Treatments

Skin Cancer Treatments

Your dermatologist can use a variety of leading-edge techniques to remove skin cancers and to make sure the surrounding area is free of cancer. If the cancer is caught early, it has a high chance of being cured.

Basal cell and squamous cell carcinoma treatments

Your course of treatment will be determined based on the size, location and stage of your cancer. Factors also include your age, overall health and what side effects you’ll find acceptable.

Treatment options may include:

• Cryosurgery: This method uses cold to destroy cancer cells that are very small and near the skin’s surface. Your physician uses a device that sprays liquid nitrogen onto the tumor to freeze cells and destroy them
• Shave excision: You are given a local anesthetic before your physician uses a small blade to shave off the tumor. This method is used for cancer that is only in the top layers of the skin
• Simple excision: Your physician uses a scalpel to remove the tumor from the skin along with some of the healthy tissue around it. The tissue that was removed is sent to a pathologist for analysis. If the report reveals that not all the margins are clean, you’ll likely need another procedure to remove the rest of the cancer
• Curettage and electrodesiccation: This procedure removes tissue and cauterizes the area using a sharp, spoon-shaped instrument called a curette. After curettage, your physician passes an electric needle over the surface of the scraped area to stop any bleeding and destroy any remaining cancer cells
• Laser treatment or dermabrasion: Laser therapy uses a narrow beam of intense light to remove cancer cells. Dermabrasion removes the top layer of skin with a rotating wheel or small particles that rub away skin cells. These types of surgery are not as common, as they don’t produce a tissue sample for a pathologist to check if all the cancer cells were removed
• Chemotherapy: Most often topical chemotherapy is used, applied as a cream or ointment onto the skin. These medicines are only used when the cancers are just in the top layers of the skin. Intravenous chemotherapy may be used for squamous cell cancer after it spreads
• Mohs surgery: The cancer is removed from the skin one layer at a time, and each layer is checked under a microscope for cancer. The surgeon performing the procedure is also the pathologist reading the specimen slides. If cancer cells are seen, another layer of skin is removed until the physician doesn’t see any more cancer. Mohs surgery may be a good option if:
• Your physician is not sure of the exact depth and shape of the tumor
• The tumor is very large
• The tumor is located in a hard-to-treat place
• The skin cancer has come back

The skin cancer is on the face

Mohs surgery is especially useful for treatment on the face, nose, mouth, ears and feet because it removes the cancerous skin while keeping as much healthy tissue as possible and reducing deep scarring and the need for reconstructive surgery.

Electron beam radiation: This type of radiation does not go deeper than the skin, which helps limit side effects. The radiation damages the cancer cells and stops them from growing and dividing. It is used when:

• You’re unable to have surgery due to a health condition, such as bleeding problems
• The cancer is in an area that makes it hard to remove with surgery, such as your eyelid, nose or ear
• You’ve had surgery, but you have an increased risk of the cancer coming back

Melanoma treatments

There are various treatment choices for melanoma. The one that will work best for you depends on a number of factors, including the size, location and stage of your melanoma. Learn more about melanoma treatments.

Cutaneous lymphoma treatment

Treatment may include:

• Chemotherapy: This is treatment with drugs to destroy cancer cells. Drugs may be put on the skin as a cream or gel injected into a vein.
• Other drug therapies (retinoids, corticosteroids, targeted drugs): Some are applied to the skin, while others are taken by mouth or given as an injection.
• Radiation therapy: This therapy uses a radiation machine that emits X-rays to kill cancer cells and shrink tumors.
• Photodynamic therapy: This therapy uses a certain type of light and a special chemical to kill cancer cells.

Research and clinical trials

Clinical trials are currently being conducted using biological therapy, also called biological response modifier therapy, or immunotherapy. Biological therapy tries to get your own body to fight cancer by using materials made by your own body, or made in a laboratory, to boost, direct, or restore your body's natural defenses against disease.

Research efforts in this field at Northwestern are also burgeoning. Northwestern is one of 11 collaborating sites studying hedgehog inhibitors and their role in treating basal cell cancers, which are currently treated by surgery.

It is the hope that hedgehog-inhibiting drugs could prevent, cure, or provide alternative treatment for those who have cancer that is inoperable or cannot be treated with radiation (e.g., basal cell cancer near the eye).

TARGET: (Treatment of Adverse Reactions and Graft-versus-host disease EffecTs of cancer)

Northwestern has one of the few clinics in the nation dedicated to the care of the mucocutaneous side effects of traditional chemotherapy, newer targeted anti-cancer therapies, and stem cell transplantation.

Our clinical team is deeply committed to better understanding these reactions through research and ameliorating the quality of life of patients undergoing chemotherapy who often suffer from severe rashes, skin tumors, and itchiness.

Special Cosmetic Procedures

Northwestern Medicine dermatologists and oncologists treat and reduce skin complications from chemotherapy by advising patients on how to manage increased sensitivity, redness, itching and brittle nails at home, and by examining other side effects such as burning and rashes to rule out serious complications and prevent tissue damage.

Chemotherapy sometimes causes skin complications such as increased sensitivity to the sun, redness and rashes, itching and acne. The skin along the vein used to administer chemotherapy may darken.

Nails can also become darkened or yellow, brittle, and may develop cracks and ridges. Some effects can be treated by applying cornstarch, avoiding sunlight and fragrances that contain alcohol, and avoiding nail-strengthening products.

You should report side effects such as burning or pain immediately since chemotherapy drugs can leak out of the vein and cause tissue damage.