Is skin cancer curable?

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The main treatment option for melanoma is surgery. Doctors may suggest this treatment method first, as it can cure early-stage melanomas.

There are different surgical methods when it comes to treating melanoma. These include the following.

Wide excision

After diagnosing melanoma using a skin biopsy, doctors may suggest a wide excision to completely remove the cancer.

For this procedure, a dermatologist or surgeon will inject a local anesthetic and cut out the tumor, as well as a small amount of regular skin around the edges. They will then stitch the wound shut. This will leave a scar after it has healed.

Rarely, if melanoma is present on a digit such as a finger or a toe and has spread into deep tissues, doctors may consider amputating the digit.

Mohs surgery

Not all doctors agree on using this procedure for melanoma. However, it may be an option for some, such as those whose melanoma affects the face, genitals, or other sensitive areas.

During the procedure, a specially trained dermatologist removes very thin layers of skin in the area one by one.

They examine each layer under a microscope, looking for cancer cells. If they find signs of cancer, they remove another layer until there are no cancer cells present.

The procedure may take several hours, but it may decrease scarring after surgery, as they remove less skin.

Learn more about Moh’s surgery here.

Doctors can cure almost all cases of early-stage BCC or SCC either with surgery, radiation therapy, targeted therapy, or cryotherapy.

Surgery

Some surgical methods that can cure BCC or SCC include:

• Curettage and electrodesiccation: This involves scraping the skin with a thin, sharp instrument before using an electric needle to eliminate the rest of the cancer. Doctors may suggest this for BCC or SCC that is only on the top layer of skin.
• Wide excision: Removing the tumor and some of the surrounding skin can cure BCC or SCC.
• Mohs surgery: This method spares as much tissue as possible and may be useful for BCC or SCC tumors in certain locations. For example, doctors may suggest Mohs for skin cancer on the face, around the eyes, or on the genitals and nipples.

Other treatments

Other possible treatments for BCC or SCC include:

• Radiation therapy: Doctors may suggest this for those who cannot undergo surgery. They may also use it to eliminate any cancer cells that remain after surgery.
• Targeted therapy: If BCC spreads to other body parts, or if a person cannot have surgery, doctors may suggest drugs such as vismodegib (Erivedge) or sonidegib (Odomzo) to shrink the cancer. However, doctors do not use these drugs for SCC.
• Cryotherapy: Doctors can use this for smaller BCCs or SCCs. It involves using liquid nitrogen to freeze and kill the cancer cells.

If surgery has not been successful in treating skin cancer, or if the cancer has spread to other areas, doctors may consider other treatment methods.

However, it is likely the aim of these treatments will be to reduce pain and prolong a person’s life rather than to cure the cancer. Skin cancer is more difficult to cure when it has spread to other areas.

Lymph node dissection

The main purpose of lymph node dissections is to manage melanoma that has spread to the lymph nodes.

Doctors will first use imaging tests to examine the lymph node and take a biopsy to check if the melanoma has spread to a node or nodes.

If the cancer has spread to any lymph nodes, they will opt to remove the affected nodes.

Although experts are unsure if this method can cure melanoma that has spread to the lymph nodes, some doctors think it can help prolong a person’s life and decrease pain in the later stages of the cancer.

Immunotherapy or targeted therapy

These two therapies involve taking specific medications that specifically target the cancer and aid the body’s immune system in attacking cancer cells.

NMSCs

Doctors can use cemiplimab (Libtayo) in immunotherapy for SCC and BCC.

Vismodegib (Erivedge) and sonidegib (Odomzo) are some drugs that doctors use as targeted therapy for BCCs, but not SCCs.

Targeted therapy for SCCs may involve using EGFR inhibitors like cetuximab (Erbitux).

Melanoma

Doctors mainly use pembrolizumab for melanoma immunotherapy. This is a PD-1 inhibitor that inhibits a protein in immune cells called PD-1. Inhibiting this protein can improve the body’s immune response against cancer cells.

For some types of melanoma, BRAF inhibitors such as Vemurafenib (Zelboraf), dabrafenib (Tafinlar), and encorafenib (Braftovi) may be an option for targeted therapy.

These medications attack a certain gene called BRAF that helps melanoma cells grow and survive. However, some melanomas do not have this particular gene, and so would not benefit from this treatment.

Chemotherapy

Chemotherapy is not as useful for all skin cancers, but doctors may suggest it for advanced cases. It involves taking medications that kill the cancer cells.

Chemo might be an option after doctors have tried other treatments, such as immunotherapy and targeted therapy.

This is because chemo is not as helpful in treating melanoma, BCCs, or SCCs.

The outlook for skin cancer depends on the type and stage of cancer, but generally, the outlook is very good.

According to the American Academy of Dermatology (AAD), the 5-year survival rate for melanoma is 99% if doctors detect and treat it before it spreads to the lymph nodes.

This means that, compared to the overall population, a person with this type and stage of cancer has a 99% chance of surviving another 5 years after diagnosis.

The 5-year survival rate decreases in the later stages — for example, the rate for melanoma that spreads to nearby lymph nodes is 68%. The rate for melanoma in distant lymph nodes and other organs is 30%.

Basal cell and squamous cell carcinomas have a great outlook, as they are highly treatable if doctors catch them early.

Most skin cancers are curable and have a good outlook, especially if medical experts find and treat them before they spread.

Surgery is usually the first option for melanoma, BCC, and SCC. If surgery does not work, is not an option, or if the cancer recurs, a person may need other treatments such as immunotherapy, targeted therapy, or chemotherapy.

Because skin cancer is generally highly treatable if doctors catch it early, a person can live a long life after diagnosis and treatment.