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Treating skin cancer

Depending on the type of skin cancer you have, as well as its size and location, your doctor can help you decide which treatment will work best for you.

Like the disease itself, skin cancer treatment comes in a variety of forms. Some skin cancers can be removed with surgery. Others require a more complex process that may combine two or more remedies.

When deciding on a treatment plan to recommend, your doctor will consider what type of skin cancer you have, its size, its location and whether it has spread to other parts of the body. For example, that means:

  • Melanoma treatment may differ from that needed for basal or squamous cell skin cancer.
  • Special techniques may be needed if the cancer is large or on a delicate area like the face.
  • Additional procedures may be needed if the cancer has spread to lymph nodes or other tissues.

Many skin cancers are removed quickly and easily, according to the National Cancer Institute (NCI). Most can be successfully treated when found early. Here's a look at some of the treatment options available for skin cancer.

Surgery

This is the usual treatment for people with skin cancer. According to the NCI and the American Cancer Society (ACS), types of surgery include:

Excisional surgery. This can be used to remove all types of skin cancer. The surgeon removes the growth and some nearby tissue to help make sure no cancer cells remain.

Mohs surgery. This surgery is usually used for basal or squamous cell skin cancers, though some doctors also suggest it for melanoma.

The surgeon carefully shaves away a thin layer of skin and examines it under a microscope. If cancer cells are found, the process is repeated.

This often slow technique removes the cancer but just a small amount of healthy tissue. It helps to limit disfigurement and can be particularly useful when the cancer is on the face.

Electrodesiccation and curettage. These techniques are typically used for small basal or squamous cell skin cancers. A surgeon uses a special spoon-shaped surgical tool—a curette—to remove the growth. An electrical current is then applied to the site to stop the bleeding and kill any lingering cancer cells. The procedure is generally quick and simple, but it will leave a scar.

Cryosurgery. This procedure is used for small basal or squamous cell cancers, especially when they're found early. Cancer cells are killed by extremely cold liquid nitrogen, which is applied directly to the skin.

Cryosurgery may cause swelling or damage nerves. It is usually reserved for people who cannot have more traditional types of surgery.

Laser surgery. Instead of a scalpel, the doctor uses a laser's powerful, focused beam of light to vaporize cancer cells situated close to the skin's surface.

This relatively new type of surgery isn't as widely used as other methods, according to the ACS. It's not yet known if it's as effective as more traditional procedures.

Lymph node removal. If cancer has spread to the lymph nodes, those tissues might have to be removed. Unlike many skin surgeries, where only the surgical site is numbed, this operation usually requires general anesthesia.

Skin grafts. If a particularly large area of tissue was removed, a skin graft may be done. In a graft, healthy skin from another part of the body is transferred to the area where the skin cancer was cut away.

Chemotherapy

In some cases, chemotherapy drugs are used to kill cancer cells or stop them from multiplying. Chemotherapy may be used with surgery or on its own. The treatment can be given in several ways, depending on the type of skin cancer.

For example, some very thin, early-stage basal or squamous cell skin cancers respond to drugs applied directly to the skin. While these lotions or creams may make skin turn red, swell, itch or ooze, they usually do not leave a scar.

However, people with melanoma may need to take oral or intravenous chemotherapy to kill or control their cancer, according to the NCI.

Depending on how it's given, chemotherapy can travel throughout the body or be limited to a particular area. Side effects may include weakness, hair loss and nausea.

Immunotherapy

Also called biological therapy, this approach involves boosting the body's immune system so it's better able to fight cancer. It may be used for advanced skin cancers when surgery or other treatments aren't possible. Side effects may include a rash, fatigue, muscle aches and fever, according to the NCI.

Photodynamic therapy

This two-step process involves a drug and a special light. The drug, either rubbed on the skin or injected, travels to the cancer cells, where it's absorbed. After several hours or days, a device that produces specific types or colors of light is shined on the skin. The light activates the drug, which kills the cancer cells.

The process generally causes little damage to healthy tissue, but the skin may become very sensitive to sunlight or bright indoor light. That sensitivity usually goes away after several weeks.

Radiation

According to the NCI, radiation isn't a common remedy for skin cancer, but it may be used to treat a tumor on the nose, eyelid, ear or similar location where surgery would be difficult or a scar more likely. It also may be used when melanoma has spread to other parts of the body.

Radiation may come from a machine outside the body or be delivered internally from small radioactive seeds or catheters placed on or near the cancer.

Side effects vary and may include red, tender or itchy skin.

What's right for you?

Your healthcare provider can help you decide on the treatment plan that's best for you. It may also be a good idea to get a second opinion before you move forward with treatment. Your doctor, your health insurance representative or another medical professional may be able to recommend another specialist to review your case.

reviewed 10/4/2019

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