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Treatment

Skin cancers are always removed. Non melanoma skin tumours (basal cell carcinoma and squamous cell carcinoma) are treated similarly and are discussed together below:

Early non melanoma skin cancers can be treated by burning (cautery), scraping (curettage) or freezing with liquid nitrogen (cryotherapy), radiation, application of ointments or surgical removal under local anaesthesia. The main aim is to remove the cancer and leave only a small scar.

In Curettage and desiccation a scoop like instrument (curette) is used to scoop out the non-melanoma skin cancer. An electric current is applied to control bleeding and kill remaining cancer cells, this procedure is called desiccation. Small cancers are treated with this method.

Surgical excision involves application of local anaesthetic to numb the area and the entire cancer is removed. Stitches are applied to close the wound and aid healing.

Radiation therapy is used to treat skin cancer in areas difficult to reach for surgical intervention.

Cryosurgery involves application of liquid nitrogen to freeze and kill the cancer cells.

Mohs micrographic surgery, also known as "microscopically controlled excision" is a procedure in which small pieces of the tumour are removed and examined under the microscope during surgery. Sequential cutting and microscopic examination is repeated and the non-melanoma cancer is mapped and taken out without having to guess the width and depth of the lesion. This is a method of choice for large basal cell carcinomas, recurrent non-melanoma tumours and cancers on those parts of the body with high recurrences after treatment by other methods.

Creams and ointments can be used to treat small non melanoma skin cancers. Drugs, like 5-Fluorouracil (5-FU) are used to kill cancer cells. Other drugs that stimulate the immune system like imiquimod can also be used. This treatment can be performed at home.

Advanced squamous cell carcinomas are removed with the surrounding tissue and sometimes lymph nodes draining the cancer area to ensure that all the cancer is removed. The type, site, size, location of the tumour, the person’s age, general health, medical history, risk of scar formation and grade and stage of tumour are considered in planning the treatment.

There are various types of treatment available for melanomas. The treatment type depends upon the type of melanoma, thickness, location on the body, age of the person and stage of the tumour.

  • Surgery is the primary treatment of all stages of melanoma. Various types of surgery include one or more of:
    • Wide local excision: In this procedure the melanoma and some of the normal tissue around it (less than 1.5 cm) is removed. Some of the local lymph nodes may also be removed.
    • Lymphadenectomy: A surgical procedure in which the lymph nodes draining the area of the tumour are removed and samples of tissue are examined under a microscope to see if melanoma cells are present.
    • Sentinel lymph node biopsy: In this procedure a radioactive substance and/or a blue dye are injected close to the tumour. The radioactive substance or dye flows via the lymph vessels to the lymph nodes. The first lymph nodes to receive the substance and/or dye are removed (Sentinel node). A pathologist views the sentinel lymph nodes under a microscope to look for melanoma cells. If melanoma cells are found another operation to remove all lymph nodes in the area is performed.
    • Skin grafting involves removal of skin from another part of the body to replace the skin that is removed from the area of the tumour. This is usually performed if a large area of the skin is involved by the tumour.
  • Chemotherapy: Drugs are used to halt the growth of cancer cells. These drugs either kill the tumour cells or prevent them from dividing. Chemotherapy is given to kill the tumour cells that might remain in the body after the surgery and to prevent the cancer from coming back.
  • Radiation therapy: High energy X-rays or other types of radiation is used to impede cancer cell division and kill the cancer cells. The two types of radiation therapy are: External and internal radiotherapy. The type of therapy used depends on the stage and type of melanoma.
  • Immunotherapy therapy: Also known as biotherapy. This method involves the person’s immune system to combat the tumour. Interferon, interleukin-2 (IL-2) and tumour necrosis factor (TNF) are currently used against melanoma.
  • Targeted therapy: Involves drugs that specifically identify and kill tumour cells without doing any harm to the healthy cells. These treatments are still under development.

Last Review Date: March 15, 2016