Once you have been diagnosed with skin cancer, your doctors will develop a treatment plan based on the type of skin cancer you have, the stage of the cancer (how far it has spread), and your general health conditions.
There are four skin cancer treatment options available: Surgery, Immunotherapy, Topical chemotherapy and Radiation therapy.
The goal of skin surgery is to directly remove the tumors from the skin. The surgeon will remove the tumors along with your healthy skin surrounding it. The amount of healthy skin will depend on how big the cancer is and the type of skin cancer. There are many different types of surgery used to treat skin cancer:
- Excision: The surgeon will remove the tumors with scalpel, after numbing the area. The surgeon will examine a border of skin around the tumor, called the margin, to ensure sure that all the growth have been removed.
- Skin Grafts: The surgeon will take a layer of skin from other part of the body. The layer is then placed over the area where the skin cancer has been removed. After a skin graft, you may either go home at the same day or stay in the hospital for several days depend on how big the graft is taken. Sometimes a graft is taken from the thigh area. This takes about two weeks or more to heal and may be a bit sore.
- Mohs surgery (Mohs’ micrographic surgery): In Mohs surgery, the surgeon will remove the tumor piece by piece and it is immediately examined under a microscope. Skin tissue is gradually removed until there are no cancers can be seen under the microscope. This method aims to remove as little healthy skin as possible, while remove all cancerous cells.Mohs surgery is particularly useful for basal and squamous cell carcinoma that has come back in the same place. It is also sometimes used for large skin cancers or skin cancers on the face to minimize the effects of surgery. If the tumor is large, you may also need to have a skin graft or skin flap to cover the wound.
- Curettage and Electrocautery: In this procedure, you will be given a local anaesthetic. When the area is numb, the doctor will scrape away the cancer using a spoon-shaped tool called curette. An electric current is then applied to the treated area to stop bleeding and kill any remaining cancer cells. This method is usually simple and fast, which is effective for small basal cell carcinoma and squamous cell carcinoma.
- Lymphadenectomy: In this operation, the doctor will remove lymph node that has been affected by the cancer cells to prevent further spread. After a lymphadenectomy, you will have tubes (drains) in place to allow fluid to drain from the wound. These will be removed a few days after the operation.Occasionally Lymphadenectomy may cause swelling of the affected area. The swelling is called lymphoedema and it is happens because lymph fluid cannot drain properly from the area after the lymph nodes have been removed.
Immunotherapy or also called targeted therapy is a cancer treatment that uses materials either made by the body or in a laboratory to boost body’s immune system to help fight cancer cells.
Immunotherapy can be used as part of a clinical trial or in combination with other treatments such as surgery or chemotherapy. Many other targeted drugs are being tested now, including therapeutic vaccines.
For basal and squamous cell carcinoma, an immunotherapy cream called imiquimod is an “immune response modifier” that is commonly prescribed. It is also used to treat melanoma. The two most common medications used are interferon alfa-2b and interleukin-2. Occasionally, side effects of an immunotherapy vary from person to person. These may include fever, fatigue, chills, headache, muscle aches, and skin irritation.
Chemotherapy is a type of cancer treatment that uses drugs to kill cancer cells. A drug that is commonly used to treat skin cancer is called 5-fluorouracil (Efudix®), which also known as 5FU. The chemotherapy cream is usually applied once or twice a day for several weeks.
The treatment should make the skin red and inflamed. Once the area becomes sore and weepy, the treatment will need to be stopped. The symptoms will gradually subside once the treatment has stopped. Exposure to the sun can make the symptoms worse, so you should protect the area until it has healed. Occasionally, there are no other side effects with this type of chemotherapy.
Radiation therapy is a treatment that use of high-energy radiation to destroy cancer cells. This therapy is often used to treat cancer in the area where surgery might be difficult and for tumor that have penetrated deeply into the skin.
The treatment is given in the hospital radiotherapy department. Often only a single treatment is needed, but sometimes several doses of treatment are necessary and these are given over one or more weeks.
After a week or two of radiation therapy, the treated skin will be red and inflamed. If radiation therapy is used around the head, side effect, such as hair fall, may occur. However, these side effects usually go away once the treatment is finished.