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Non-melanoma skin cancer
A variety of treatments for non-melanoma skin cancer include:
- Curettage and electrodessication. The cancer is removed by scraping it with a long, thin tool (a curette). The area is treated with an electric needle to destroy any remaining cancer cells. This is repeated 1 to 3 times.
- Excision and suturing. The cancer and some skin around it are cut out. Then the skin is sewn together.
- Freezing with liquid nitrogen.
- Mohs micrographic surgery for difficult-to-cure or recurrent skin tumors. After the tumor is removed, it is cut into pieces, stained, frozen and examined under a microscope. If the tissue indicates that some tumor cells remain on the patient, it is indicated on a skin tumor map. The surgeon then extracts more tissue from the patient, but only where the tumor is located. This process is repeated as many times as necessary to totally remove the tumor.
- 5-Fluorouracil cream, a topical chemotherapy agent applied by the patient can sometimes be used.
- Injections of interferon, a protein that helps the body fight the cancer.
- Local Radiation therapy if indicated.
Although basal and squamous cell carcinomas are seldom fatal, removing these cancers sometimes may cause scars and disfigurement.
Melanoma
If a biopsy confirms a melanoma diagnosis, the cancer is "staged" by physical examination, blood tests and scans, according to the location and thickness of the tumor, how deeply the melanoma has invaded the skin, and whether melanoma cells have spread to nearby lymph nodes or other parts of the body. The stage that the tumor is in largely determines the treatment plan.
According to the National Institutes of Health (NIH), melanomas that are thin (less than 1 millimeter in depth) can usually be cured by removing the lesion or biopsy site along with a half-centimeter border of the surrounding normal skin and a layer of underlying tissue. Studies indicate the eight-year survival rate with this treatment approach is 95 percent.
For melanoma, removal of nearby lymph nodes for examination under a microscope is frequently necessary if the melanoma is more advanced. According to the NIH, such surgery may be considered part of the treatment because removing cancerous lymph nodes may help control the disease. The doctor also does a careful physical examination and, depending on the thickness of the tumor, may order chest X-rays, CT scans, blood tests, scans of the liver and bones, and a brain MRI to stage the disease.
After diagnosis and staging, the doctor develops a treatment plan to fit each patient's needs. Treatment for melanoma depends on the extent of the disease, the patient's age and general health and other factors.
The standard treatment for melanoma is surgery. In some cases, doctors may also use the following:
- Biological therapy involves cytokines, or proteins that activate the immune system in a general way. According to the American Cancer Society (ACS), interferon-alpha and interleukin-2 can help shrink nearly 10 percent to 20 percent of advanced-stage melanomas.
- Chemotherapy is the use of drugs to kill fast-growing cells, including cancer cells. A new type of chemotherapy, called isolated limb perfusion, is sometimes used for melanoma. First, the flow of blood to and from the limb is stopped for a short time using a tourniquet. Then chemotherapy drugs are put directly into the blood of the limb. This allows the person to receive a high dose of drugs in the area where the melanoma is.
- Radiation therapy exposes the tumor site to high doses of cancer-killing radiation.
- Experimental research protocols, such as vaccines and antiangiogenic treatments, are becoming available. Talk to your oncologist. (Antiangiogenic drugs target the natural physiologic process responsible for tumor growth by targeting tumor blood vessel formation and shutting down the mechanisms of cancer progression at an early stage.)
Any of these treatments may be used alone or in combination.
Melanoma vaccine
Several researchers are testing vaccines to prevent melanoma recurrence. In one study, published in the Journal of Clinical Oncology, David Berd, M.D., and colleagues at Thomas Jefferson University showed a vaccine prepared from the patient's own cancer cells extended the survival of melanoma patients whose disease had spread to their lymph nodes. The cancer cells were weakened before being used in the vaccine. Experimental vaccine programs are being investigated at many melanoma cancer centers.
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External Sources
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National Institutes of Health (NIH)
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Dollinger M, Rosenbaum, EH, Tempero M., et al. Everyone's Guide to Cancer Therapy, Fourth Edition, Kansas City, Missouri: Andrews McMeel Publishing, 2002.
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This article was reviewed and updated June 2007.
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