Diagnosing skin cancer in the early stages is imperative to expand treatment options. In the case of pre-cancerous lesions and less-dangerous skin malignancies, such as basal and squamous cell carcinomas, there are treatment options that can minimize scars while possibly curing cancer.
Cryotherapy is the process of freezing pre-cancerous or cancerous lesions in the early stages. Liquid nitrogen is applied directly to the area in several freeze-thaw cycles. In the coming days, the area will react similar to frostbite and eventually scab over. The procedure is frequently used for actinic keratosis growths, which are considered pre-cancerous lesions because they may eventually turn into squamous cell skin cancer. Cryotherapy may need to be repeated several times before the lesion is completely destroyed. In some cases, cryotherapy may be used for early-stage basal or squamous cell cancers when they are on the surface of the skin.
Small, superficial lesions of basal or squamous cell carcinoma may be treated with topical chemotherapy. This can be used to minimize damage to healthy skin that surrounds the lesion, especially when removing the lesion would be difficult to do without causing significant cosmetic damage. The chemotherapy is usually applied in the form of a cream and may need to be used for several weeks to completely eliminate cancerous cells. Since topical chemotherapy cannot reach deep under the skin, there is the possibility that some cancer cells may be too deep to be affected by the topical chemotherapy. In this case, other methods of removing the lesion will need to be performed.
When excision of a cancerous lesion is necessary, Mohs surgery has numerous benefits over traditional excision techniques. Since Mohs is a precise and time-consuming procedure, it can have a better cosmetic result than routine skin cancer excisions. In traditional excision techniques, the lesion is removed with a blade or through a punch biopsy. The doctor may create a large excision in hopes that all the cancer has been removed. Whether all the margins are clear or not cannot be confirmed until the sample is sent for pathology. In many cases, healthy tissue is removed in hope of achieving clear margins.
With Mohs surgery, the excision and pathology are done at the same time. The lesion is removed while sparing the surrounding tissue. After the excision, the sample is immediately prepared and viewed under the microscope to check for clear margins. If the margins are not clear, more tissue can be removed. Mohs surgery is especially useful to preserve as much healthy skin as possible on the face or other highly visible areas.
Although removing and curing skin cancer is the priority, reducing disfigurement can also be important. With many techniques to treat basal and squamous cell skin cancers, there are options to minimize the cosmetic impact.