Treating Skin Cancer
Various Treatment Options
There are a number of treatment options for skin cancer, depending on the type and stage of the cancer. Some treatments are standard (the usual treatment), and some are being tested in clinical trials. Before starting treatment, patients may want to think about taking part in a clinical trial. A clinical trial is a research study to find out if a drug, treatment, or therapy is safe and effective.
When non-melanoma skin cancers are caught early, often the biopsy process removes all of the cancer and no further treatment is needed. For melanoma and advanced non-melanoma skin cancers, further treatment is usually needed. The standard treatments people choose most often are surgery, chemotherapy, radiation therapy, photodynamic therapy and immunotherapy (also called biologic therapy).
What Standard Treatments Do
These standard cancer treatments work in different ways.
- Surgery removes the cancer.
- Chemotherapy uses anti-cancer drugs to kill cancer cells or stop their growth.
- Radiation therapy uses high-energy beams to kill cancer cells and shrink tumors.
- Photodynamic therapy uses a drug and a type of laser to kill cancer cells.
- Immunotherapy, which is newer, uses the patient's immune system to fight cancer.
Surgery is Usually the First Step
A combination of these therapies is often used at different points in the treatment process. Surgery to remove the suspicious area of skin is usually the first step and may have already occurred in the process of diagnosis (the biopsy).
In the past few years, great advances have been made so that surgery requires removing much less tissue. Some surgeries require only local anesthesia, which means that you will be awake for the procedure, but will not feel any pain. Healing generally occurs in one to two weeks, with minimal scarring. However, if the cancer has already spread, the doctor may recommend chemotherapy or radiation therapy.
Further surgery to remove cancerous cells may be required once the diagnosis of cancer has been made and the extent of the spread of the cancer is determined. This may involve removing more skin tissue and removing lymph nodes containing cancer cells. Skin grafting may be done to cover the wound caused by surgery. This involves taking skin from another part of the body to replace the skin that was removed.
Even if the doctor removes all the melanoma that can be seen at the time of the operation, some patients may be offered chemotherapy or radiation after surgery to kill any cancer cells that are left. When chemotherapy is given after surgery, to increase the chances of a cure, it is called adjuvant therapy.
Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be taken by mouth in pill form, or it may be put into the body by inserting a needle into a vein or muscle. For some non-melanoma cases, chemotherapy can also be given as a cream that is rubbed on the skin.
Surgery and radiation are local therapies, meaning they specifically treat only a small affected area of the body. Traditional chemotherapy is called whole body or systemic treatment because the drugs enter the bloodstream, travel through the body, and can kill cancer cells anywhere in the body. Treatment with chemotherapy can be as short as two months or as long as several years.
Chemotherapy treatment can possibly destroy some healthy tissues in other parts of the body, depending on how the drugs are delivered. For this reason, chemotherapy can cause side effects like hair loss, weakness, and nausea.
Radiation therapy is used less frequently for the treatment of skin cancer. This type of treatment uses high-energy x-rays or other types of radiation to damage DNA, putting a stop to cell growth.
During radiation therapy, a machine outside the body sends high-energy beams to kill the cancer cells that may still be present in the affected skin or in nearby lymph nodes. Doctors sometimes use radiation therapy in addition to chemotherapy.
Radiation is usually given to one specific area instead of the entire body. Radiation therapy is normally given several times a week for up to six weeks or more. Scientists are currently looking for new ways to deliver radiation in order to reduce damage to surrounding healthy tissues.
Photodynamic therapy is a cancer treatment that uses a drug and a certain type of laser light to kill cancer cells. A drug that is not active until it is exposed to light is injected into a vein. The drug collects more in cancer cells than in normal cells.
Fiberoptic tubes are then used to deliver the laser light to the cancer cells, where the drug becomes active and kills the cells. Photodynamic therapy causes little damage to healthy tissue. It is used mainly to treat tumors on or just under the skin or in the lining of internal organs, such as the lungs and the esophagus.
Immunotherapy uses your immune system to fight cancer. One type of immunotherapy uses drugs made from biological molecules called cytokines. Your body normally produces cytokines to activate immune cells in response to infection. Immunotherapy drugs stimulate immune cells to fight harder against the abnormal cells causing the cancer.
Adoptive immunotherapy is another type of cancer treatment. Doctors remove your immune system's own white blood cells that have developed specifically to target the cancer. Then they grow more of these cells in the laboratory and put them back into your blood. This therapy provides your body with billions of extra immune cells designed to kill cancer cells.