How Skin Cancer Is Treated
Treatments for skin cancer depend on the type of cancer, the stage, the size and location of the tumor, and its features. For basal cell carcinomas and squamous cell carcinomas, surgery or electrodesiccation and cautery of the cancer is often all that is needed. Mohs surgery is an additional option to reduce scarring. The treatment of melanoma also includes surgery, but typically with a wider excision. Depending on the cancer stage, additional treatments such as immunotherapy, targeted therapy, chemotherapy, and radiation therapy may be needed.
A team of doctors will work with you to determine your best skin cancer treatment plan. The team may include specialists such as a surgical oncologist, medical oncologist, radiation oncologist, dermatologist, plastic surgeon, and pathologist.
Verywell / Emily Roberts
Remission And The Chance Of Recurrence
A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.
A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. While many remissions are permanent, it is important to talk with your doctor about the possibility of the cancer returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.
If skin cancer returns after the original treatment, it is called recurrent cancer. It may come back in the same place , nearby , or in another place . Certain parts of the body, such as the ears and lips, are more prone to develop recurrent skin cancers. In addition, people whose immune system is suppressed due to a medication or disease are also at higher risk for skin cancer recurrence.
When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence. After this testing is done, you and your doctor will talk about the treatment options. Often the treatment plan will include the treatments described above. Your doctor may suggest clinical trials that are studying new ways to treat this type of recurrent cancer. Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects.
How Long Can Skin Cancer Go Undetected
For example, certain types of skin cancer can be diagnosed initially just by visual inspection though a biopsy is necessary to confirm the diagnosis. But other cancers can form and grow undetected for 10 years or more, as one study found, making diagnosis and treatment that much more difficult.
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Complementary And Alternative Treatments
It’s common for people with cancer to seek out complementary or alternative treatments. When used alongside your conventional cancer treatment, some of these therapies can make you feel better and improve your quality of life. Others may not be so helpful and in some cases may be harmful.
It is important to tell all your healthcare professionals about any complementary medicines you are taking. Never stop taking your conventional treatment without consulting your doctor first.
All treatments can have side effects. These days, new treatments are available that can help to make many side effects much less severe than they were in the past.
Treating Squamous Cell Carcinoma Of The Skin
Treatment options for squamous cell skin cancer depend on the risk of the cancer coming back, which is based on factors like the size and location of the tumor and how the cancer cells look under a microscope, as well as if a person has a weakened immune system.
Most squamous cell skin cancers are found and treated at an early stage, when they can be removed or destroyed with local treatment methods. Small squamous cell cancers can usually be cured with these treatments. Larger squamous cell cancers are harder to treat, and fast-growing cancers have a higher risk of coming back.
In rare cases, squamous cell cancers can spread to lymph nodes or distant parts of the body. If this happens, treatments such as radiation therapy, immunotherapy, and/or chemotherapy may be needed.
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Electronic Skin Surface Brachytherapy
Some skin cancers that do not require very deep radiation may be treated with a new form of radiation therapy applied directly to the skin, called electronic skin surface brachytherapy .
In ESSB, we apply smooth, round disks to the skin these disks are attached to a radiation therapy machine. They are left in place for just a few minutes while the radiation is delivered, allowing the tumor to be treated. The approach spares underlying healthy skin from the effects of the radiation.
Cryosurgery For Skin Cancer
Cryosurgery is less invasive than conventional surgery. It is often used to treat actinic keratosis and occasionally used for small, newly developed skin cancers.
During this procedure, the doctor uses liquid nitrogen to freeze and destroy diseased tissue. This process may be repeated. Because the doctor can focus cryosurgical treatment on a limited area, the destruction of nearby healthy tissue is typically avoided.
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Comprehensive Evaluation Diagnosis And Treatment Of Skin Cancer
Skin cancer is the most common form of cancer in the United States, affecting one in five Americans over the course of their lifetime. A majority of skin cancers are caused by damage from chronic ultraviolet radiation, through sun exposure or tanning beds, but other causes of skin cancer include HPV , chronic inflammation , and genetic predisposition. The most common forms of skin cancer include basal cell carcinoma, squamous cell carcinoma, and melanoma, but there are many less common types such as Merkel cell carcinoma, dermatofibrosarcoma protuberans, atypical fibroxanthoma, among others.While the majority of basal cell and squamous cell cancers are cured with surgical removal, some of these cancers, especially melanoma and Merkel cell carcinoma can spread or metastasize to other parts of the body and may require further workup and multidisciplinary care.
