Options For Skin Cancer Treatment
Your doctor will recommend a certain type of treatment for your skin cancer based on many factors including size, location, previous treatment, and tumor type. The following information is provided to help you understand the various options for treatment of skin cancer. If you have any additional questions or concerns about the type of treatment selected for you by your doctor, please contact our office at (307) 635-0226 and ask to speak with one of the dermatology nurses.
Standard surgical excision—This is a common skin cancer treatment in which cancerous tissue is cut out along with a portion of normal skin in our surgery center. The tissue is then sent to a laboratory where the tissue is processed by slicing it vertically, similar to cutting several slices from a loaf of bread, and these representative slices are sent for pathological examination which takes 5-7 days to find out if the cancer is removed. This is the preferred method of treatment for most skin cancers and has a cure rate above 90%.
Mohs Micrographic Surgery—Mohs micrographic surgery is a highly specialized technique which allows for examination of the entire underside and edges of the tissue which results in a higher cure rate while minimizing removal of normal tissue. This surgery involves removal of the cancerous cells in stages, one layer at time, allowing for mapping of the cancer as it is removed and leaving as much normal skin as possible. The tissue is processed and examined under the microscope to identify any remaining cancer cells while you wait. If cancer cells are still present, another layer is taken and examined. Once the tumor has entirely been removed, the area is repaired. The entire process is typically completed in one day. Mohs surgery is not indicated for most skin cancers but is useful in treating certain tumors as listed below:
- Recurrent tumor which has been previously treated
- Location in a cosmetically sensitive area (nose, lip, eyelid, ear, finger, etc) where sparing of normal tissue is essential
- Tumor that is large in size
- Tumor that has been incompletely removed by another procedure
- Tumor with an aggressive growth pattern on microscopic examination of the biopsy
- Tumors appearing in patients or locations with a high risk for recurrence.
- Poorly demarcated tumors in which the borders are difficult to determine
Electrodessication and curettage—This commonly used treatment, also known as ED&C, involves scraping away a cancerous tumor and its extensions. An advantage of this method is that it is relatively quick with an easy recovery. The disadvantages of this method include a slightly lower cure rate since no tissue is available for microscopic examination to ensure that all the cancer has been removed. Depending on the area treated, a round, whitish scar may result.
Radiation therapy—This method involves a series of treatments using X-rays to treat the skin cancer. Radiation is sometimes used along with surgical treatment of an aggressive skin tumor to obtain a higher cure rate. Radiation therapy can also be used alone in cases where the skin cancer may be inoperable. The disadvantages of this method include the inconvenience of multiple treatment sessions, a lower cure rate when used alone, and damage to the surrounding normal tissue. In addition, there may be an increased long-term risk of developing additional cancers within the treated area as a result of radiation damage.
Topical immuno-modulating agents—Topical agents can be used to treat skin cancer by application of the drug to the cancer over a period of 6-8 weeks. One advantage is that these drugs are relatively simple to use and can be applied by the patient at home. The disadvantages include a lengthy treatment course, and the risk of burning and pain associated with treatment. In addition, there is a lower cure rate since no tissue is available for microscropic examination to ensure that all the cancer has been removed. These drugs are FDA approved to treat certain types of early skin cancer but are not approved to treat deeper skin cancers.
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