preserve healthy tissue for maximum functional and cosmetic result, such as eyelids, nose, ears, lips
  • the cancer is large
  • the edges of the cancer cannot be clearly defined
  • the cancer grows rapidly or uncontrollably

Radiation and chemotherapy—may be recommended in cases when the cancer has spread, or when other medical conditions prevent the use of other treatments.

If you are diagnosed with a skin cancer, your doctor will discuss with you which option or options are best suited for you and individually tailor a treatment course based on the varying factors listed above.