Skin Cancer (Non-Melanoma)

This section outlines treatments that are the standard of care (best proven treatments available) for this specific type of cancer. When making treatment plan decisions, patients are also encouraged to consider clinical trials as an option. A clinical trial is a research study to test a new treatment to evaluate whether it is safe, effective, and possibly better than standard treatment. Your doctor can help you review all treatment options. For more information, see the Clinical Trials and Current Research sections.

Treatment overview

In cancer care, different types of doctors often work together to create a patient's overall treatment plan that combines different types of treatments. This is called a multidisciplinary team.

Descriptions of the most common treatment options for skin cancer are listed below. Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, and the patient's preferences and overall health. Learn more about making treatment decisions.

Surgery

Surgery is the removal of the tumor and surrounding tissue during a medical procedure. Many skin cancers can be removed from the skin quickly and easily in a simple surgical procedure, and often no further treatment is needed. Most of these surgical procedures use a local anesthetic to numb the skin and can be done outside of a hospital by a dermatologist (a doctor who specializes in diseases and conditions of the skin), general surgeon, plastic surgeon, nurse practitioner, or physician assistant. Different types of surgical procedures are used depending on the size of the cancer and where it is located.

Curettage and electrodessication. In this common procedure, the cancer is removed with a curette, which is a sharp, spoon-shaped instrument. The area can then be treated with electrodessication, which uses an electric current to control bleeding and kill any remaining cancer cells. Many people have a flat, pale scar after this procedure.

Mohs surgery. This technique involves removing the visible tumor, in addition to small fragments of the edge around the area where the tumor existed. Each small fragment is examined under a microscope until all cancer is removed. This is typically used for larger tumors, those in hard to reach places, and for cancers that have come back in the same place.

Freezing. Used most often on precancerous skin conditions, this procedure (called cryosurgery) uses liquid nitrogen to freeze and kill cells. The skin will later blister and shed off. This procedure will sometimes leave a pale scar. More than one freezing may be needed.

Laser therapy. A narrow beam of high-intensity light can destroy precancer that is located only in the outer layer of the skin.

Grafting. When a large tumor is removed, surgeons may use skin from another part of the body to both close the wound and reduce scarring.

Reconstructive surgery. Since skin cancer often occurs on a person's face, a reconstructive (plastic) surgeon or facial specialist may be part of your health care team. Before surgery begins, talk with your doctors about whether changes to your appearance are likely.

Learn more about cancer surgery.

Radiation therapy

Radiation therapy is the use of high-energy rays or other particles to kill cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. Radiation therapy may be used for skin cancer that is hard to treat with surgery, such as skin cancer that appears on the eyelid, tip of the nose, and ear; several treatments may be needed. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. A radiation therapy regimen (schedule) usually consists of a specific number of treatments given over a set period of time.

The side effects from radiation therapy may include a rash, dry or red skin, or a change in the color of the skin. Most side effects go away soon after treatment is finished. Learn more about radiation therapy.

Topical chemotherapy

Chemotherapy is the use of drugs to kill cancer cells, usually by stopping the cancer cells' ability to grow and divide. For cancers located only on the top layer of the skin or to treat precancerous skin conditions, doctors may prescribe chemotherapy in a cream or lotion. These drugs are usually applied daily for several weeks. They may cause inflammation, which goes away once treatment is finished.

In addition to the topical chemotherapy that has been used for many years, some doctors are using imiquimod (Aldara), a topical immune response modifier, to treat early basal cell carcinomas, actinic keratoses (a precancer to squamous cell carcinoma), and very thin squamous cell carcinoma. Imiquimod is applied several times a week.

Learn more about chemotherapy and preparing for treatment. The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions by using searchable drug databases.

Recurrent skin cancer

Once your treatment is complete, talk with your doctor about the possibility of the cancer returning. Many people with one skin cancer later develop another skin cancer.

Sometimes, people feel worried or anxious about the possibility that the cancer will come back. Learn more about coping with this fear.

If the skin cancer does return after the original treatment, it is called recurrent cancer. It may come back in the same place (called a local recurrence), nearby (regional recurrence), or in another place (distant recurrence).

When this occurs, a cycle of testing will begin again to learn as much as possible about the recurrence. After testing is done, you and your doctor will talk about your treatment options.

People with recurrent cancer often experience emotions such as fear. Patients are encouraged to talk with their health care team about these feelings and ask about support services to help them cope. Learn more about dealing with cancer recurrence.

Metastatic skin cancer

In rare cases, non-melanoma skin cancer can grow deeper into the skin and can spread to other parts of the body. If cancer has spread to another location in the body, it is called metastatic cancer. Sites of a chronic inflammatory skin condition, mucous membranes (skin that lines the mouth, nose, anus, and a woman's vagina), and the lips are most susceptible to squamous cell cancer.

Patients with this diagnosis are encouraged to talk with doctors who are experienced in treating this stage of cancer, because there can be different opinions about the best treatment plan. Learn more about seeking a second opinion before starting treatment, so you are comfortable with the treatment plan chosen. This discussion may include clinical trials studying new treatments.

Surgery alone is not effective to treat skin cancer that has metastasized. To control this distant spread, a person's health care team may recommend chemotherapy, radiation therapy, or immunotherapy. Immunotherapy (also called biologic therapy) is designed to boost the body's natural defenses to fight the cancer. It uses materials made either by the body or in a laboratory to bolster, target, or restore immune system function.

In addition to treatment to slow, stop, or eliminate the cancer (also called disease-directed treatment), an important part of metastatic cancer care is relieving a person's symptoms and side effects. It includes supporting the patient with his or her physical, emotional, and social needs, an approach called palliative or supportive care. People often receive disease-directed therapy and treatment to ease symptoms at the same time.

If disease-directed treatment is not successful, this may also be called advanced cancer. This diagnosis is stressful, and it may be difficult to discuss. However, it is important to have open and honest conversations with your doctor and health care team to express your feelings, preferences, and concerns. The health care team is there to help, and many team members have special skills, experience, and knowledge to support patients and their families. Learn more about advanced cancer care planning.

Find out more about common terms used during cancer treatment.