Nonmelanoma skin cancer treatments
Nonmelanoma skin cancers such as basal cell and squamous cell carcinomas are the most common skin cancers. They can often be cured with minor surgery. In most cases, no other treatment is needed. But follow-up doctor visits are important because some skin cancers will come back.
Which type of surgery is best will depend on the type of cancer, how big the cancer is, and where it is located. Types of surgery include:
- Curettage and electrodessication. This is often a good choice for small cancers.The cancer is scraped away with a thin tool called a curette. An electric current is used to destroy any remaining cancer cells. This process may be repeated.
- Excision. The doctor cuts out the cancer and also removes a small margin of normal skin. The area is then stitched together.
- Mohs surgery. A thin layer of affected skin is removed and examined under a microscope. The doctor continues to remove one layer at a time until no cancer cells are found. This takes time and requires special training, but it results in less scarring than other surgeries. It is often used for large or hard-to-reach tumors or ones that have come back in the same area.
- Skin grafting. If a large section of skin must be removed, the surgeon may take skin from another part of the body and graft it over the wound. This can help the wound heal and reduce scarring.
Other treatments that may be used include:
- Radiation therapy. A machine is used that focuses high-intensity rays at the cancer site. This may be used instead of surgery for large tumors or ones in places that are hard to treat with surgery, such as the eyelid, the tip of the nose, or the ear. Radiation may also be used after surgery to kill any remaining cancer cells.
- Cryosurgery. This does not involve cutting. Instead, the cancer is destroyed by freezing it with liquid nitrogen. It may need to be repeated. This process may be used for small skin cancers or precancerous growths.
- Topical chemotherapy. A cancer-killing medication called fluorouracil (5-FU) may be applied to the skin. It is only effective for pre cancers or cancers limited to the outer layers of the skin. Another topical medication called imiquimod (Aldara) that works with the immune system is sometimes used to treat early skin cancers as well.
- Immunotherapy. Interferon is a manmade protein called an immune response modifier. It may be injected into a skin cancer to stimulate the immune system to destroy the cancer cells. More studies are being done to see how safe and effective this treatment is.
- Laser therapy. A doctor uses a laser beam to destroy a small tumor or pre cancer that is near the surface of the skin. It is sometimes used if bleeding could be a problem with other treatments.
If the cancer has spread from the skin to other organs, a doctor may recommend:
- Systemic chemotherapy. This means the cancer-killing medicines are swallowed or injected. Then they travel through the bloodstream and attack cancer cells throughout the body.
- Radiation therapy. This is used to treat the lymph nodes or other organs.
- Lymph node dissection, or surgery to remove lymph nodes. A surgeon may remove lymph nodes near a tumor so they can be examined for cancer cells.
Melanoma is less common than nonmelanoma skin cancers, but it is more dangerous and more likely to spread to other parts of the body. As a result, it often requires more aggressive treatment. Good follow-up after treatment is important to watch for a recurrence of melanoma.
Surgery is usually the first treatment for melanoma. Surgeries that may be done include:
- Excision. Thin, early-stage melanoma can often be cured by removing the tumor and a margin of normal tissue around it.
- Skin grafting. After removing a large melanoma, a surgeon may take healthy skin from another part of the body to help close the wound and limit scarring.
- Lymph node surgery. The surgeon may take a few lymph nodes near the tumor to check them for cancer. This is called a sentinel lymph node biopsy. If melanoma has spread to the lymph nodes,the rest of the lymph nodes in the area may be removed. This is called lymph node dissection.
After surgery, one or more of the following treatments may be recommended, especially if the cancer has spread:
- Chemotherapy. For systemic chemo, one or more cancer-killing drugs are injected into a vein or swallowed. A type of chemotherapy called isolated limb perfusion is sometimes used for advanced melanoma that affects one arm or leg. High-dose chemo drugs are put directly into the blood of the limb. This gets a high dose of drugs to the area where the cancer is without many of the side effects of systemic chemotherapy.
- Immunotherapy. This stimulates the immune system to fight cancer. Interferon-alpha and interleukin-2 are types of immunotherapy that can sometimes be used to treat melanoma. They may be given as injections to treat advanced melanoma. Interferon-alpha can also be used after surgery to help prevent recurrence. A combination of immunotherapy and chemotherapy is sometimes used. This is called biochemotherapy.
- Radiation therapy. High-energy rays may be used to treat melanoma that can't be removed or has spread to the lymph nodes. Radiation may also be used to ease symptoms caused by cancer that has spread to other organs.
Clinical trials are an option for people with advanced melanoma. Clinical trials are research studies of new treatments. People who take part in clinical trials may get access to the latest therapies before they become widely available. Your doctor can help you decide if this is an option for you. If so, he or she can help you find a clinical trial in your area.
Created on 11/05/1999
Updated on 02/17/2011
- American Cancer Society. Melanoma skin cancer.
- American Cancer Society. Skin cancer: basal and squamous cell.
- American Society of Clinical Oncology. Skin cancer (non-melanoma): treatment.
- National Cancer Institute. Melanoma treatment PDQ (health professional version)