Surgery (an operation) is the main treatment for non-melanoma skin cancer. Your doctor will remove the cancer and some of the normal-looking skin around it.
Other treatments for non-melanoma skin cancer include:
- freezing (cryotherapy)
- chemotherapy
- immunotherapy
- targeted therapy
- radiotherapy
- light treatment called photodynamic therapy (PDT)
Your treatment will depend on:
- the type of cancer you have
- the stage of the cancer (its size and if it has spread)
- your general health
Your doctors will talk to you about the treatment options to help make the best decision.
Chemotherapy given into a vein (intravenous chemotherapy) is rarely used to treat non-melanoma skin cancer.
How well treatment works
Treatment for non-melanoma skin cancer is usually successful.
Treatment cures at least 9 out of 10 cases of non-melanoma skin cancer.
The risk that the cancer will spread to other parts of your body is lower than most other types of cancer.
Basal cell carcinoma (BCC) usually does not spread to other parts of your body.
There is a slightly higher risk of squamous cell carcinoma (SCC) spreading. If it spreads, SCC may be found in the lymph nodes or other parts of your body.
Surgery
In most cases, surgery is enough to cure non-melanoma skin cancer.
Excision is surgery to remove the cancer. The surgeon will also remove some normal-looking skin around it.
Sometimes you will need a skin graft to help close the wound.
A skin graft is where the surgeon takes a patch of healthy skin from another part of your body. They place it on the wound to help it heal.
A flap is when the surgeon moves some nearby skin into the wound to help it heal. Your surgeon will discuss which option is best for you.
Mohs micrographic surgery
Mohs micrographic surgery is a specialised type of surgery.
This is where the surgeon removes the cancer and a small area of surrounding skin.
The edges are immediately checked under a microscope. If there are still cancer cells, you have more surgery. This is usually done on the same day.
This process is repeated until there are no more cancer cells.
The advantages of Mohs surgery include:
- the least amount of healthy skin is removed
- the cancer is fully removed
- a lower risk of it coming back
- a smaller scar
Curettage and cautery
Curettage and cautery is only suitable if the cancer is small and low risk.
The surgeon will use a small blade to scrape off the cancer. They will then burn (cauterise) the skin to remove any remaining cancer cells and seal the wound. They may need to do this 2 or 3 times. This is to make sure all the cancer is gone.
Cryotherapy
Cryotherapy is only used for small low-risk skin cancers.
Cryotherapy uses liquid nitrogen to freeze the cancer. This causes the area to blister and scab over. After about a month, the scab containing the cancer will fall off. Cryotherapy may leave a small white scar on your skin.
Cancer medicines
Your care team may recommend treatment with cancer medicines. These will be to either kill or slow the growth of cancer cells.
Chemotherapy
Chemotherapy uses medicines to kill cancer cells.
It is also known as cytotoxic chemotherapy or cytotoxic cancer medicine. Cytotoxic means toxic to cells.
Chemotherapy cream
If your cancer only affects the top layer of your skin your care team may recommend you use a chemotherapy cream.
Immunotherapy
Immunotherapy medicines can either:
- use your immune system to find and kill cancer cells
- boost your immune system and help it work better to fight cancer cells
You may have tests to check if immunotherapy is likely to work for you. These are called biomarker tests.
Targeted therapy
Targeted therapy uses medicines to find and attack cancer cells.
Targeted therapy medicines target parts of cancer cells that have gene changes (mutations) that make them different from normal cells.
You will only be offered targeted therapy if your cancer has these gene changes.
You may have tests to check if targeted therapy is likely to work for you. These are called biomarker tests.
Photodynamic therapy (PDT)
This cream makes your skin sensitive to light. About 3 to 4 hours after it is applied, your doctor or nurse shines a strong light source onto the affected area. This kills the cancer.
In summer months, sunlight may be used instead of the light source.
PDT may cause a burning sensation. It may also leave a scar, but not as much as with surgery.
Radiotherapy
Radiotherapy involves using low doses of radiation to kill the cancer cells. Your skin may feel sore for a few weeks after radiotherapy.
Sometimes you will have radiotherapy after excision. This is called adjuvant radiotherapy. It can help stop the cancer coming back.
After you finish your treatment
If you had non-melanoma skin cancer, you have a higher risk of developing another. It's important to protect your skin and check it regularly.
Content supplied by the NHS and adapted for Ireland by the HSE
