skin cancer treatment
Treatment for skin cancer depends on the type and stage of the disease, the size and place of the growth, and your general health and medical history. In most cases, the aim of treatment is to remove or destroy the cancer completely.
It often helps to make a list of questions before an appointment. To help remember what the doctor says, you may take notes or ask whether you may use a tape recorder. You may also want to have a family member or friend with you when you talk to the doctor – to take part in the discussion, to take notes, or just to listen.
Your doctor may refer you to a specialist, or you may ask for a referral. Specialists who treat skin cancer include dermatologists, surgeons, and radiation oncologists.
Getting a second opinion
Before you have treatment, you might want a second opinion about the diagnosis and treatment plan. Many insurance companies cover a second opinion if you or your doctor requests it. It may take some time and effort to gather medical records and arrange to see another doctor. Usually it is not a problem to take several weeks to get a second opinion. In most cases, the delay will not make treatment less effective. To make sure, you should discuss this delay with your doctor. Sometimes people with skin cancer need treatment right away.
There are a number of ways to find a doctor for a second opinion:
You may want to ask the doctor these questions before treatment begins:
Your doctor can describe your treatment choices and what to expect. You and your doctor can work together to develop a treatment plan that meets your needs.
Surgery is the usual treatment for people with skin cancer. In some cases, the doctor may suggest topical chemotherapy, photodynamic therapy, or radiation therapy.
Because skin cancer treatment may damage healthy cells and tissues, unwanted side effects sometimes occur. Side effects depend mainly on the type and extent of the treatment. Side effects may not be the same for each person.
Before treatment starts, your doctor will tell you about possible side effects and suggest ways to help you manage them.
Many skin cancers can be removed quickly and easily. Even so, you may need supportive care to control pain and other symptoms, to relieve the side effects of treatment, and to ease emotional concerns.
You may want to talk to your doctor about taking part in a clinical trial, a research study of new ways to treat cancer or prevent it from coming back.
Surgery to treat skin cancer may be done in one of several ways. The method your doctor uses depends on the size and place of the growth and other factors.
Your doctor can further describe these types of surgery:
The time it takes to heal after surgery is different for each person. You may be uncomfortable for the first few days. However, medicine can usually control the pain. Before surgery, you should discuss the plan for pain relief with your doctor or nurse. After surgery, your doctor can adjust the plan if you need more pain relief.
Surgery nearly always leaves some type of scar. The size and color of the scar depend on the size of the cancer, the type of surgery, and how your skin heals.
For any type of surgery, including skin grafts or reconstructive surgery, it is important to follow your doctor's advice on bathing, shaving, exercise, or other activities.
You may want to ask your doctor these questions about surgery:
Chemotherapy uses anticancer drugs to kill skin cancer cells. When a drug is put directly on the skin, the treatment is topical chemotherapy. It is most often used when the skin cancer is too large for surgery. It is also used when the doctor keeps finding new cancers.
Most often, the drug comes in a cream or lotion. It is usually applied to the skin one or two times a day for several weeks. A drug called fluorouracil (5-FU) is used to treat basal cell and squamous cell cancers that are in the top layer of the skin only. A drug called imiquimod also is used to treat basal cell cancer only in the top layer of skin.
These drugs may cause your skin to turn red or swell. It also may itch, hurt, ooze, or develop a rash. It may be sore or sensitive to the sun. These skin changes usually go away after treatment is over. Topical chemotherapy usually does not leave a scar. If healthy skin becomes too red or raw when the skin cancer is treated, your doctor may stop treatment.
You may want to ask your doctor these questions about topical chemotherapy:
Photodynamic therapy (PDT) uses a chemical along with a special light source, such as a laser light, to kill cancer cells. The chemical is a photosensitizing agent. A cream is applied to the skin or the chemical is injected. It stays in cancer cells longer than in normal cells. Several hours or days later, the special light is focused on the growth. The chemical becomes active and destroys nearby cancer cells.
PDT is used to treat cancer on or very near the surface of the skin.
The side effects of PDT are usually not serious. PDT may cause burning or stinging pain. It also may cause burns, swelling, or redness. It may scar healthy tissue near the growth. If you have PDT, you will need to avoid direct sunlight and bright indoor light for at least 6 weeks after treatment.
You may want to ask your doctor these questions about PDT:
Radiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells. The rays come from a large machine outside the body. They affect cells only in the treated area. This treatment is given at a hospital or clinic in one dose or many doses over several weeks.
Radiation is not a common treatment for skin cancer. But it may be used for skin cancer in areas where surgery could be difficult or leave a bad scar. You may have this treatment if you have a growth on your eyelid, ear, or nose. It also may be used if the cancer comes back after surgery to remove it.
Side effects depend mainly on the dose of radiation and the part of your body that is treated. During treatment your skin in the treated area may become red, dry, and tender. Your doctor can suggest ways to relieve the side effects of radiation therapy.
You may want to ask your doctor these questions about radiation therapy:
Follow-up care after treatment for skin cancer is important. Your doctor will monitor your recovery and check for new skin cancer. New skin cancers are more common than having a treated skin cancer spread. Regular checkups help ensure that any changes in your health are noted and treated if needed. Between scheduled visits, you should check your skin regularly. You will find a guide for checking your skin below. You should contact the doctor if you notice anything unusual. It also is important to follow your doctor's advice about how to reduce your risk of developing skin cancer again.