Treating Non-Melanoma Skin Cancer

  • David Cohan, MD, performs an operation. Surgery is almost always the primary treatment for skin cancer.

More Options, Better Outcomes

Our Roswell Park skin cancer team will assess and plan the best treatment strategy for your skin cancer. Your individualized plan may include one or more of the following therapies:

Surgery

Removing the cancer surgically is almost always the primary treatment for skin cancer. If your cancer was removed entirely during your biopsy, further treatment may not be necessary. For cancers that have not spread beyond the epidermis, surgery alone may be curative. Surgical removal of skin cancer may involve:

  • Excisional skin surgery: Surgery to remove the cancer along with some surrounding healthy tissue, leaving the margins (bordering tissue) free from cancer. If necessary, surgeons repair the surgery site with a skin graft, using healthy skin tissue taken from another part of your body. 
  • Mohs micrographic surgery (or Mohs surgery): A specialized technique in which one skin layer at a time is shaved away and examined under a microscope until no cancer remains. This reduces the amount of healthy tissue that’s removed. 
  • Electrodessication and curettage: The cancer is removed with a sharp, spoon-shaped instrument called a curette and a needled-shaped probe delivers electric current to the area to stop bleeding and kill any remaining cancer cells. 
  • Cryosurgery: Liquid nitrogen is applied directly to the cancer to freeze it and kill the cancer cells.
  • Lymphadenectomy: Surgery to remove one or more lymph nodes in the tumor area. Nodes are then examined for cancer by the Pathology Department.
  • Plastic and reconstructive surgery: Surgery to restore or improve the appearance and/or function of body structures.

Medicines

Chemotherapy refers to therapy that uses medicine to treat the cancer and different drugs attack your cancer in various ways. Chemotherapy may be given before and/or after surgery. 

Systemic chemotherapy: uses anticancer drugs that are taken orally, injected or given intravenously. The drugs enter the bloodstream and circulate the body, attacking cancer cells by preventing them from multiplying. Systemic chemotherapy may be recommended for Kaposi’s sarcoma and Merkel cell carcinoma.

For many basal and squamous cell cancers and for Bowen’s disease, the drugs may be applied directly to the skin or tumor in a cream or lotion form. These include:

Photodynamic Therapy

Photodynamic Therapy (PDT), a non-surgical treatment, was pioneered here at Roswell Park. It involves taking a photosensitizing drug (may be in a cream that’s applied to the skin or injected intravenously) and exposing the cancer cells to a special kind of light. The photosensitizing agent, called porfimer sodium, concentrates in the cancer cells and when exposed to a specific wavelength of light, the cancer cells absorb the light, and produce an active form of oxygen that kills the cancer cells. Side effects are usually not serious and may include burning or stinging pain. You will also have to avoid direct sunlight and bright lights for about 6 weeks. Learn more by reading the National Cancer Institute's Fact Sheet on Photodynamic Therapy for Cancer.

Roswell Park researchers are currently developing new photosensitizing agents that work better and have even fewer side effects than porfimer sodium. 

Radiation Therapy

Also called radiotherapy, this treatment directs high-energy radiation at the cancer cells to kill them or to keep them from growing.

  • External radiation: uses a machine outside the body to direct radiation to the cancer
  • Internal radiation: uses a radioactive substance sealed in seeds, needles, wires or catheters that are placed directly in or near the tumor site
  • Palliative radiation: goal of radiation is to relieve symptoms and improve quality of life

Your treatment plan may include radiation therapy if your skin cancer:

  • Is located in a place where surgical treatment would result in excessive scarring
  • Is located on the eyelid, ear or nose
  • Cannot be removed completely with surgery
  • Has spread to lymph nodes