Skin Cancer Treatment Options
There are several ways to approach skin cancer treatment. Your oncologist will work with you to find the best combination, given the stage and your overall health. Four types of skin cancer treatments are often used, alone or in combination. They include:
You may also be eligible for clinical trials for melanoma that are available through New York Oncology Hematology.
Nonmelanoma skin cancers are typically removed with surgery. In rare cases, where these have spread, additional therapy through an oncologist may be advised. For melanoma, surgery is also the primary treatment, with possible follow up with other types of therapy.
Surgery to treat skin cancer may be done in one of several ways. A surgeon will typically recommend the type of surgery most appropriate for your skin cancer. These may include:
- Wide-local excision (WLE) is a common treatment to remove skin cancer. After numbing the area, the surgeon removes the growth with a scalpel. The surgeon also removes a border of skin around the growth. This skin is the margin. The margin is examined under a microscope to be certain that all the cancer cells have been removed. The size of the margin depends on the size of the growth.
- Mohs surgery (also called Mohs micrographic surgery) may be used for skin cancer. The area of the growth is numbed. A specially trained surgeon shaves away thin layers of the growth. Each layer is immediately examined under a microscope. The surgeon continues to shave away tissue until no cancer cells can be seen under the microscope. In this way, the surgeon can remove all of the cancer and only a small bit of healthy tissue.
- Electrodesiccation and curettage are often used to remove small basal cell skin cancers. The doctor numbs the area to be treated. The cancer is removed with a sharp tool shaped like a spoon. This tool is a curette. An electric current is sent into the treated area to control bleeding and kill any cancer cells that may be left. Electrodesiccation and curettage is usually a fast and simple procedure.
- Grafts are sometimes needed to close an opening in the skin left by surgery. The surgeon first numbs and then removes a patch of healthy skin from another part of the body, such as the upper thigh. The patch is then used to cover the area where skin cancer was removed. If you have a skin graft, you may have to take special care of the area until it heals.
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. Many patients with basal cell or squamous cell skin cancers will be treated surgically with excellent results. For selected patients, especially those who cannot be treated surgically, HDR Brachytherapy for skin cancer provides an alternative treatment.
This is an in-office treatment performed by a Radiation Oncologist.
High dose radiation (HDR) brachytherapy can be an effective skin cancer treatment for non-melanoma skin cancers, especially when surgery would leave disfiguring scars or skin cancer surgery wasn’t able to remove all of the cancer.
With a skin cancer diagnosis, an NYOH physician will evaluate the best options for each patient, including HDR brachytherapy, as part of the skin cancer treatment when appropriate. Brachytherapy for skin cancer is typically non-invasive, non-scarring, and performed at our offices in the Albany, Amsterdam, and Saratoga areas.
The HDR brachytherapy process involves a tiny radioactive seed that travels through a plastic applicator which is set on top of the skin and placed precisely where the cancer is located. There is nothing inserted into the body for skin cancer brachytherapy.
The radiation is then delivered directly to the cancer site, minimizing the amount of radiation going to nearby healthy skin and surrounding tissue. This helps to reduce the risk of side effects. Each session lasts 5-10 minutes and there are typically 6-10 skin cancer brachytherapy treatments administered before evaluating its effectiveness the skin cancer.
Immunotherapy is a treatment that uses the patient's own immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. Immunotherapy is different from chemotherapy and typically has fewer side effects, though it varies by patient.
Immunotherapy is currently used for patients with disease that has spread to other parts of the body. It may also be used as an additional treatment, after surgery, to reduce the likelihood of reoccurrence in cases where the melanoma is at high risk of returning. Clinical trials have shown immunotherapy can help reduce this risk.
Checkpoint Inhibitor: These more recently approved treatments help the immune system to recognize melanoma is present and stimulate the immune cells to kill the cancer cells. Checkpoint inhibitors may be used alone or in combination with Ipilimumab to achieve more successful outcomes.
NYOH was part of the very first clinical research trial that led to FDA approval of the first immunotherapy available. We continue to participate in skin cancer trials offering patients the latest treatment options.
Targeted therapy is a type of treatment that uses specifically designed medications to identify enzymes or proteins in cancer cells that are responsible for cancer’s growth while having less impact on normal cells.
These medications come in many different forms, often oral tablets, and are used to stop cancer cells from growing or speed up the process of cancer cells dying.
Development of these medications is a fast-growing area of research, with many therapies being tested alone or in combination with other medications to improve outcomes. NYOH continues to offer patients access to these types of clinical trials, through our research program.