The treatment for skin cancer usually involves some type of surgery. In some cases, doctors suggest radiation therapy or chemotherapy . Sometimes a combination of these methods is used.

Surgery
Many skin cancers can be cut from the skin quickly and easily. In fact, the cancer is sometimes completely removed at the time of the biopsy, and no future treatment is needed.

Curettage and Electrodesiccation
Doctors commonly use a type of surgery called curettage. After a local anesthetic numbs the area, the cancer is scooped out with a curette , an instrument with a sharp, spoon-shaped end. The area is also treated with electrodesiccation. An electric current from a special machine is used to control bleeding and kill the cancer cells remaining around the edge of the wound. Most patients develop a flat, white scar.

Moh's Surgery
Moh's Surgery is a special type of surgery used for skin cancer. Its purpose is to remove all the cancerous tissue and as little of the healthy tissue as possible. It is especially helpful when the doctor is not sure of the shape and depth of the tumor. In addition, this method is used to remove large tumors, those in hard-to-treat places, and cancers that have recurred. The patient is given a local anesthetic, and the cancer is shaved off one thin layer at a time Each layer is checked under a microscope until the entire tumor is removed. The degree of scaring depends on the location and size of the treated area. This method should only be used by doctors who are specially trained in this type of surgery.

Cryosurgery
Extreme cold may be used to treat precancerous skin conditions, such as actinic keratosis, as well as certain small skin cancers. In Cryosurgery liquid nitrogen is applied to the growth to freeze and kill the abnormal cells. After the area thaws, the dead tissue falls off. More than one freezing may be needed to remove the growth completely. Cryosurgery usually doesn't hurt, but patients may have pain and swelling after the area thaws. A white scar may form in the treated area.

Laser Therapy
Laser therapy uses a narrow beam of light to remove or destroy cancer cells. This approach is sometimes used for cancers that involve only the outer layer of skin.

Grafting
Sometimes, especially when a large cancer is removed, a skin graft is needed to close the wound and reduce the amount of scaring. For this procedure, the doctor takes a piece of healthy skin from another part of the body to replace the skin that was removed.

Radiation
Skin cancer responds well to radiation therapy (also called radiotherapy), which uses high-energy rays to damage cancer cells and stop them from growing. Doctors often use this treatment for cancers that occur in areas that are hard to treat with surgery. For example, radiation therapy might be used for cancers of the eyelid, the tip of the nose, or the ear. Several treatments may be needed to destroy all of the cancer cells. Radiation therapy may cause a rash or make the skin in the area dry or red. Changes in skin color and/or texture may develop after the treatment is over and may become more noticeable many years later.

Topical Chemotherapy
Topical chemotherapy is the use of anticancer drugs in a cream or lotion applied to the skin. Actinic keratosis can be treated effectively with the anticancer drug fluorouracil (also called 5-FU). This treatment is also useful for cancers limited to the top layer of skin. The 5-FU is applied daily for several weeks. Intense inflammation is common during treatment, but scars usually do not occur.

Clinical Trials
In clinical trials (research studies with patients), doctors are studying new treatments for skin cancer. For example, they are exploring the value of injecting interferon directly into the tumor. They are also testing photodynamic therapy, the use of the laser light and drugs that make the cancer cells sensitive to light so the laser can destroy them.

Followup Care
Even though most skin cancers are cured, people who have been treated for skin cancer have a higher-than-average risk of developing a new cancer of the skin. That's why it's so important to continue to examine themselves regularly, to visit their doctor for regular checkups, and to follow their doctor's instructions on how to reduce their risk of developing skin cancer again.

Skin cancer has a better prognosis, or outcome, than most other types of cancer; it is curable in over 95 percent of cases. But any diagnosis of cancer can be frightening, and it's natural to have concerns about medical tests, treatments, and doctors' bills.

Patients have many important questions to ask about cancer, and their doctor is the best person to provide answers. Most people want to know exactly what kind of cancer they have, how it can be treated, and how successful the treatment is likely to be. The following are some other questions that patients might want to ask their doctor:

• What types of treatments are available?
• Are there any risks or side effects of treatment?
• Will there be a scar?
• Will I have to change my normal activities?
• How can I protect myself from getting skin cancer again?
• How often are checkups needed?

Some patients become concerned that treatment may change their appearance, especially if the skin cancer is on their face. Patients should discuss this important concern with their doctor. And they may want to have a second opinion before treatment (see Treatment
Planning ).

Scientists at hospitals and research centers are studying the causes of skin cancer and looking for new ways to prevent the disease. They are also exploring ways to improve treatment.

When laboratory research shows that a new prevention or treatment method has promise, doctors use it with people in clinical trials. These trials are designed to answer scientific questions and to find out whether the new approach is both safe and effective. People who take part in clinical trials make an important contribution to medical science and many have the first chance to benefit from improved methods.

People interested in taking part in a trial should discuss the option with their doctor. What are clinical trials all about? is an NCI booklet that explains some of the possible benefits and risks of such studies.

One way to learn about clinical trials is through PDQ, a computerized resource developed by NCI. PDQ contains information about cancer treatment and an up-to-date list of trials all over the country. The Cancer Information Service can provide PDQ information to doctors, patients, and the public.