Skin cancer: treatment
How skin cancer should be treated depends on all sorts of things — what kind it is, whether it has spread to other parts of the body, and where it is, as well as a person’s age and state of health. Every person is different, and so is every cancer.
Most skin cancers are treated with surgery. Occasionally radiotherapy or chemotherapy, or 2 or all 3 of these treatments, are used. But the basic approach is, in most cases, to cut out the cancer tissue, leaving healthy tissue behind.
Basal cell carcinomas (BCCs) and sun spots are sometimes removed with cryotherapy — liquid nitrogen is used to freeze the cancer cells, which kills them.
Surgery
Sometimes, if the cancer is small and the surrounding tissue is healthy, the whole cancer can be removed when the doctor does a biopsy. Or minor surgery, with a local anaesthetic and a couple of stitches in the wound afterwards, may be enough.
If the cancer, particularly a melanoma, has gone deeper into the skin the person may need a hospital operation, with a general anaesthetic. Sometimes stitches won’t be enough and a skin graft, where skin is taken from another part of the body to patch the wound, may be needed.
If a skin cancer has spread to nearby lymph nodes, some of them may have to be removed too.
Mohs technique.
Mohs technique (microscopically controlled surgery) is a highly specialised type of surgery. The cancer is removed little by little and checked under the microscope immediately. Mohs technique can be used to treat large skin cancers that have penetrated into the skin, cancers that have come back and ones in areas that are difficult to treat such as near the eye.
Cryotherapy
Liquid nitrogen is sprayed over sunspots and early-stage BCCs to freeze and kill the skin. The treated area will be sore for a few days. After a while the dead tissue will fall off. Healing can take up to a few weeks and a white scar may form in the area.
Curettage with cautery
This treatment is mainly used for superficial BCCs. The doctor applies a local anaesthetic and the cancer is scooped out with a small spoon-shaped instrument called a curette. Electric current is applied to stop bleeding and destroy any remaining cancer. The wound should heal within a few weeks, leaving a pale scar.
Imiquimod
Imiquimod is a cream that destroys skin cancer by stimulating the body’s immune system to fight the cancer. The cream is applied 5–7 times a week for up to 6 weeks, Sometimes the treated skin becomes red, sore and may scab or flake.
Photodynamic therapy
Photodynamic therapy (PDT) uses a light source and a special cream to destroy cancer cells. A light-sensitive cream is applied to the skin and a few hours later a light is shone on the area. The treated area must be covered and sometimes the treatment needs to be repeated. Some people require a local anaesthetic before the PDT to help ease pain. After PDT the skin usually heals quickly and without scarring.
Radiotherapy
In radiotherapy (or radiation therapy) high energy X-rays are fired at the cancer. They may kill it completely, or at least shrink it.
Radiotherapy may be used for BCCs and squamous cell carcinomas (SCCs) that are hard to treat with surgery because of where they are (close to an eye, for instance), and for melanoma that has spread to other parts of the body. Radiotherapy may have side effects, including feeling sick or tired, and a sore mouth or itchy skin. It doesn't make a person radioactive.
The Cancer Council’s booklet Understanding Radiotherapy talks about ways to manage side effects. Phone the Cancer Helpline on 13 11 20 for a copy.
Chemotherapy
Chemotherapy is treatment with drugs, either pills or injections. It’s not used much for skin cancer, but it may be used for melanoma that has spread to other parts of the body.
Topical chemotherapy is sometimes used to treat solar keratoses (sun spots). In this treatment, a cream containing the drug fluorouracil (or ‘5FU’) is rubbed on the skin every day for a few weeks.
For further information and advice, call the Cancer Helpline on 13 11 20.
Last Reviewed: 03 January 2007
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