When you come to Siteman for the treatment of skin cancer, you will be treated as the unique person you are. You will receive a care plan designed for your specific cancer, but also for you: for your age, your lifestyle, and your goals.
Your treatment will depend on the type of skin cancer you have. Basal cell, squamous cell carcinoma, and less aggressive cancers don’t require as much treatment as more aggressive cancers, like melanoma.
No matter what type of cancer you have and what you’re coping with, Siteman is here for you. In addition to your WashU Medicine physicians, our experienced nurses, therapists, social workers, and other professionals are here to address your needs.
Cancer is a challenging disease. When you come to Siteman, you and your loved ones will have our full support.
Treatments for Basal Cell and Squamous Cell Carcinoma
Treatment for basal cell and squamous cell carcinoma usually begins with surgery. Depending on the extent of the cancer, you may also receive radiation therapy, chemotherapy, photodynamic therapy, and immunotherapy.
Types of surgery for basal cell and squamous cell carcinoma
- Simple tumor removal (simple excision): The surgeon cuts the tumor from the skin along with some of the normal skin around it.
- Tumor removal with electric current (electrodesiccation and curettage): The surgeon cuts the tumor from the skin with a curette (a sharp, spoon-shaped tool). Then, the surgeon uses a needle-shaped electrode to treat the area with an electric current. This stops the bleeding and destroys skin cancer cells that remain around the edge of the wound:
- Mohs microscopic surgery: This procedure usually treats tumors on the face. It involves cutting the tumor from the skin in thin layers, removing as little normal tissue as possible.
Radiation Therapy for Basal Cell and Squamous Cell Carcinoma
Radiation therapy can be a good option for large basal cell or squamous cell carcinomas. We also use it for cancers on an area of the body that is difficult to treat.
During radiation therapy, experienced technicians aim high-energy particles at the cancerous spot. This kills the cancer cells.
Other treatments for basal cell and squamous cell skin cancer
You may need more treatment after surgery and radiation therapy. This might include:
- Topical chemotherapy: To make sure no cancer cells are left behind, doctors may prescribe topical chemotherapy. This is applied to the skin as a cream or a lotion.
- Photodynamic therapy: This cancer treatment uses a drug and a certain type of laser light to kill cancer cells. It is a way of killing cancer cells without damaging healthy tissue.
- Immunotherapy: Also called biologic therapy, these drugs use your immune system to fight the cancer.
Treatments for Melanoma
Melanoma can be a very serious disease, depending on where it is located and if it has spread. Patients who come to Siteman can be confident that we will work to cure your cancer or control it like a chronic illness.
Thanks to new drugs and clinical trials, patients with melanoma have more treatment options than ever. WashU Medicine physicians at Siteman are driving these developments for patients with skin cancer.
Surgery for Melanoma
Surgical procedures to treat melanoma include:
- Removal of the tumor (wide local excision): Surgery to remove the tumor is the primary treatment of all stages of melanoma. A wide local excision is used to remove the melanoma and some of the normal tissue around it.
- Lymph node biopsies (lymph node sampling): Melanoma can spread to other areas of the body. Your doctors may biopsy lymph nodes that are large or close to the melanoma. This is called the “sentinel” lymph node.”
- Lymph node removal (lymphadenectomy): If there are cancer cells in the lymph nodes, the cancer may have spread. This means your physician will remove more lymph nodes and check tissue samples for signs of cancer.
Drug Therapy for Melanoma
In many cases, patients with melanoma take medications that kill cancer cells. There are different types of medications for melanoma. Each of these drugs work differently.
- Chemotherapy: This is a type of medication that kills cancer cells. You can take it as pills or through an IV. If your melanoma is only in one arm or leg, you might have “isolated limb perfusion.” This technique delivers medicine only to the affected arm or leg. This prevents the medicine from spreading to the whole body. Keeping the chemotherapy contained lessens side effects.
- Targeted Therapy: These drugs don’t kill cancer cells immediately. Instead, they target part of the cancer cell. Targeted therapy singles out what a cancer cell needs to live and grow. Then they block that part. This starves the cancer cells, killing them over time. As they die, cells can’t grow, spread, or cause more harm.
- Immunotherapy: Immunotherapy is a type of treatment that uses your own immune system to attack cancer cells. A new form of immunotherapy called “tumor-infiltrating lymphocyte therapy,” or TIL, has proven effective at treating melanoma. TIL focuses on a patient’s T-cells, which are a type of white blood cell that serve the immune system. TIL teaches these T-cells to kill melanoma cells.
WashU Medicine physicians at Siteman helped lead late-stage clinical trials for this promising new treatment. Now it is licensed for patients with advanced melanoma.
Radiation Therapy for Melanoma
Radiation therapy is not a common treatment for melanoma. But some patients see benefits. Your care team will evaluate whether radiation therapy is right for you.
Treatments for Eye Cancer
In rare cases, cancer can develop inside the eye. These are called “intraocular cancers.”
The most common type of eye cancer is called “choroidal melanoma.” It’s a form of melanoma that begins in the layer of the eye beneath the retina (the choroid).
Melanoma can also develop in the lining of the eyeball (the conjunctiva) and on the eyelid. Squamous cell cancers can also develop in the conjunctiva.
If you have a cancer in your eye, your Siteman care team will recommend one or more of the following treatments:
- Surgery: During surgery for intraocular melanoma, a surgeon will work to remove the cancer while taking out the smallest amount of tissue possible. In some cases, they will be able to save the eye. In other cases, it is necessary to remove the eye to preserve the patient’s life.
- Radiation therapy: Radiation can be an effective treatment for patients with intraocular melanoma. At Siteman, we offer special techniques, such as proton beam therapy, that work well for tumors in highly-sensitive areas. Proton beam therapy is one. It uses a single beam of particles called protons to kill cancer cells. The proton beam does not pass through the body, but stops directly inside the tumor. This limits radiation exposure to healthy tissue.
- Photocoagulation: Photocoagulation is a treatment option for patients with small tumors. It uses a laser light to destroy the tumor and its blood supply.
- Chemotherapy: Patients with intraocular melanoma or squamous cell carcinoma sometimes receive chemotherapy. The chemotherapy might be put into an eye drop, given through a vein, or injected into the eye.
- Active surveillance: Sometimes, cancers in the eye don’t need to be treated right away. Your care team will monitor you regularly to make sure the tumor isn’t growing.