Treatment for skin cancer
More than 90% of people with basal cell and squamous cell cancers are cured with treatment.
There is a variety of treatments for skin cancer – the options offered to you will depend on several factors including the size of the skin cancer, where it is on your body and your biopsy results.
Monitoring Your specialist may want to keep an eye on the changes to your skin rather than give treatment immediately.
Surgery This is an important treatment for many skin cancers. It can be done in a variety of ways.
Cryotherapy This destroys cancer cells by using liquid nitrogen to freeze them. It’s a very quick way of treating small, low-risk skin cancers such as superficial basal cell carcinomas.
Radiotherapy This may be used instead of surgery. It can be a very effective treatment for basal and squamous cell carcinomas. Radiotherapy may be given after surgery if there’s a risk that some cancer cells may still be present. Sometimes it’s used for tumours that have grown into the deeper layers of the skin.
Photodynamic therapy (PDT) PDT uses light sources, combined with a light-sensitive drug (sometimes called a photosensitising agent), to destroy cancer cells.
Topical chemotherapy A chemotherapy cream containing a drug called 5FU (Efudix®) can be used to treat some early squamous cell carcinomas and superficial basal cell carcinomas.
Topical immunotherapy A cream called imiquimod (Aldara®) can be used to treat some basal cell carcinomas and squamous cell carcinomas.
How treatment is planned
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In most hospitals a team of specialists will talk to you about the treatment they feel is best for your situation. This multidisciplinary team (MDT) will include:
oncologists (chemotherapy, immunotherapy and radiotherapy specialists)
dermatologists (skin disease specialists)
pathologists (who advise on the type and extent of the skin cancer by examining tissue under a microscope)
skin cancer specialist nurses
counsellors and psychologists.
The MDT will take a number of factors into account when advising you on the best course of action, including your age, general health, any medication you are taking, the type and size of the cancer, where it is on your body and what the cells look like under a microscope.
You may be asked if you’d like to take part in a clinical trial.
Discussing your treatment
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If you have any questions about your treatment, don’t be afraid to ask your doctor or nurse. It often helps to make a list of questions and to take a relative or close friend with you. They can remind you of questions you want to ask and help you remember what was said. You can use the form on page 50 to write down your questions and the answers you receive.
Before you have any treatment, your doctor will explain its aims. They will usually ask you to sign a form saying that you give permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you are asked to sign the form you should be given full information about:
the type and extent of the treatment
its advantages and disadvantages
any significant risks or side effects
any other treatments that may be available.
If you don’t understand what you’ve been told, let the staff know straight away, so they can explain again. Some cancer treatments are complex, so it’s not unusual for people to need repeated explanations.
It’s a good idea to have a relative or friend with you when the treatment is explained, to help you remember the discussion. You may also find it useful to write a list of questions before your appointment.
People sometimes feel that hospital staff are too busy to answer their questions, but it’s important for you to know how the treatment is likely to affect you. The staff should be willing to make time for your questions.
You can always ask for more time if you feel that you can’t make a decision when your treatment is first explained to you.
You are also free to choose not to have the treatment. The staff can explain what may happen if you don’t have it. It’s essential to tell a doctor, or the nurse in charge, so they can record your decision in your medical notes. You don’t have to give a reason for not wanting treatment, but it can help to let the staff know your concerns so they can give you the best advice.
Your MDT uses national treatment guidelines to decide the most suitable treatment for you. Even so, you may want another medical opinion. If you feel it will be helpful, you can ask either your specialist or GP to refer you to another specialist for a second opinion. Getting a second opinion may delay the start of your treatment, so you and your doctor need to be confident that it will give you useful information.
If you do go for a second opinion, it may be a good idea to take a relative or friend with you, and have a list of questions ready, so that you can make sure your concerns are covered during the discussion.