Skin Cancer Treatment

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

Skin cancer definition and symptoms

Skin cancer is the most common type of cancer in the world. More than than 5.4 million people developed a form of skin cancer in 2016. Three and a third million Americans will develop one or more skin cancers this year. The vast majority of these are curable if found and treated early. Most skin cancers are preventable by reducing the skin's exposure, especially on the face, to ultraviolet (UV) radiation from the sun.

The major types of skin cancers are basal cell, squamous cell, and melanoma cancers. Basal and squamous cell cancers infrequently spread to areas other than the skin but melanomas, if not found and treated early in their development, often spread beyond the skin. Signs of skin cancer (basal and squamous) are occasionally similar so the combined symptoms are as follows:

  • Any unusual bump or sore that does not go away
  • A waxy skin patch that may be translucent, brownish, or crusty that may bleed if injured
  • A firm lump with reddish scaly covering

Melanoma signs and symptoms

Melanomas are aggressive. About 75,000 Americans were diagnosed with melanoma in 2016. While usually curable if found early, melanoma killed more than 10,000 Americans in 2016.  The following signs and symptoms of melanoma are summarized by the Cancer Treatment Centers of America as follows. Melanoma skin cancer signs include new spots on the skin, or a change in size, shape, or color of an existing mole. The ABCD rule is another way to recognize abnormal growths:

  • A is for Asymmetry: A mole that has an irregular shape, or two different looking halves.
  • B is for Border: Irregular, blurred, rough, or notched edges may be signs of skin cancer.
  • C is for Color: Most moles are an even color -- brown, black, tan or even pink -- but changes in the shade or distribution of color throughout the mole can signal melanoma.
  • D is for Diameter: Moles larger than ¼ inch (6 mm, the size of a pencil eraser) across may be suspect, although some melanomas may be smaller than this.

Other potential signs of melanoma in a mole include:

  • A sore that does not heal
  • Pigment, redness, or swelling that spreads outside the border of a spot to the surrounding skin
  • Itchiness, tenderness, or pain
  • Changes in texture or scales, oozing, or bleeding from an existing mole

Skin cancer treatments

Basel and squamous cell cancers are usually easily treated in office visits by a dermatologist using safe and effective methods such as superficial excision with a skin scraping tool (curette), heat (cauterization), freezing (cryotherapy), or low dose radiation of the skin lesion. Some clinicians use chemotherapeutic agents (5-fluorouracil or imiquimod) topically to kill these cancer cells. If these cancers do spread, surgical removal, chemotherapy, and radiation may be used in combination to treat the patient.

Melanomas occur more deeply in the skin and spread more aggressively to other areas and organs. The first treatment option is to surgically remove enough tissue so that the remaining tissue contains no cancer cells. Because of the tendency of melanoma to spread fairly rapidly, some clinicians recommend removing lymph nodes near the cancer site. In contrast to basal and squamous cell cancers, surgery, radiation, or chemotherapy will cure advanced melanomas but such treatments may reduce symptoms and slow the disease progression. Unfortunately, about 20% of patients with skin cancer have reoccurrences within 2 years.

Other treatments for skin cancer

Researchers are using different methods to try to treat skin cancers, especially ones that have spread and the aggressive melanomas. Vaccines, drugs (interferon, interleukin-2, ipilimumab, nivolumab, pembrolizumab, and others) to stimulate immune cells, and genetic manipulation of melanomas are all being developed to treat skin cancer patients. Some drugs are available in clinical trials while others have recently been approved for patient use under special conditions.

Again, the majority of skin cancers are not only treatable but curable. However, the best news is that many people can prevent or reduce the risk of getting skin cancers by taking simple precautions of limiting skin exposure to the sun with clothing, hats, and effective sunscreen application.

Medically reviewed by Jay B. Zatzkin, MD; American Board of Internal Medicine with subspecialty in Medical Oncology

REFERENCES:

"Skin Cancer Symptoms." Cancer Treatment Centers of America.

"Skin Cancer Treatment." WebMD.

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Reviewed on 3/30/2017 12:00:00 AM