Treating skin cancer is a complex and delicate matter and the goal is to remove all of the diseased cells. Quick and decisive actions are vital during this tense time. If cancer has not spread to other organs, it is possible to remove it surgically. Please, bear in mind that all of these procedures are to be performed by a certified doctor. “If you’re unsure about a lesion, see your doctor,” says Dr Stan Green from Specialist Clinics of Australia.
Types of surgeries
- Excision: This procedure is performed at a doctor’s office by first numbing the skin and then surgically cutting out the skin cancer and a small amount of normal-looking skin around it, which is called a margin. This is precautionary with the goal of assuring that all the affected tissues are removed. There various types of excisions, which are determined by the type of the specific skin cancer. Find out more about the types of skin cancer here.
- Curettage and electrodesiccation: This procedure is also usually performed at a doctor’s office and can be used to treat small basal cell and early squamous cell skin cancers. The treatment involves two stages: first, a curette, which is a surgical instrument shaped like a long spoon, is used to scrape out the tumour. Once the area is rid off the diseased tissue, the doctor, aided by an electric needle, gently cauterizes the remaining cancer cells and some normal-looking tissue. This treatment needs to be repeated and three sessions usually are enough. The upside of scraping and cauterizing process is that it does not need stitching afterwards.
- Mohs surgery: This procedure involves removing the visible skin cancer and adjacent layers of skin and soft tissue to facilitate microscopic examination of the excised tissue. Once this is done, meticulous maps that follow the extensions of the tumour are created and continuous excisions are sequentially repeated until no cancer cells are evident upon microscopic examination.
Other treatments of skin cancer
- Topical chemotherapy: A form of therapy in which an anti-cancer medicine is placed directly onto the skin (in form of cream or ointment), rather than being injected into a vein or taken orally. Most common drugs used in this treatment are 5-fluorouracil (5-FU), Diclofenac and Ingenol mebutate. These medicines are designed to destroy the diseased skin cells. Once this is done and the skin heals, new skin will appear in the treated area.
- Cryosurgery/cryotherapy: Most often used in pre-cancerous conditions, such as actinic keratosis and for small basal cell and squamous cell carcinomas. This treatment is designed to destroy the tumour and kills the cells by applying liquid nitrogen using a cotton applicator stick or an aerosol spray. Liquid nitrogen freezes the tumour and the skin around it. Once it thaws, the area will swell, blister and crust over, and it might take a month or two for the skin to heal.
- Immunotherapy: Every patient is different and not all the treatments are equally effective on every person but certain drugs have the potency to boost the body’s immune system in order to fight the cancer. Immunotherapy treatment comes in the form of a cream, which the patient applies to the skin as directed by the doctor. The drug causes the cancer to shrink and go away.
- Photodynamic therapy: This treatment is divided in two distinct phases. First, a special liquid drug is applied to the skin where it remains for several hours or even days. While sitting on the skin, the liquid is converted into a different chemical that makes the cells very sensitive to specific types of light. In the second phase, the cancer is exposed to that light. This process kills the diseased cells.
- Radiation therapy: This form of treatment uses high-energy rays (such as x-rays) or particles (such as photons, electrons, or protons) to kill cancer cells. The high-energy rays are applied from outside the body focusing on the tumour. Radiation therapy requires a doctor who specializes in this form of treatment and is called a radiation oncologist. Radiation therapy is recommended in two cases:
- To treat areas hard to reach by surgery, such as skin cancer located on the eyelid, tip of the nose, and ear, and
- After surgery to prevent the skin cancer from coming back.
To be effective, radiation therapy needs to have scheduled a number of sessions over a particular period of time. A less common type of radiation treatment for skin cancer is brachytherapy. This involves placing the radiation source very close to (or inside of) the skin cancer.
- Chemotherapy: Also simply referred to as chemo. This is a treatment that is prescribed when cancer has spread to other organs as chemotherapy affects the whole body and because of this it is called a systemic therapy. Drugs that kill cancer cells are either injected in a vein or taken orally as a pill. The bloodstream takes the chemicals to all parts of the body where they attack cancer cells.
When skin cancer is recognised by a medical doctor, chemotherapy is rarely used as the first treatment. Nowadays, newer forms of immunotherapy and targeted drugs have become available. Having said that, chemotherapy can be used to treat advanced melanoma. Although it is more effective with other types of cancer, chemo can relieve symptoms or extend survival for some patients.
If you notice any changes on your skin, even if they seem innocent, get them checked. Australia has an extremely high cancer death rate and no changes to the skin should be taken lightly.