Treatment Options for Skin Cancer

Many different kinds of surgery can be used for basal cell and squamous cell skin cancers and melanoma. The options for surgery depend on the type of skin cancer, how large the cancer is, where it is on the body, and other factors. In most cases the surgery can be done in a doctor’s office or hospital clinic using a local anesthetic (numbing medicine). For skin cancers with a high risk of spreading, surgery sometimes will be followed by other treatments, such as radiation or chemotherapy.

Excision

This is similar to an excisional biopsy but in this case the diagnosis is already known. For this procedure, the skin is first numbed with a local anesthetic. The tumor is then cut out with a surgical knife, along with some surrounding normal skin. The remaining skin is carefully stitched back together, which will leave a scar.

Curettage and electrodesiccation

In this treatment, the doctor removes the cancer by scraping it with a long, thin instrument with a sharp looped edge on one end (called a curette). The area is then treated with an electric needle (electrode) to destroy any remaining cancer cells. This process is often repeated once or twice during the same office visit. Curettage and electrodesiccation is a good treatment for superficial (confined to the top layer of skin) basal cell and squamous cell cancers. It can leave a scar.

MOHS

Read more about Mohs Micrographic Surgery

Topical Medications

The following creams, gels, or solutions are used to treat limited, specific BCCs.

Imiquimod
Imiquimod is FDA-approved only for superficial BCCs, with cure rates generally between 80 and 90 percent. The cream is rubbed gently into the tumor five times a week for up to six weeks or longer. The first in a new class of drugs that work by stimulating the immune system, it causes the body to produce interferon, a chemical that attacks cancer.
5-Fluorouracil (5-FU)
5-Fluorouracil (5-FU), a chemotherapy drug approved to treat internal cancers,  also has been FDA-approved for superficial BCCs, with similar cure rates to imiquimod. The liquid or cream is gently rubbed into the tumor twice a day for three to six weeks. Side effects are variable, and some patients do not experience any discomfort, but redness, irritation, and inflammation usually occur.

Oral Medicine for Advanced Basal Cell Carcinoma

ErivedgeTM (vismodegib)
ErivedgeTM was approved by the FDA in 2012 for extraordinarily rare cases of metastatic BCC or locally advanced BCC that become dangerous and even life-threatening. The first medicine ever for advanced BCC, it works by blocking the “Hedgehog” signaling pathway, which is a key step in the development of BCC. It is approved only for very limited circumstances where the nature of the cancer precludes other treatment options (such as surgery or radiation). Several other targeted Hedgehog inhibitors are also being investigated as potential treatments for locally advanced and metastatic BCC. Due to a risk of birth defects, vismodegib should not be used by women who are pregnant or may become pregnant. Birth control must be used by couples if the woman is capable of becoming pregnant.

Brachytherapy

Brachytherapy provides a faster skin cancer treatment with minimal side effects and exceptional cosmetic outcomes. The technology is unique because it uses a miniaturized x-ray source that can be turned on or off, instead of the traditional radioactive seeds that are always emitting radiation. This means that the shielding requirements are very minimal, and your radiation therapy team is able to remain in the treatment room with you. Because it is a short procedure with minimal side effects, eBxTM is an ideal skin cancer treatment alternative for patients not interested in surgery.

Brachytherapy Benefits

  • Short, non‐invasive procedure with no hospital stay
  • Minimal side effects
  • Exceptional cosmetic outcomes in a relatively short timeframe
  • Ideal alternative for patients not interested in surgery or on a blood thinning medication i.e. baby aspirin

How Does HDR Brachytherapy Work?

With eBx™, a miniature x-ray source is temporarily placed on the skin using a surface applicator. This allows the radiation to be delivered directly to the skin lesion with impeccable accuracy. The treatment is non-invasive and painless, providing an ideal alternative for those not interested in surgery.

Treatment Process

The radiation treatment process will begin with a consultation where the Radiation Oncologist will evaluate your condition and determine if Brachytherapy is the right skin cancer treatment for you.
During treatment, your Radiation Oncologist and Radiation Therapist will place a miniature x-ray source temporarily on the skin using a surface applicator. This allows the radiation to be delivered directly to the skin lesion with impeccable accuracy.
It is a short procedure with minimal side effects and exceptional cosmetic outcomes in a short timeframe.