If you have recently been diagnosed with skin cancer or you’ve noticed an irregular spot on your skin that you’re worried may be cancerous, you are likely wondering what treatments and removal options are available. According to Dr. James Griffith of U.S. Dermatology Partners in Leawood and Overland Park, Kansas, “While getting a skin cancer diagnosis is never ideal news, finding out just how many treatment options are available to remove skin cancer, prevent the spread, and address related health concerns can be reassuring. After uncovering cancerous skin cells or suspected cancer, one of the first things your dermatologist will help you do is determine the best options for removal and treatment. It can be a stressful situation, so if you want to learn a bit more about these treatment options, I’ll be sharing some basic information about each treatment option in this blog.” Keep reading to hear more from Dr. Griffith about options for skin cancer removal, prevention, and ongoing treatment options.
What Is Skin Cancer?
When skin cells are damaged by the sun, pollutants, irritants, and other sources of cellular damage, cancer can develop. Skin cancer causes cells to grow and reproduce in unpredictable ways that are damaging to the skin and bodily health. There are many types of skin cancer, and each has unique characteristics and impacts the skin and body differently. Some types of cancer grow slowly and are highly unlikely to spread to other tissues (metastasize). Other forms of skin cancer can grow very quickly and easily spread to other parts of the body. Knowing what to look for and noticing changes that could be caused by skin cancer can help to ensure diagnosis happens in the earliest stages.
While there are many different types of skin cancer, the three most common are:
- Basal cell carcinoma – A form of skin cancer that develops in deeper layers of skin. It usually grows slowly and rarely metastasizes. This is the most common form of skin cancer. Roughly 8 out of 10 cases of skin cancer are basal cell carcinomas.
- Squamous cell carcinoma – Squamous cell carcinomas are the second most common form of skin cancer. This tumor typically forms in the outer layers of the skin. It is unlikely to metastasize when caught early and grows slowly like basal cell carcinoma.
- Melanoma – The rarest of the three most common forms of skin cancer is also the cause of most skin cancer-related deaths. This form of skin cancer develops in the melanocytes, the pigment-producing parts of skin cells. This form of skin cancer grows quickly and is more likely to spread to surrounding skin tissue, as well as metastasize to impact other tissues.
When it comes to skin cancer removal options, Dr. Griffith says, “In the past, skin cancer surgery was the only option available to remove skin cancer. While there are numerous surgical and non-surgical skin cancer treatment options now, surgical removals are still very common, and in many situations, surgical removal often is the best solution.” There are a few different surgical skin cancer removal options your dermatologist may use, depending on the depth and severity of skin cancer including:
- Mohs Micrographic Surgery – Offering the highest cure rate, this technique utilizes real-time microscopic analysis of the tissue removed to ensure the cancer is out and spare the maximum amount of normal tissue. It is best used for large or recurrent cancers and those located in cosmetically sensitive areas, such as the face.
- Simple excision – Cutting away the cancerous cells and a small amount of surrounding normal-appearing tissue to diminish the potential for spreading.
- Shave excision – As the name implies, the dermatologist carefully shaves cancerous cells off the surface of the skin until only healthy cells remain.
- Curettage – As skin cancers are not as firm as your normal skin, the cancer can be scraped away with a special tool before cauterizing the base to minimize the risk of bleeding, infection, and recurrence of the cancer.
- Laser surgery – A laser light beam removes cancerous skin cells and cauterizes the area to minimize bleeding and the risk of infection.
- Cryosurgery – Extreme cold can be used to freeze the area and destroy cancerous cells.
Mohs Micrographic Surgery
Mohs micrographic surgery is often referred to as innovative, but this treatment option is not as new as you may think. Mohs micrographic surgery has actually been in use since the 1930s. Even after many decades of use in skin cancer treatment, Mohs micrographic surgery is still one of the most effective and conservative skin cancer removal options. This type of skin cancer surgery allows your dermatologist to fully remove cancerous skin cells and preserve as much healthy tissue as possible. The process involves removing cancerous skin cells in ultra-thin layers. After each layer is removed, it’s carefully examined under the microscope until only healthy skin cells remain. Mohs micrography surgery is especially beneficial for sensitive areas, including the face, hands, and genitals. Mohs micrographic surgery is not usually recommended for melanoma skin cancers. Mohs micrographic surgery is typically recommended in the following situations:
- For recurrent, non-melanoma skin cancers
- Skin cancer impacting areas where scarring is a significant concern
- Very larger tumors, including those with poorly defined or evolving borders
- For patients who have compromised immune systems or who are generally not in good enough health to undergo more invasive surgical procedures
Using a small, sharp tool called a curette that resembles a sharp spoon, curettage scrapes away the cancerous skin tissue while an electric current running through a device cauterizes the treatment area. This minimizes blood loss during treatment and reduces the risk for post-treatment infection and inflammation as well as diminishing scarring in the long term.
