Skin cancers can be either melanoma or non-melanoma skin cancers. The vast majority of deaths from skin cancer are from melanoma. The two main types of non-melanoma skin cancers are basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs). Non-melanoma skin cancers are found more commonly on sun exposed areas such as the face or forearms.
In choosing the best treatment option, your doctor will consider your age and general health, the type and size of skin cancer you have, where it is on your body and what you want. The treatment choice will also depend on whether the skin cancer has spread elsewhere in your body. BCCs do not spread to distant parts of the body but can invade into local tissues. SCCs occasionally spread to nearby lymph nodes and beyond, but melanomas cause the majority of deaths because of their ability to spread, known as metastasising.
The initial treatment usually is to cut out a skin lesion suspicious as being cancer. This may be a biopsy (a removal of a small sample of the lesion for analysis) or a full excision (removal), freezing or scraping the lesion.
If a lesion is suspected of being a melanoma, a ‘wide excision’ is done to ensure all the cancer is removed and to reduce the risk of the cancer spreading. A wide excision means removing the melanoma as well as a small amount of surrounding normal-looking skin around it.
After a skin cancer is removed, most people will have stitches to repair the wound but when large skin cancers are removed, the wound may require skin from other parts of the body to cover it. This can be done using a skin flap (nearby skin moved over the wound and stitched) or a skin graft (skin is taken from elsewhere in the body and placed onto the area).
Other treatments for non-melanoma skin cancers will depend on the type, size and location of the skin cancer. They include:
- cryotherapy: liquid nitrogen is sprayed onto the spot and a small amount of normal skin around it, to treat, freeze and kill cancer cells in superficial BCCs
- immunotherapy and chemotherapy creams and lotions: where cream is directly applied to treat skin cancers that affect the top layer of the skin
- curettage and cautery: where a doctor gently removes the cancer with a sharp tool, and uses and low-level electric current to stop bleeding and destroy any remaining cancer
- photodynamic therapy: uses a light source and cream to treat superficial BCCs
Other treatment options for skin cancers that have spread or may have spread to other parts of the body include:
- surgery (such as removal of lymph nodes)
- radiotherapy - the use of x-rays to kill cancer cells
- targeted therapy - drugs that attack the genes of the melanoma cells
- immunotherapy - drugs that stimulate the body's immune system to fight cancer
- chemotherapy - generally chemotherapy drugs have not been effective in treating melanoma but may be used in some cases
Last reviewed: July 2018