Non-Melanoma

Doctors may recommend one or more of the following treatment options for nonmelanoma:

Surgery
Skin cancer treatment usually involves some type of surgery. Many nonmelanomas can often be cut from the skin quickly and easily. Many times this is completed during the biopsy. The width and depth of surrounding skin that needs to be removed depends on the cancer's thickness and how deeply it has invaded the skin. If the cancer was not completely removed during the biopsy, the doctor takes out the remaining tumor. In addition, normal tissue around the tumor is also removed to make sure the cancer has been removed entirely. Sometimes nearby lymph nodes are removed because cancer can spread to the lymphatic system. If the doctor finds cancer cells in the lymph nodes, it may mean that the cancer has spread to other parts of the body.

Mohs surgery
Mohs surgery is a procedure used to remove all the cancerous tissue and as little of the healthy tissue as possible. It is also used to remove large tumors, recurring cancers or those found in difficult-to-treat places. The patient is given a local anesthetic, and the cancer is shaved off one thin layer at a time.

Curettage and Electrodesiccation
Curettage is a surgical procedure that uses a curette, an instrument with a sharp, spoon-shaped end, to scoop out the cancer. Before the procedure, the area is numbed with a local anesthetic. In a procedure called electrodesiccation, an electric current is used to control bleeding and kills any remaining cancer cells. Possible side effects include development of a flat, white scar.

Cryosurgery
Liquid nitrogen is applied to the affected area to freeze and kill the cancerous cells. When the area thaws, the dead tissue falls off. Possible side effects include some pain, swelling or a white scar.

Radiation
For melanoma that has spread to other parts of the body, doctors sometimes recommend radiation therapy, which uses high-energy rays to kill cancer cells and prevent them from growing. This is often used for areas that are difficult to treat with surgery. Some possible side effects of radiation therapy include rashes, dry or red skin or changes in skin color or texture.

Chemotherapy
For melanoma that has spread to other parts of the body, doctors may also recommend topical or systemic chemotherapy. Topical chemotherapy is the use of anticancer drugs in a cream or lotion applied directly to the skin. The drug fluorouracil (5-FU) is commonly used for topical chemotherapy. It reaches cancer cells near the skin surface but does not reach cancer cells that have invaded deeply into the skin or spread to other organs. This form of chemotherapy is often used to treat actinic keratosis, a precancerous condition of thick, scaly patches of skin, and other cancers found only in the top layer of skin. Treatment with fluorouracil cream causes the treated skin to be red and sensitive for a few weeks. In systemic chemotherapy, anticancer drugs are given by mouth or injection into a vein (IV). The drugs travel through the bloodstream and affect cancer cells that may have spread throughout the body. Temporary side effects of systemic chemotherapy might include nausea and vomiting, loss of appetite, loss of hair, and mouth sores.

Laser therapy
A narrow light beam is used to kill the cancerous cells.

Grafting
If a large cancer is removed, a skin graft may be needed to close the wound and reduce scarring. During a skin graft, the doctor replaces the removed skin with a healthy piece from another area of the body.

Questions to ask your doctor

When skin cancer is diagnosed, many patients have a lot of questions. Your doctor is the best person to answer these questions. You should feel comfortable asking your doctor any questions you might have, such as:

• What type of skin cancer do I have?
• What is the stage of the cancer?
• What types of treatment are available?
• Which do you recommend?
• How successful are the treatments?
• Are there any risks or side effects with treatment?
• How will I feel after the surgery?
• Will I need more treatment after surgery?
• Will I have a scar?
• If I experience any pain, how can it be controlled?
• Will I have to change my normal activities?
• How can I keep from getting skin cancer again?
• How often should I receive follow-up examinations?