Skin Cancer Treatment

Recently Answered

• QHow does Mohs surgery treat skin cancer?

  3 Answers

  A

  

  A Johns Hopkins Medicine answered

  Mohs surgery - named after the technique's developer, Dr. Frederick E. Mohs - is a highly specialized treatment for the total removal of skin cancer. This method differs from all other methods of treating skin cancer by the use of complete microscopic examination of all the tissues removed surgically as well as detailed mapping techniques to allow the surgeon to remove the entire lesion. 

  The procedure is performed without hospitalization under a local anesthetic. The visible lesion and a very thin layer of skin are removed with a scalpel, carefully mapped, and examined microscopically.

  If there is still cancer seen under the microscope, another very thin layer of skin is removed from that exact location. This is repeated as often as necessary to completely remove the cancer. Mohs surgery removes as little normal tissue as possible, minimizing scarring.

  Repairs range from very simple excision and closures of small defects, to complex local tissue rearrangements, and even microvascular free tissue transfer.

  The fact that our surgeons specialize in cosmetic facial surgery as a substantial component of their practice leads to high patient satisfaction with the final results.

  See All 3 Answers
• QWhat are the treatment options for actinic keratosis or skin cancer?

  1 Answer

  A

  

  A HealthyWomen answered

  The four main treatments for actinic keratosis (precancerous skin lesions) or skin cancer are surgery, chemotherapy, immunosuppressants and radiation therapy. Most often, your healthcare professional will choose surgery. Common types of skin cancer surgery techniques include the following:

  • Cryosurgery freezes the lesion or skin cancer, which kills it.
  • Electrodessication and curettage involves cutting out the lesion or skin cancer with a special tool and using an electric current to destroy any additional abnormal cells.
  • Simple excision involves cutting the lesion or cancer from the skin in a football shape, along with a border of some of the healthy tissue around it.
  • Mohs micrographic surgery removes cancer and is a tissue-sparing technique. A specialized surgeon removes the cancer and examines the skin under a microscope, only taking additional pieces if any cancer remains. This method allows a complex repair to be done that day with the knowledge that the cancer is gone. This type of procedure is used for recurrent skin cancers or on delicate areas of the face such as the nose.
  • If the doctors are concerned that skin cancer may have spread to the lymph nodes, they will perform a lymph node dissection and check the nodes for signs of cancer under a microscope (a biopsy).
  • Laser therapy uses a highly focused beam of light to destroy cancer cells with minimal bleeding, swelling and scarring and little damage to surrounding tissue. It is usually used to treat superficial skin cancers.

  Removal of large tumors creates large defects, so sometimes skin is taken from another part of your body and grafted over the area where the cancer was removed.
  
  Other treatment options include the following:

  • Chemotherapy can be a topical cream or lotion placed on the skin to kill cancer cells, a drug that you swallow or a drug that is injected directly into the cancer or into a vein or muscle.
  • Radiation therapy shrinks tumors with x-rays aimed at the affected area from outside the body.
  • Certain drugs called immune response modulators can cause an immune response to the cancer, which causes it to shrink.
  • Less commonly, photodynamic therapy uses a certain type of light and a special (light-sensitive) chemical to kill cancer cells. Photodynamic therapy can be used to treat actinic keratosis and is also used to treat or shrink non-melanoma skin cancers.
• QHow is biochemotherapy for skin cancer given?

  1 Answer

  A

  

  A Aurora Health Care answered

  Biochemotherapy (a combination of chemotherapy drugs and immunotherapy agents) for skin cancer patients involves the following:

  • The treatment will require an inpatient hospitalization of five to seven days for each course of therapy.

  • The treatment will be a combination of chemotherapy agents (cisplatin, dacarbazine, Velban) and immunotherapy agents (interleukin-2, interferon). Dacarbazine will be given intravenously (in a vein, IV) on day one of treatment only. Cisplatin and Velban will be given by IV once daily on days one through four. Interleukin-2 will be given as a continuous IV infusion on days one through four. Interferon will be given as a subcutaneous injection (shot under the skin) daily on days one through five.

  • Patients will be evaluated approximately two to three weeks after a course of therapy for response.

  • Additional courses of therapy may be offered depending on response and tolerance to treatment.
• QWhat is Mohs surgery?

  4 Answers

  A

  

  A Johns Hopkins Medicine answered

  Before Mohs Surgery
  When you are planning for Mohs surgery, your doctor will conduct a careful physical examination and will discuss with you what your expectations should be. It is important that you have realistic expectations going into the surgery. The doctor will also assess you for potential areas on your body from which he or she could possibly graft tissue. The doctor will look for areas that will cause you the least possible discomfort and loss of function. Sometimes your doctor will order special tests to look for blood vessels that are available to use in what is called a free tissue transplant.

  During Mohs Surgery 
  When you have Mohs surgery, you will not need to be in a hospital, and you can have a local anesthetic. The doctor will remove your visible skin lesion and a very thin layer of skin with a scalpel and then carefully analyze it under a microscope.

