Treatment & Procedures
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The treatment your physician recommends is based on information about the type of tumor you have and how far it has spread, which is reflected in the “stage” of the tumor. The staging system for skin cancer starts with stage 0 (carcinoma in situ), in which abnormal cells are confined to the topmost layer of the skin, and goes to stage 4, where the cancer has spread (metastasized) through the blood and lymph nodes to other parts of the body, such as the lung, liver or brain.
Surgical removal is the most common treatment for the majority of melanomas, and this approach usually cures early-stage disease. The surgical options include the following:
- Wide excision is a fairly minor surgery performed with local anesthesia that cures most thin melanomas. It involves cutting out the tumor and a small amount of non-cancerous skin at the edges.
- Lymph node dissection is done to remove all the lymph nodes in the region near the primary melanoma when the cancer has spread.
- Surgery for metastatic melanoma is indicated if the melanoma has spread from the skin to distant organs such as the lungs or brain. The aim of the surgery is to remove some of the tumors and try to control, rather than cure, the cancer.
These surgical approaches as well as others are also used for patients with basal cell and squamous cell skin cancers.
Learn more about surgery, including the roles that different surgical approaches have in preventing, diagnosing and treating cancer.
Immunotherapy involves use of drugs to stimulate a patient’s own immune system to recognize and destroy cancer cells more effectively. Numerous types of immunotherapy can be used to treat skin cancer, either alone or in combination with other treatments.
Some immunotherapy treatments are given as intravenous infusions, whereas others are injected directly into the tumor or applied as a cream. With all immunotherapy treatments, your healthcare team will discuss the rationale for this approach and its
potential side effects and their prevention and management.
Learn more about immunotherapy treatment offered at Houston Methodist.
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Chemotherapy can be used to treat advanced melanoma, but immunotherapy and targeted therapy are generally preferred methods. Chemotherapy is usually not as effective in treating melanoma as it is in treating other types of cancer, but it may relieve symptoms or extend survival for some patients. If chemotherapy is part of your treatment plan, your care team will discuss the medications, any side effects and the ways in which you and your family will be supported during your treatment.
Learn more about chemotherapy treatment, including how it works within your body and what to expect while undergoing treatment.
Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. Many different types of radiation can be employed, depending on the size and location of the tumor.
In patients with skin cancer, radiation therapy is used primarily in three settings:
- After surgery to reduce the chance that the cancer will recur.
- In the event of recurrence, either in the skin or lymph nodes
- To relieve symptoms when melanoma spreads, especially to the brain or bones
Learn more about the variety of innovative radiation therapies offered at Houston Methodist.
Targeted therapy is a newer type of treatment for skin cancer that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. One common advantage of targeted therapy over chemotherapy is that the targeted drugs are associated with less severe side effects and can be taken orally.
Targeted therapies used in the treatment of skin cancer include multiple drugs that target two genes:
- BRAF gene: About half of all melanomas contain a mutation in the BRAF gene, which can be targeted by a variety of drugs.
- C-KIT gene: A small portion of melanoma tumors have mutations in the C-KIT gene, which can be targeted by several drugs.
Clinical trials are in progress with the aim of improving present and future care for patients with melanoma and other types of skin cancer. Learn about our current cancer-related clinical trials.