Skin Cancer Treatments For Non-Melanoma Skin Cancer
Non-melanoma skin cancers (basal and squamous cell carcinomas) typically can be cured if malignant cells are detected and properly removed at an early stage.
Today, there are many effective basal and squamous cell carcinoma treatment options. The procedures are typically performed on an outpatient basis with minimal pain or discomfort both during and after the treatment:
Mohs Micrographic Surgery
Mohs surgery is the most advanced and effective treatment for certain types of skin cancer. It combines the surgical removal of the tumor with the immediate microscopic examination of the tumor and surrounding tissue. Using a scalpel or curette (a sharp, ring-shaped instrument), the physician removes the visible tumor and then a very thin layer of tissue around it (the margin). This layer is immediately checked under a microscope with the entire margin examined. If tumor is still present in the deep or peripheral margin, the procedure is repeated until the last layer viewed under the microscope is tumor-free.
Mohs surgery has been shown to be a highly effective treatment for certain types of skin cancer, with a cure rate of up to 99% for certain cancers. Mohs surgery provides the most precise method for removal of all cancerous tissue, while sparing the greatest amount of healthy tissue. For this reason, Mohs surgery may result in a smaller surgical defect and less noticeable scarring, as compared to other methods of skin cancer treatment.
The skin cancer, along with a surrounding border (margin) of healthy skin, is surgically removed using a scalpel. The wound is then closed using sutures. Excised tissue is then sent to the lab to verify that all cancerous cells have been removed. This method is safe and effective in the treatment of skin cancer in many cases.
Electrodesiccation and Curettage or “ED&C”
The physician uses a curette to scrape off the growth while an electrocautery tip produces heat to destroy residual cancerous tissue and control bleeding. This is repeated several times during the procedure. Sutures are not needed with this method. ED&C is typically used to treat smaller or superficial basal or squamous cell skin cancers, especially on lower risk sites (such as the back.)
Surgical treatments are not right for every case of skin cancer. For example, in some cases a person cannot undergo surgery. Some treatments are used in conjunction with surgery if surgery is not able to remove all of the cancer cells. In some cases, the tumor is caught very early or is very superficial and surgery may not be necessary.
Photodynamic Therapy (PDT)
The PDT procedure utilizes a topical agent that is applied to the area with abnormal cells. After several hours, the area is then exposed to blue or red light. The light activates the topical agent and the tumor cells are destroyed. PDT is relatively ineffective for invasive and recurrent tumors. However, PDT has shown promise for use on superficial non-melanoma skin cancer. The use of PDT in the treatment of skin cancer is considered off-label use (not approved by the FDA.)
Imiquimod and 5-fluorouracil (5-FU) can be used especially in cases of superficial skin cancers of lower-risk sites. Imiquimod works by targeting the patient’s own immune system to fight off the cancer cells. 5-fluorouracil is a topical chemotherapy agent that is applied as a cream and destroys the cancer cells. After the cream is used, the skin heals with new skin cells. Both medications may not be effective for treating invasive or aggressive tumors. These medications are not-FDA approved for use for squamous cell carcinoma, but are approved for use for certain cases of superficial basal cell carcinoma.
In cryosurgery, the physician applies liquid nitrogen through a spray devise to freeze and destroy tumor tissue. The process may need to be repeated several times to ensure complete destruction of all cancerous cells. While cryosurgery may be less expensive and invasive, it does have a lower success rate; which is why it is mostly utilized on pre-cancerous lesions.
Radiation based treatments use high energy rays or particles to kill cancerous cells. Typically complete destruction requires multiple treatments which are administered over a period of time. There are short and long-term risks and side effects associated with radiation exposure. Radiation treatment may be used alone for patients who cannot undergo surgery or for tumors on which surgery cannot be performed (large or in a difficult site); or in conjunction with surgery to improve cure.
Systemic chemotherapy may be used to treat skin cancer. This is typically used only in advanced cases where there has been spread to lymph nodes or other organs and is often used along with surgery and/or radiation.
Your physician will recommend a treatment type after taking into account your age and general health as well as characteristics of the tumor (type, size, location, and depth of invasion).