What Are The Signs Of Skin Cancer
The most common warning sign of skin cancer is a change on your skin, typically a new growth, or a change in an existing growth or mole. The signs and symptoms of common and less common types of skin cancers are described below.
Basal cell carcinoma
Basal cell cancer is most commonly seen on sun-exposed areas of skin including your hands, face, arms, legs, ears, mouths, and even bald spots on the top of your head. Basal cell cancer is the most common type of skin cancer in the world. In most people, its slow growing, usually doesnt spread to other parts of the body and is not life-threatening.
Signs and symptoms of basal cell carcinoma include:
- A small, smooth, pearly or waxy bump on the face, ears, and neck.
- A flat, pink/red- or brown-colored lesion on the trunk or arms and legs.
- Areas on the skin that look like scars.
- Sores that look crusty, have a depression in the middle or bleed often.
Squamous cell carcinoma
Squamous cell cancer is most commonly seen on sun-exposed areas of skin including your hands, face, arms, legs, ears, mouths, and even bald spots on the top of your head. This skin cancer can also form in areas such as mucus membranes and genitals.
Signs and symptoms of squamous cell carcinoma include:
- A firm pink or red nodule.
- A rough, scaly lesion that might itch, bleed and become crusty.
Melanoma
Signs and symptoms of melanoma include:
- A brown-pigmented patch or bump.
- A mole that changes in color, size or that bleeds.
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Risk Of Further Melanomas
Most people treated for early melanoma do not have further trouble with the disease. However, when there is a chance that the melanoma may have spread to other parts of your body, you will need regular check-ups.
Your doctor will decide how often you will need check-ups everyone is different. They will become less frequent if you have no further problems.
After treatment for melanoma it is important to limit exposure to the sun’s UV radiation. A combination of sun protection measures should be used during sun protection times .
As biological family members usually share similar traits, your family members may also have an increased risk of developing melanoma and other skin cancers. They can reduce their risk by spending less time in the sun and using a combination of sun protection measures during sun protection times.
It is important to monitor your skin regularly and if you notice any changes in your skin, or enlarged lymph glands near to where you had the cancer, see your specialist as soon as possible.
Nutrition And Diet For Skin Cancer
Skin experts know that the mineral zinc and the antioxidant vitamins A , C, and E can help repair damaged body tissue and promote healthy skin. Now, researchers are trying to determine whether these and other nutrients might protect skin from the harmful effects of sunlight. To test the theory, selected skin cancer patients are given experimental supplements of these vitamins in the hope of preventing cancer recurrence.
Nicotinamide 500 mg twice daily helps to reduce the incidence for squamous cell and basal cell skin cancers by 23%.
Polypodium Leucotomos oral supplement has been shown to alter the effects of UVB light.Also studies suggest that alcohol consumption can increase the risks of skin cancer and melanoma- stay tuned for more definitive studies.
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When Should I See My Healthcare Provider
Make an appointment to see your healthcare provider or dermatologist as soon as you notice:
- Any changes to your skin or changes in the size, shape or color of existing moles or other skin lesions.
- The appearance of a new growth on your skin.
- A sore that doesnt heal.
- Spots on your skin that are different from others.
- Any spots that change, itch or bleed.
Your provider will check your skin, take a biopsy , make a diagnosis and discuss treatment. Also, see your dermatologist annually for a full skin review.
Laser Surgery For Skin Cancer
Lasers surgery is used to treat precancerous conditions like actinic keratosis and early, superficial skin cancers. During laser surgery, doctors use an intense, focused beam of light to destroy skin cancer.
The laser can be set to remove the skin in controlled layers, depending on the depth of the cancer. The surgeon may remove the top layer only or the top layer plus additional deeper layers.
The laser destruction, plus the body’s immune response to the injury, results in a blistered wound that takes several weeks to heal.
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Where Does Skin Cancer Develop
Skin cancer is most commonly seen in sun-exposed areas of your skin your face , ears, neck, arms, chest, upper back, hands and legs. However, it can also develop in less sun-exposed and more hidden areas of skin, including between your toes, under your fingernails, on the palms of your hands, soles of your feet and in your genital area.
Certain Factors Affect Prognosis And Treatment Options
The prognosis for squamous cell carcinoma of the skin depends mostly on the following:
- Stage of the cancer.
- Whether the patient is immunosuppressed.
- Whether the patient uses tobacco.
- The patient’s general health.
Treatment options for basal cell carcinoma and squamous cell carcinoma of the skin depend on the following:
- The type of cancer.
- The stage of the cancer, for squamous cell carcinoma.
- The size of the tumor and what part of the body it affects.
- The patients general health.
