Multi-disciplinary teams (MDTs) are necessry for the treatment of skin cancer. An MDT is made up of a number of different specialists including:

• a dermatologist (skin specialist),
• a plastic surgeon ,
• a clinical oncologist (a specialist in the non-surgical treatment of cancer using techniques such as radiotherapy and chemotherapy),
• a pathologist (a specialist in diseased tissue),
• a social worker ,
• a psychologist , and
• a counselor .

If you have skin cancer, you may see several, or all, of these professionals as part of your treatment.

Deciding what treatment is best for you can often be confusing. Your cancer team will recommend what they think is the best treatment option, but the decision will be yours.

Before visiting hospital to discuss your treatment options, you may find it useful to write a list of questions that you would like to ask the specialist. For example, you may want to find out what the advantages and disadvantages of particular treatments are.

The type of treatment you will receive will depend on the type, location and progression of your skin cancer. The different treatment options are outlined below.

Surgical excision

Surgical excision is where the surgeon cuts out the cancerous tissue, as well as some surrounding healthy tissue (this is done to ensure that no cancerous cells remain in the skin).

If a surgical excision is likely to leave significant scarring, it may be done in combination with a skin graft. A skin graft involves removing a patch of healthy skin which will usually be taken from a part of your body where any scarring cannot be seen, such as your back. It is then connected, or grafted, to the affected area.

Curettage and electrocautery

Curettage and electrocautery is a similar technique to surgical exclusion, but it is only suitable for cases where the affected area of tissue is quite small. The surgeon will use a small, spoon-shaped blade to remove the tumor, and then an electric needle will be used to kill the cells surrounding the wound to ensure that any remaining cancerous cells are removed. The procedure may need to be repeated two or three times, to ensure that the cancer is completely removed.

Radiation therapy

Radiation therapy is often used to treat basal cell and squamous cell carcinomas in cases where surgical excision would leave an unacceptable level of disfigurement - for example, where tumors are present on the face.

Radiation therapy involves using low doses of radiation to destroy the cancerous cells. The level of radiation involved is perfectly safe but, afterwards, your skin may feel sore for a few weeks.

Radiation therapy is also sometimes used after surgical excision to ensure that the cancer does not return.

Cryotherapy

Cryotherapy is sometimes used to treat skin cancers that are in their early stages. The technique uses liquid nitrogen to freeze the affected tissue which causes the area to scab over.

After about a month, the scab, containing all the cancerous cells, falls off the skin. The treatment may leave a small white scar on the skin.

Mohs' surgery

Mohs' surgery is used to treat skin cancer when it is felt that there is a high risk of the cancer spreading, or returning. It involves removing the tumor piece by piece, so that each piece can be checked immediately for the presence of cancerous cells.

The benefit of this approach is that it minimizes the removal of healthy tissue and therefore reduces any scarring. It is also a good way of ensuring that the cancer will not spread to other areas of your body.

Chemotherapy

Chemotherapy involves using medicines to kill cancerous cells. In the case of skin cancer, chemotherapy is only recommended when the tumor is contained within the top layer of the skin.

This type of chemotherapy involves applying a cream, containing cancer-killing medicines, to the affected area. As only the surface of the skin is affected, you will not experience the side effects associated with other forms of chemotherapy, such as vomiting, or hair loss. However, afterwards, your skin may feel sore for several weeks.

Photodynamic therapy (PDT)

Photodynamic therapy (PDT) is a relatively new treatment of basal cell carcinoma. It involves using a special cream containing a medicine known as 5- aminolaevulinic acid (5-ALA). 5-ALA makes the skin very sensitive to light.

After the cream has been applied, a strong light source is shone on the affected area of your skin which kills the cancerous cells. PDT may cause a burning sensation and around 2% of people will be left with some superficial scarring.