Therapies:

Cryotherapy

If your cancer is very small and only affecting the surface layers of the skin it may be possible to remove it by freezing it. This is called cryotherapy or cryosurgery. Liquid nitrogen is sprayed on to the cancer to freeze it. The cold can be a bit painful when the liquid nitrogen is applied (some patients describe the feeling as like a bee-sting).

After the treatment you may feel a sensation in the area like a burn. Within a day or so the area may blister. The blister may contain blood. Fluid may need to be drained from the blister using a sterile needle, but the top of the blister should be left intact. The treated area needs to be covered with a dressing until a scab forms. About a month after the treatment, the scab drops off and the tumour should have cleared. You may have a white scar in the area. Occasionally, more than one cryotherapy treatment is needed to get rid of the tumour completely.

Radiotherapy

Radiotherapy treats cancer by using high-energy rays which destroy the cancer cells while doing as little harm as possible to normal cells. It works well for skin cancers and is particularly useful in areas where surgery might be difficult or disfiguring (such as the face) and for tumours that have penetrated deeply into the skin.

The treatment is given in the hospital radiotherapy department. Often only a single treatment is needed but sometimes several doses of treatment are necessary, and these are given over a period of one or more weeks. Your doctor will discuss your individual treatment plan with you.
The radiographer watches on a closed circuit tv screen while the treatment is given
The radiographer watches on a closed circuit tv screen while the treatment is given

The radiographer watches on a closed-circuit TV screen while the treatment is given

The radiotherapy treatment affects only a small area of skin and will not make you feel unwell. For a week or two after treatment, the treated skin will be red and inflamed. During this time, it will look as though the treatment has made things worse rather than better. It is very important not to be worried by this - after a few weeks the area will dry up and form a crust or scab. Over another week or so, the scab will peel away, leaving healed new skin underneath. At first, the new skin will look pinker than the skin around it. This will gradually fade, and the treated area will come to look like the skin around it, although it can eventually be slightly paler.

Radiotherapy to areas that produce hair, such as the head, can cause hair loss in the treated area. The hair may grow back within 6–12 months, depending on the dose of radiotherapy and the length of treatment you have had. Some people find that the hair loss is permanent. Your clinical oncologist can discuss with you whether your hair is likely to grow back once the treatment has ended.

Radiotherapy does not make you radioactive and it is perfectly safe for you to be with other people, including children, throughout your treatment.

Chemotherapy

Chemotherapy is the use of anticancer (cytotoxic) drugs to destroy cancer cells. Chemotherapy is not often used to treat skin cancer. It may occasionally be used to treat carcinoma in situ or early-stage basal or squamous cell cancers.

If chemotherapy is used, it is usually applied directly to the skin cancer as a cream or lotion. The chemotherapy cream should be applied once or twice a day for three or four weeks, or as your doctor prescribes. If possible, a waterproof dressing should be put over the cream. The treatment makes the skin red and inflamed. Your doctor can prescribe a steroid cream to reduce the inflammation if it is too sore. The skin will take a week or two to heal after the treatment has finished. Until the area has healed you should keep it out of the sun, as sun exposure can make the inflammation worse. Usually there are no other side effects with this type of chemotherapy.

Occasionally chemotherapy for squamous cell cancer may be given in the rare situation where the cancer has spread to other parts of the body. The chemotherapy is given by injection (intravenously) so that the drugs are carried round the body in the blood and reach cancer cells wherever they are. It is generally given in the hospital outpatients department. How long the treatment takes to give, and how long the course of treatment will be, vary depending on the drugs that are being used.

Intravenous chemotherapy can cause unpleasant side effects. These can usually be well controlled with medicine. Common problems include feeling sick, hair loss, reduced resistance to infection and a sore mouth. The side effects will disappear once the treatment is over.

Photodynamic therapy

Photodynamic therapy (PDT) is a new treatment for several types of cancer, including skin cancer. PDT uses laser, or other light sources, combined with a light-sensitive drug (sometimes called a photosensitising agent) to destroy cancer cells.

A photosensitising cream will be applied to your skin. You will then need to wait for approximately four to six hours before being treated. Treatment with the light will last 20–45 minutes. Afterwards a dressing will be put on to cover the area and protect it from light. Usually only one treatment is needed, but occasionally two or three further treatments may be given.
Side effects of PDT for skin cancer

Pain You will be given a local anaesthetic before your PDT, to prevent any possible pain. For many people this is all that they will need. You may be given a tube of steroid cream to apply to the area if it becomes painful when you are at home.

Sensitivity to light The treated area of skin will be sensitive to daylight and bright, indoor lighting. This effect will probably last for about 24 hours. You will need to keep the treated area of skin covered during this time. After that you can wash, bathe or shower as usual, but you will still need to treat your skin gently and not rub the area until healing has occurred.
Healing

After PDT the skin normally heals quickly, and without scarring, so the appearance is usually very good.