Skin Cancer Treatment By Type

The goals of skin cancer treatment are to remove the tumor and kill any other cancer cells that may cause it to recur or spread.¹

Treatment is selected based on cancer type, stage, overall health, and other factors. Options can generally be categorized:¹

• Surgery
• Topical medicines
• Other local treatments
• Radiation therapy
• Systemic medicines
• Complementary and integrative medicine

Surgery

Several surgical procedures are used to treat skin cancer and precancer.¹

Excision

Your doctor will cut the tumor using a surgical knife. The scar will be a flat, thin line when a football-shaped incision is made. Narrower margins are used for tumors that are unlikely to recur. Wider margins are used for tumors that are more likely to recur. Mohs surgery is preferred.^1,2

Excision is used for:¹

• High-risk basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)
• Melanoma
• Merkel cell carcinoma (MCC)
• Kaposi sarcoma, when there are few lesions

Mohs surgery

Mohs surgery removes skin cancer in areas where it is critical to save as much healthy tissue as possible. The surgeon removes the tumor and a thin layer of normal tissue around it. The removed tissue is then checked under a microscope to see if any cancer cells are present. If cancer cells are found, the doctor will cut out more of the skin and look at it under a microscope. This process is repeated until no cancer cells are found.³

Mohs surgery is often used to treat:³

• High-risk BCC or SCC
• BCC or SCC that need re-treatment
• Some melanomas with unclear borders
• Some MCC
• Cancers on areas where function and scar appearance are important

Topical medicines

Topical medicines are creams, gels, or liquids applied directly to the skin to treat skin cancer. These medicines can be used to treat:⁴

• Actinic keratosis
• Basal cell carcinoma
• Squamous cell carcinoma

Some examples of topical medicines include:⁴

• Imiquimod
• Fluorouracil
• Diclofenac
• Ingenol mebutate

Other local treatments

Local procedures that may be used to remove some thin, low-risk non-melanoma skin cancers include:^4,5

• Curettage and electrodesiccation (C&E) treat low-risk tumors and precancerous lesions. C&E scrapes away the cancerous tissue and destroys the remaining cancer cells with an electric needle.
• Cryotherapy is a way to kill abnormal tissue by using extreme cold. Liquid nitrogen is often sprayed above the lesion. Depending on the lesion, your doctor may allow the area to thaw for 2 to 3 minutes and then re-freeze the area.
• Photodynamic therapy (PDT) is a treatment for actinic keratosis that uses a drug that makes cells sensitive to light. Then, a special light is used to destroy the abnormal cells.

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy beams to kill cancer cells.⁶

Radiation therapy can be a main treatment for:⁶

• Large non-melanoma skin cancer
• Non-melanoma skin cancer in complicated or delicate locations
• Lentigo maligna melanoma
• Kaposi sarcoma lesions on the skin, mouth, or throat
• Merkel cell carcinoma that has returned (recurred) or is likely to recur

Systemic medicines

Medicines that go through your whole body (systemic) are a possible treatment for cancer that has spread. They can be used as the main treatment (primary) or after other treatments (adjuvant). Several different types of drugs are available. Immunotherapy turns your immune system against the cancer. Targeted therapy aims at the abnormal mutations that lead to uncontrolled cell growth. Chemotherapy is often less effective than newer drugs but remains an option in some cases.⁷

Examples of systemic drugs used to treat various types of skin cancer include:⁸

• Bavencio^® (avelumab)
• Erivedge (vismodegib)
• Keytruda^® (pembrolizumab)
• Libtayo^® (cemiplimab-rwlc)
• Odomzo (sonidegib)
• Opdivo^® (nivolumab)
• Zynyz™ (retifanlimab)

Imlygic (talimoge laheraparepvec) is another type of systemic drug injected into a melanoma tumor.⁸

Complementary and integrative medicine

Some people use complementary medicine together with conventional treatment. These approaches include:⁹

• Mind-body practices
• Natural products and supplements
• Alternative healing practices

Some of these practices can be used safely. They may reduce stress or side effects and improve well-being. Others may have harmful interactions with medicines.⁹

Evaluate claims about home remedies that cure cancer with skepticism. Effective treatments should be supported by sound science, and you should develop a plan with your doctor. Delaying effective treatment for skin cancer can lead to worse outcomes.⁹