While curettage uses the heat from an electric current to cauterize during skin cancer treatment, cryosurgery uses extreme cold to achieve the same result. The cold destroys the cancerous cells while avoiding unnecessary damage to healthy skin cells.
Other Skin Cancer Treatments
According to Dr. Griffith, “In addition to the removal of the cancerous legion from the skin, your dermatologist, often in partnership with a cancer specialist called an oncologist, may need to provide a variety of other treatments to prevent or minimize the spread of skin cancer to other tissue.” Other common skin cancer treatments include:
- Photodynamic therapy (PDT) – Uses an injected or topical light-sensitive medication that is activated by applying laser light to the target area. The medication accumulates in greater amounts in cells damaged by cancer, so when the laser light is applied, it destroys the cancer cells and has little to no effect on healthy skin cells.
- Immunotherapy – Cancer is able to damage our body because it mutates and imitates our own cells, so the body doesn’t know which cells to fight. Immunotherapy trains the immune system to destroy cancer cells. Additionally, immunotherapy medication prevents the replication of cancerous cells and increases the strength and production of new, healthy skin cells.
- Drug therapies – Also called targeted therapies these treatments use medications to attack cancer cells while minimizing the impact on healthy surrounding skin cells and tissues. They may be topical, oral, or injected medications. In most cases, these treatments are only recommended for treating basal and squamous cell carcinomas.
- Superficial radiation – Using a form of radiation that cannot penetrate deeper into the body, energy in the form of electrons, photons, or protons can be focused onto superficial skin cancers to destroy the cancerous cells.
What Is the Best Treatment Option for Me?
The best treatment for each patient will be determined in partnership with a trusted dermatologist. Mohs micrographic surgery is often the best option for treating the two most common forms of skin cancer, basal and squamous cell carcinomas, especially when these types of skin cancer develop on areas of the skin that are thin or sensitive. In other areas, these types of skin cancer may be removed through traditional surgical excision or other removal options. For melanoma skin cancers, Mohs micrographic surgery is rarely recommended. Typically, it’s best to remove the cancerous lesion as well as surrounding tissues as melanoma spreads quickly. Additionally, those with melanoma may need to partner with an oncologist as well as a dermatologist to receive treatments to prevent the spread of melanoma to other areas of the body, which is much more likely with melanoma than other forms of skin cancer.
Can I Prevent Skin Cancers?
According to Dr. Griffith, “Skin cancers can be caused by many things, including frequent or prolonged exposure to chemicals and pollutants, but the vast majority of skin cancers are related to the damaging effects of the sun’s UVA and UVB rays. For this reason, the most essential aspect of skin cancer prevention is always to limit mid-day sun exposure and take steps to protect against sun damage, including wearing sunscreen every day – even if it’s cloudy or cold. Additionally, early intervention may mean skin cancer is more treatable. So, it can be just as important to have regular skin checks and report any new spots or changing lesions to a dermatologist as soon as possible.”
Each form of skin cancer has its own unique symptoms and side effects, but the most noticeable symptoms of skin cancer are often new and changing spots or lesions on the skin. You may hear common skin changes related to cancer referred to as the ABCDEs of skin cancer, and these are the most important things to look for during regular skin cancer self-exams. The ABCDEs of skin cancer are:
- A – Asymmetry – A new or existing spot is different on one side than another
- B – Border – The outside edges of a spot are jagged or scalloped rather than smooth
- C – Color – The color of a new or existing spot is different from other skin lesions and/or has multiple colors within the same spot or changes colors
- D – Diameter – Any spots that are bigger around than a standard pencil eraser
- E – Evolving – A new or existing spot that changes from one self-exam to the next in any way
In addition to monitoring skin for new skin cancer, people who have previously had skin cancer should also keep a close eye on their skin as they may be at greater risk for the recurrence of skin cancer. Some common warning signs of skin cancer recurrence to be aware of during self-exams include:
- Changes in skin (redness, inflammation, skin thickening) around the site where skin cancer was removed
- Scarring that occurs or scars that change long after the skin cancer removal process
- Bleeding after skin cancer removal site has fully healed
- Changes in coloring or development of spots that are a different color on the skin around previous skin cancer sites
- New lesions form that are similar to the previously removed cancerous spots
In addition to regular at-home screenings, you should visit your dermatologist at least once each year for a professional skin cancer screening. This ensures you haven’t missed any areas of concern in difficult-to-see spots. Some types of skin cancer can also be very subtle, so a dermatologist’s trained eye is much more likely to notice these more subtle changes.
How Do I Work with a Dermatologist for Skin Cancer Treatment?
If you’re concerned about skin irregularities that might be cancerous or you’re ready to begin treatment for skin cancer, we hope you’ll trust the team at U.S. Dermatology Partners to provide the right treatment options to remove skin cancer and renew your skin health. Getting started working with U.S. Dermatology Partners is quick and easy. Simply take a few moments to complete our online scheduling request form. Once a local dermatology office receives your request, they’ll be in touch to set up the final details of your visit and answer any questions you have.
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