  If cancer is seen under the microscope, the doctor will then remove another very thin layer of skin at the same location. This is repeated as often as necessary - removing a thin layer of skin, looking at it under a microscope, and removing another layer if necessary - until the doctor feels confident that the cancer has been completely removed. In this procedure, the doctor removes as little normal tissue as possible, which minimizes scarring.

  Repairs using this method can range from very simple to very complex levels of treatment, and can even include something called microvascular free tissue transfer, which involves using tissue from one part of your body to repair the affected area of your face. The goals of this surgery are to maximize the chance of a cure and minimize the effects on your appearance.

  After Mohs Surgery
  On the average you can expect to stay in the hospital anywhere from three to seven days.

  See All 4 Answers
• QHow is skin cancer treated?

  5 Answers

  A

  

  A Johns Hopkins Medicine answered

  When caught early, most skin cancers can be easily treated as an outpatient procedure with a very high cure rate. The specific treatment varies depending on the type of skin cancer.

  The most common and effective treatments for nonmelanoma skin cancer are surgical. Pre-cancerous actinic keratoses (AKs), which can go on to become squamous cell carcinomas (SCCs) in a small percentage of cases, appear as rough, scaly bumps, most commonly on sun-exposed parts of the face. These growths are often treated with liquid nitrogen spray or 5-fluorouracil cream.

  Very shallow basal cell carcinomas and SCCs are often treated by scraping them and cauterizing the base, especially if a soft, flat, white resulting scar is not a problem. This is called "curettage and electrodessication" or "C + E".

  More invasive tumors are best excised with margins to insure complete removal. Finally, the most invasive and difficult-to-visualize tumors, including recurrent cancers and those located in very visible areas, such as on the ears, eyes, nose, or lip, may benefit from the use of Mohs micrographic surgery.

  Talk to your dermatologist to discuss your options.

  See All 5 Answers
• QWhat are treatments for basal and squamous cell skin cancers?

  1 Answer

  A

  

  A Dr. Celeste Robb-Nicholson , Internal Medicine, answered

  Options for treating basal and squamous cell cancers are similar; in both cases, the cancer and a margin of healthy tissue around it are surgically removed. Other options for superficial skin cancers include cryosurgery with liquid nitrogen, laser surgery, and treatment with the fluorouracil or imiquimod creams used for treating actinic keratosis (AK).
• QHow do chemical peels work to treat skin cancer?

  2 Answers

  A

  

  A Dr. Ellen Marmur, MD , Dermatology, answered

  

  Many precancers, such as actinic keratosis, are in the epidermis. Because they are on the surface of the skin, fairly invasive chemical peels such as a 30% trichloracetic acid (TCA) peel and also fractionated laser or CO2 laser resurfacing of the skin can take them off. These methods literally burn off the damaged cells, along with the top surface of the skin. (Laser resurfacing is more expensive and not often used as a treatment for AKs.) Both treatments have been shown to decrease the incidence of squamous cell precancers. TCA is also melanotoxic, which means it decimates melanosomes (tiny balloons containing melanin), so it works well on pigment problems such as melasma. Frequently, doctors treat a section of sun-damaged actinic keratosis with a TCA peel spot treatment, rather than treating the entire face and neck. After a peel like this, the patient's skin becomes red and irritated, and after a day or two the damaged stratum corneum starts to peel off. Ironically, it looks and feels like a horrible sunburn.

  

  Find out more about this book:

  Simple Skin Beauty: Every Woman's Guide to a Lifetime of Healthy, Gorgeous Skin
  Buy book

  See All 2 Answers
• QWhen should treatment start if skin cancer is found?

  1 Answer

  A

  

  A Dr. Nathan W. Hanson, MD , Dermatology, answered on behalf of Intermountain Healthcare

  Treatment for skin cancer should be pursued as soon as possible after diagnosis, particularly for higher risk skin cancers such as melanoma and squamous cell carcinoma. These skin cancers, as well as other less common skin cancer types, have a risk of spreading beyond the skin or metastasizing and the more rapidly treatment is ensued, the less likely this will occur. Early treatment means less scarring and higher cure rates.

• QWhat types of skin cancer does Mohs micrographic surgery treat?

  1 Answer

  A

  

  A Aurora Health Care answered

  Mohs micrographic surgery is used to treat the most common skin cancers, basal cell carcinoma and squamous cell carcinoma, as well as some kinds of melanoma and several uncommon skin cancers. Mohs surgery is especially useful in the following situations:
  

  • Cancer reoccurrence
  • Difficulty determining a cancer's borders
  • Larger tumors
  • Rapid- or deep-growing cells
• QHow is surgery used to treat skin cancer?

  2 Answers

  A

  

  A Dr. Stuart A. Linder, MD , Plastic Surgery, answered

  Surgery can be used to both treat skin cancer by removal of tumor and flap reconstruction. Moh's surgery may be performed under a microscope to remove tumors of the skin and examine the margins. Once the margins are free of cancer, reconstructive tissue flaps can be performed to close the defect. 

  See All 2 Answers