Surgical
Treatment of Skin Cancer
- Cryosurgery
- Very cold! (-321°F or -196°C)
- Treatment of choice for individual pre-cancers
- Applied with a spray gun or cotton tipped applicator
- A burning or "frostbite" sensation is felt
- Treated areas turn red, swollen, and sometimes blister during
healing
- Curettage with electrodessication
- Precancerous lesions are scraped away with a curette
- Then the area is cauterized with an electric needle to control
bleeding and kill any remaining cancerous cells
- Photodynamic therapy
- A light-sensitizing solution is applied to the skin and allowed
to absorb over several hours
- Chemical is selectively absorbed by the abnormal cells
- An activating light is shined on the patient, causing destruction
of the abnormal cells
- Burning sensation is experienced
- Lesions turn red and crusty
- Patients must avoid any sun exposure after treatment, as their
skin is still light sensitive
- Mohs micrographic surgery
- Technique of surgery that has the highest five-year cure rates
for surgical treatment of both primary (96 %) and recurrent (90
%) skin cancers
- Removes all of the cancerous tissue and as little of the healthy
tissue as possible to minimize scaring and maximize cosmetic outcome
- The cancer is shaved off one thin layer at a time. Each layer
is checked under a microscope until the entire tumor is removed
- This method should be used only by physicians who are specially
trained in this type of surgery
- More detail on Mohs
micrographic surgery
| Invasive SCC |
MMS or excision |
| Aggressive histology |
MMS or excision |
| Perineural SCC |
MMS or excision followed
by Radiotherapy |
| High risk anatomical
site |
MMS or excision |
Large tumor
|
MMS or excision |
| Recurrent Cancer |
MMS or excision
|
| In-transit metastases |
Excision, Radiotherapy,
Oral retinoids, Reduction of immunosuppressions |
Table 5: Management of High Risk Squamous Cell Carcinoma in Transplant
Recipients (4, 5)
SCC = squamous cell carcinoma
MMS = Mohs Micrographic surgery
References:
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3. J.-C. Martinez et al., Arch Dermatol 139, 301 (March 1, 2003, 2003).
4. P. Jensen et al., J Am Acad Dermatol 40, 177 (Feb, 1999).
5. P. O'Donovan et al., Science 309, 1871 (Sep 16, 2005).
6. J. D. Wagner et al., Arch Dermatol 140, 75 (Jan, 2004).
7. T. Stasko et al., Dermatol Surg 30, 642 (Apr, 2004).
8. M. T. Ballo, K. K. Ang, Oncology (Williston Park) 18, 99 (Jan, 2004).
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Dermatol Surg 30, 679 (Apr, 2004).
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2004).
12. C. Traywick, F. M. Reilly, Dermatologic Therapy 18, 12 (2005).
13. I. M. Neuhaus, W. D. Tope, Dermatol Ther 18, 28 (Jan-Feb, 2005).
14. G. Stallone et al., N Engl J Med 352, 1317 (Mar 31, 2005).
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