How is Skin Cancer Treated?

Treatment for skin cancer is determined by several factors, including:

• How advanced or widespread the cancer is (also called the cancer stage)
• Skin cancer type
• Your overall health

Types of treatment for skin cancer

Skin cancer can be treated in several different ways. Not all treatment approaches are appropriate for every patient or cancer. Treatment options may include:

Surgery

The skin tumor may be removed with surgery. Surgery is the first choice of treatment for many people with skin cancer. If the cancer has spread to the lymph nodes, the lymph nodes may be removed too.

Radiation therapy

Radiation therapy is the use of high-energy rays to kill cancer cells. Radiation therapy can be used as a main treatment, adjuvant (secondary) treatment, or palliative therapy.

Local treatment procedures

Procedures that only affect the top layers of skin may be used to remove actinic keratosis (a precancer) and some non-melanoma skin cancers. This group of procedures includes curettage and electrodesiccation, cryotherapy, and photodynamic therapy, chemical peeling, and laser surgery.

Topical medication

Medications applied to the skin are used to treat actinic keratosis and some non-melanoma skin cancers that affect only the very top layers of skin.

Targeted therapy

Targeted therapy medications aim at the mutations that make cancer cells different from normal cells. This means that their effect is directed specifically at the cancer cells, but can still cause side effects. Targeted therapies have been approved for certain forms of melanoma and basal cell carcinoma.

Immunotherapy

Medications in this class treat skin cancer by turning your own immune system against the cancer. Immunotherapy medications are available to treat certain forms of melanoma, Merkel cell carcinoma, basal cell carcinoma, cutaneous squamous cell carcinoma, and Kaposi sarcoma.

Oncolytic virus therapy

Advanced melanoma can be treated with an oncolytic virus. This weakened virus is injected into the tumor, where it makes copies of itself. The virus kills tumor cells directly. It also generates a response from your immune system.

Chemotherapy

Chemotherapy medications are drugs that kill or damage rapidly dividing cells, such as cancer cells. Chemotherapy use in skin cancer can vary depending on the specific form of skin cancer being treated.

Tissue-agnostic treatment

A tissue-agnostic treatment treats various forms of cancer as long as the cancer has a specific molecular change or biomarker that is targeted by the treatment.

Complementary medicine

Complementary practices may be used in combination with conventional treatment to relieve stress, reduce side effects or symptoms, and improve well-being.

Clinical trials

The US Food and Drug Administration (FDA) is the government agency that makes sure medications are effective and safe. Before the FDA approves a drug, it must be tested in several clinical trials.

Researchers are working on finding new and better treatments for skin cancer. Clinical trials provide important information about these treatments. By participating in a clinical trial, you may get access to new treatments. You will receive excellent care and will be carefully monitored. You also help future patients, who will benefit from better treatments.

However, clinical trials are not right for everyone. You must weigh the potential benefits with the potential risks. Potential risks include side effects, receiving a treatment that does not work, and the need for frequent medical visits.

Not everyone qualifies to participate in a clinical trial. If you are considering a clinical trial, talk with your doctor.

Treatment team

Treatment for skin cancer ranges widely. Your primary care doctor or dermatologist may be able to treat a small non-melanoma skin cancer in a single office visit. For large or aggressive tumors, you might need a plastic surgeon or dermatologist who specializes in extensive surgery and repair. If the cancer has spread beyond the skin tumor, you may be treated by a team of oncologists.

The healthcare providers who diagnose and treat skin cancer include:

• Primary care provider: May identify skin cancer, perform a biopsy, or refer to a dermatologist.
• Dermatologist: May identify skin cancer, perform a biopsy, treat cancerous lesions, or refer you to an oncologist.
• Pathologist: Examines tissue samples to provide a definitive diagnosis of skin cancer.
• Surgical oncologist: Treats cancer with surgery.
• Medical oncologist: Treats cancer with medications such as targeted therapy, immunotherapy, or chemotherapy.
• Radiation oncologist: Treats cancer with radiation therapy.
• Plastic surgeon: Specializes in repairing defects, may remove large or prominent skin cancers.

Second opinion

Getting a second opinion on a diagnosis or course of treatment is common in cancer care, as long as time safely allows. A good doctor will welcome input from another professional.¹

You may seek a second opinion for many reasons.² A second opinion is especially important if there is uncertainty about the diagnosis. It may be necessary if your doctor is not a specialist in the type of cancer you have. A second opinion is helpful if you have trouble communicating with your doctor. It can reassure you to know that you have explored all your treatment options.

When seeking a second opinion, bring your medical records, including biopsy results, imaging tests, laboratory tests, operative reports, and discharge summaries. If you do not have copies, your doctor’s office and hospital can provide these records.