Skin Cancer Treatments
For most skin cancers early treatment will result in a cure.
BCCs and SCCS can be treated with a variety of methods, depending on the tumour type, depth, location etc.
Your dermatologist will discuss your options with you.
Malignant melanomas must always be surgically excised.
Skin biopsies are often required to establish a diagnosis.
A biopsy is a simple procedure done at the time of the consultation.
Under local anaesthetic a small sample of the skin cancer is taken.
The sample is the sent to pathology for analysis.
Options for treating skin cancers
Depending on the type of skin cancer and the location of the cancer, there may be the option of treating the cancer with a cream.
Pros and cons of the different treatment options for Superficial Basal cell cancers (not nodular BCC or Infiltrative BCC).
Pros and cons of the different treatment options for Bowens Disease =non-invasive squamous cell cancer.
Surgical excision
At Drummoyne Dermatology, surgical excision of your skin cancer will be under local anaesthetic. This will make the skin go numb, so no pain should be felt during the procedure
The lesion is excised and sent to pathology for analysis.
The skin edges will then be sewn together to make a thin suture line.
There may be two layers of sutures (stitches) a layer underneath that is absorbable and a layer of sutures on the surface which will need to be removed in 7-14 days.
The excision is usually designed so that the resulting scar runs parallel with existing skin creases.
It is impossible to cut the skin without scarring in some way, so you will always have some sort of scar. Your dermatologist will try to excise the lesion in a way that will keep the scar to a minimum.
Some people have an abnormal response to skin healing and these people may get larger scars than usual (keloid or hypertrophic scarring).
Curette and Cautery
This treatment works well for early SCCs and superficial BCCs.
Under local anaesthetic the lesion is biopsied with a surgical blade, then scraped off with a curette (which is like a small spoon with very sharp edges) and then cauterised.
The treated area usually looks like a graze and takes 2-6 weeks to heal.
The wound can heal well with a flat or raised scar which is often permanently paler than the surrounding skin.
Superficial BCC
SCC
Aldara cream to treat superficial skin cancers (Imiquimod)
Aldara is a treatment option for some superficial BCCs and Bowen’s disease.
The skin cancer must be biopsied before Aldara is used. This is to confirm the type of skin cancer and the depth. If the cancer is deep then Aldara is not a suitable option.
Aldara is applied by the patient once or twice a day for 6-10 weeks depending on a number of factors.
Aldara mobilizes your own immune system to attack the skin cancer cells.
The reaction to this cream is variable but most people experience some redness and crusting.
The cure rate with Aldara is approximately 80%.
The cost is subsidized by medicare for superficial BCCs, so it is the price of a normal prescription($6-$35).
The cost is not subsidised for Bowens disease, approximately $120.
The cosmetic result of a skin cancer treated with Aldara is usually better than a surgical scar.
If Aldara is not effective then the skin cancer can be treated by other methods such as excision, curette and cautery, PDT, radiotherapy etc.
Treatment of Superficial BCCs with Aldara. Bowens Disease can also be treated with Aldara.
Efudix cream to treat Bowen’s disease (5 Fluorouracil)
Bowen’s disease (SCC in-situ) can be treated with Efudix cream.
Efudix cream is usually applied twice a day for 4-10 weeks to the skin cancer.
During treatment the area will become red and crusted.
Efudix cream has a high cure rate and excellent cosmetic result when treating Bowen’s disease.
Bowen’s Disease
Photodynamic therapy (PDT)
Photodynamic therapy (PDT) is treatment for superficial types of skin cancer. PDT is effective in treating solar keratoses, squamous cell carcinoma in situ (Bowen’s disease) and superficial basal cell carcinomas. It has a cure rate of approximately 80%.
PDT or photodynamic therapy is the application of a cream (which contains a chemical that is more selectively absorbed by abnormal cells in comparison to normal tissue) to the lesion to be treated. The chemical in the cream is then activated by exposure to a specific wavelength of light which destroys the abnormal cells leaving normal tissue unaffected. PDT can either be daylight activated or Lamp activated. Usually 2 treatments are given, 1 week apart.
Other non-surgical skin cancer treatments (Aldara and Efudix) are equally as effective as PDT.
PDT has 2 advantages , compared to Aldara and Efudix. The red crusted stage is of shorter duration 1-2 weeks, compared to Aldabra or Efudix, which maybe 4-10 weeks.
Also PDT usually has a better cosmetic outcome. Aldara may leave a large permanent white mark, whereas PDT usually does not.
The disadvantage of PDT is the expense, approximately $600
You can find our more on PDT or photodynamic therapy
Mohs’ Micrographic Surgery
This is a surgical technique for treating large, deep and recurrent skin cancers, as well as some skin cancers in difficult sites such as the eye and nose.
The skin cancer is surgically removed, colour coded and mapped to identify the location of any remaining cancer cells.
The skin cancer is examined under a microscope at the time of surgery.
Further sections will be taken if there is any skin cancer left.
The treatment is repeated until all the tumour is removed.
Your Dermatologist will organize for you to have Mohs Surgery if this is the most appropriate treatment for you.
You can find more on Mohs’ Micrographic Surgery here and Mohs’ Surgery Information
Radiotherapy
Radiotherapy for skin cancers is usually for patients over 60yrs, with large or difficult to treat tumours.
The advantage of radiotherapy for these tumours is that a skin graft or flap is avoided.
The treatment is painless and the patient does not feel sick or unwell.
The main disadvantage of radiotherapy treatment is that it requires attendance at the hospital 5 days a week for about 3 weeks.
Cure rates are high with radiotherapy.
The initial cosmetic result is excellent.
After 10 to 20 years a white or yellow scar develops in the area.
Your Dermatologist will organize for you to have radiotherapy if that is the most appropriate treatment for you.
Dermatologists
On an average day, Dermatologists find 10 to 20 skin cancers that may have otherwise gone undiagnosed.
Dermatologists are highly skilled and experienced in detecting and treating cancer and melanoma and accurately diagnosing and managing diseases of the skin, hair, and nail.
Drummoyne Dermatology provides facilities and support staff for independent Dermatologists who operate their businesses from this location.
We are proud to be
supporting world-class specialist care for patients with skin cancer and other skin diseases.
Book your Appointment from 8 am to 4:30 pm
Monday-Friday
Phones unattended 12:00 pm - 1:30 pm