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Skin Cancer Of The Head And Neck Treatment
Many early-stage small basal cell cancers or squamous cell cancers can be removed by Mohs surgery, a technique that spares normal tissue through repeated intraoperative margin testing, removing only the cancer and leaving adjacent normal tissue. Tumors with nerve involvement, lymph node involvement or of a large size are not suitable for Mohs surgery. They require a multimodality approach to treatment, with formal surgical resection and adjuvant radiation or chemotherapy.
Melanoma is more likely to spread, and aggressive surgical resection with wide margins is required, in addition to radiation and/or chemotherapy.
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Symptoms Of Skin Cancer
Skin cancers arent all identical, and they may not cause many symptoms. Still, unusual changes to your skin can be a warning sign for the different types of cancer. Being alert for changes to your skin may help you get a diagnosis earlier.
Watch out for symptoms, including:
- skin lesions: A new mole, unusual growth, bump, sore, scaly patch, or dark spot develops and doesnt go away.
- asymmetry: The two halves of the lesion or mole arent even or identical.
- border: The lesions have ragged, uneven edges.
- color: The spot has an unusual color, such as white, pink, black, blue, or red.
- diameter: The spot is larger than one-quarter inch, or about the size of a pencil eraser.
- evolving: You can detect that the mole is changing size, color, or shape.
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What Is A Skin Cancer Screening
During a skin cancer screening, Dr. Paul Yamauchi of the Dermatology Institute and Skin Care Center will evaluate a patient from head to toe. He will look for areas of concern that may be indicative of cancer. For example, moles may be one area where skin cancer can develop. Most moles are benign, but if moles are changing in shape, size, and color, it may mean that skin cancer is present. The doctor removes a small sample of the area of concern and send these samples to the lab for testing. This is called a biopsy. The sample is evaluated, and if skin cancer is present, patients will get a diagnosis of their condition. Once skin cancer has been diagnosed, the doctor and patient discuss treatment options.
Thinking About Taking Part In A Clinical Trial
Clinical trials are carefully controlled research studies that are done to get a closer look at promising new treatments or procedures. Clinical trials are one way to get state-of-the art cancer treatment. In some cases they may be the only way to get access to newer treatments. They are also the best way for doctors to learn better methods to treat cancer. Still, they’re not right for everyone.
If you would like to learn more about clinical trials that might be right for you, start by asking your doctor if your clinic or hospital conducts clinical trials.
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How Is Skin Cancer Diagnosed
First, your dermatologist may ask you if you have noticed any changes in any existing moles, freckles or other skin spots or if youve noticed any new skin growths. Next, your dermatologist will examine all of your skin, including your scalp, ears, palms of your hands, soles of your feet, between your toes, around your genitals and between your buttocks.
If a skin lesion is suspicious, a biopsy may be performed. In a biopsy, a sample of tissue is removed and sent to a laboratory to be examined under a microscope by a pathologist. Your dermatologist will tell you if your skin lesion is skin cancer, what type you have and discuss treatment options.
How Is Skin Cancer Of The Head And Neck Diagnosed
Diagnosis is made by clinical exam and a biopsy. Basal cell and squamous cell cancers are staged by size and extent of growth. Basal cell cancers rarely metastasize to lymph nodes, but they can grow quite large and invade local structures. Squamous cell cancers have a much higher incidence of lymph node involvement in the neck and parotid gland and can spread along nerves.
Melanoma is staged, based not on size but on how deeply it invades the skin layers. Therefore, a superficial or shave biopsy will not provide accurate staging information used to guide treatment. Melanomas can have a very unpredictable course and may spread to distant organs. Melanomas with intermediate thickness often require sentinel node biopsy, a surgical procedure performed by a head and neck surgeon, to determine if microscopic spreading to lymph nodes has occurred.
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Topical Treatments For Skin Cancer
Some skin spots and superficial skin cancers can be treated with creams or gels that you apply to the skin. These are called topical treatments. They may contain immunotherapy or chemotherapy drugs, and are prescribed by a doctor.
Only use these treatments on the specific spots or areas that your doctor has asked you to treat. Dont use leftover cream on spots that have not been assessed by your doctor.
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What Questions Should I Ask My Healthcare Provider
Questions to ask your dermatologist may include:
- What type of skin cancer do I have?
- What stage is my skin cancer?
- What tests will I need?
- Whats the best treatment for my skin cancer?
- What are the side effects of that treatment?
- What are the potential complications of this cancer and the treatment for it?
- What outcome can I expect?
- Do I have an increased risk of additional skin cancers?
- How often should I be seen for follow-up checkups?
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