Skin Cancer Treatments
Depending on the type, size and stage of your skin cancer, its location on your body, and your overall health, specific treatments will be considered appropriate for your cancer. Most skin cancers can be treated with liquid nitrogen, a scrape and burn procedure called electrodessication and curettage, topical chemotherapy and immunotherapy creams, radiation, excisional surgery, or Mohs micrographic surgery.
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Non-Surgical Treatments for Localized Disease
Liquid nitrogen can be used to treat superficial skin cancers. This method involves spraying the lesion with liquid nitrogen, a very cold substance at -196 degrees Fahrenheit. This freezes, damages, and kills the malignant cancer cells. The treatment area blisters and then heals as a shallow wound.
Topical application of a medication called 5-fluorouricil (Efudex) may be appropriate for very thin, superficial skin cancers. The medication is applied twice daily to the cancer for several weeks. It targets and destroys the cancer cells but leaves normal cells intact. During the treatment period, the skin cancer becomes significantly inflamed as the cancer cells are destroyed before the area begins to heal.
Immunotherapy involves applying a topical cream called imiquimod (Aldara or Zyclara) to your cancer for several weeks. This medication stimulates your own immune system to attack and kill the skin cancer. During the treatment period, the skin cancer becomes significantly inflamed as the cancer cells are destroyed before the area begins to heal.
Radiation treatment is usually most appropriate for patients who are not fit for surgery because of health problems or for patients who have very large tumors that would require disfiguring surgery, even with multiple surgical reconstructions. Radiation typically requires up to 30 separate treatments over a period of weeks and is performed by a radiation oncologist in the outpatient setting.
Curettage and Electrodessication
Also known as a “scrape and burn,” this method of treatment is appropriate for shallow and non-aggressive skin cancers. The cancer biopsy site is first numbed with local anesthesia. Then, a tool called a curette is used to scrape out the tumor cells, which are discohesive and fall apart more easily than normal cells. Next, an electric needle is used to burn the area. This “scrape and burn” process is repeated 3 times to ensure that an appropriate clear margin of skin has been removed both around and underneath the skin cancer. The treated area heals in by nature as a shallow wound.
Excisional surgery involves removing your skin cancer surgically. The cancer biopsy site is first numbed with local anesthesia. Then, depending on the size and type of your skin cancer, a specific margin of skin around your cancer is removed in a football shape. This piece of skin is sent to the lab and its edges are examined to make sure that no cancer remains. The wound is sutured shut with two layers of stitches. The top layer is removed in 1-2 weeks. The bottom layer dissolves on its own in 2-3 months.
Mohs Micrographic Surgery
Mohs micrographic surgery is a highly specialized technique used to completely remove skin cancers with the highest cure rates. It was developed by Dr. Frederic Mohs in the 1930s and has been modernized over time. Through direct microscopic examination and specialized marking techniques, Mohs surgery removes only cancerous areas, and preserves as much healthy skin as possible. This minimizes scarring and is especially useful when treating skin cancers on the face, neck, ears, hands and feet. Learn more about Mohs micrographic surgery.