Treatment for Other Skin Cancers
Although any diagnosis of cancer is frightening, very few people die of nonmelanoma skin cancers. They are generally slow-growing and very curable. A number of options are available for treating these skin problems, including surgery, cryosurgery, phototherapy, radiation, and topical 5-fluorouracil. Few comparison studies have been performed to see which procedures are most effective for these skin problems.
Surgery
For any skin cancer and for some keratoses that require removal, surgery is the first treatment. It is usually one of the following:
Excisional Surgery. This is the surgical removal of the cancerous lesion.
Curettage and Electrodesiccation. This procedure involves scraping away of the cancerous tissue followed by electric cauterization to stop the bleeding.
Mohs Micrographic Surgery. Mohs surgery is a meticulous procedure used for skin cancers at high risk for recurrence or becoming invasive. Studies indicate patients with the following skin cancers are among the good candidates for this procedure:
- Squamous cell carcinomas.
- Basal cell carcinomas greater than 1 cm (about half an inch).
- Basal cell carcinomas on the face, ear, or neck.
- Skin cancer that occurs in young people.
This procedure involves the following:
- Very thin layers are removed one at time, with each layer examined immediately under a microscope.
- When the layers are shown to be cancer free, the surgery is complete.
- Because the doctor needs to be certain that all cancer cells are removed, in some cases the surgical area required is very wide and requires plastic surgical techniques. Human skin substitute (Apligraf) is a living biological dressing that is being investigated. It is applied to the surgical area to achieve a better cosmetic effect.
Mohs surgery saves more healthy tissue than other procedures and is highly effective. It results in a 99% cure rate for primary tumors and a 95% cure rate for recurrent ones. It can be safely performed in the doctor's office. Complications are uncommon but can include bleeding and infection.
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