Nonmelanoma Skin Cancer: Treatment Choices

There are various treatment choices for skin cancer. Which one may work best for you? It depends on a number of things. These include how large the skin cancer is, where it is, and what stage it is. Other things that affect your treatment choices include your age, health, your preferences, and what side effects you’ll find acceptable.

Learning about your treatment options

You may have questions and concerns about your treatment options. You may also want to know how you’ll feel and function during and after treatment, and if you’ll have to change your normal activities.

Your doctor is the best person to answer your questions. He or she can tell you what your treatment choices are, how successful they’re expected to be, and what the risks and side effects are. Your doctor may advise a specific treatment. Or he or she may offer more than one, and ask you to decide which one you’d like to use.

You may have just one treatment, or a combination of treatments.

Types of treatment for nonmelanoma skin cancer

Surgery

Surgery is a common treatment for nonmelanoma skin cancer. It is used in most cases when the cancer is still at an early stage. Many skin cancers can be removed easily and need only very minor surgery. Others may need a more extensive surgery. The surgery choices include:

• Simple excision. This is done to cut the cancer from the skin, along with some of the healthy tissue around it.

• Curettage and electrodesiccation. The surgeon cuts the tumor from the skin using a sharp, spoon-shaped instrument called a curette. Then he or she uses a needle-shaped electrode to stop bleeding and kill any cancer cells that may have been left behind in the edges of the wound.

• Mohs surgery. This procedure removes the cancer and as little normal tissue as possible. It’s done in sensitive areas such as the face. During this surgery, the surgeon removes a thin layer of skin including the cancer, and then uses a microscope to make sure no cancer cells remain. If cancer cells are seen, another layer of skin is removed. This is repeated until all of the cancer has been removed.

• Cryosurgery. This procedure uses liquid nitrogen to freeze the tumor and kill cancer cells.

• Laser therapy. The surgeon uses a narrow beam of intense light to remove cancer cells.

• Skin grafting after surgery. The surgeon takes a skin graft from another part of the body to replace skin where the cancer was removed.

Chemotherapy

Chemotherapy is done with medicines. With nonmelanoma skin cancer, chemotherapy is most often done by applying strong medicine to the skin to kill cancer cells. Basal cell cancer rarely spreads, and IV or oral medicine is not often used for it. Squamous cell cancer can sometimes spread. If this happens, medicines may be given through an IV or by mouth.

Targeted therapy

Targeted therapy is also done with medicine, but it works differently than regular chemotherapy. It also can have different side effects. The medicine targets specific parts of cancer cells. In rare cases of advanced basal cell cancer, or where surgery or radiation can’t be used, a basal cell cancer may be treated with a targeted medicine.

Radiation therapy

Radiation therapy uses high energy X-rays or other types of radiation. The goal of this treatment is to kill cancer cells. In some cases, this treatment is used instead of surgery. It can also be used to get rid of any cancer cells that may be left after surgery.

Photodynamic therapy

The goal of this treatment is to kill cells at the tumor site by using a medicine to make the cells more sensitive to a special laser light. This limits damage to healthy tissue. This therapy is sometimes used for nonmelanoma skin cancer. For more information, ask your doctor about this therapy.

Biologic therapy

This type of therapy is done with medicines. The medicines use chemicals that affect the immune system. It is also called immunotherapy, antibody therapy, or vaccine therapy. The medicine uses your body’s immune defense to attack the cancer cells. The treatments can be given as a cream that is applied on the tumor. Or it can be given as an injection into the tumor.

Clinical trials for new treatments

Researchers are always finding new ways to treat cancer. These new methods are tested in clinical trials. Talk with your doctor to find out if there are any clinical trials you should consider.

Talking with your healthcare provider

At first, thinking about treatment options may seem overwhelming. Talk with your doctors, nurses, and loved ones. Make a list of questions. Consider the benefits and possible side effects of each option. Discuss your concerns with your doctor before making a decision.