Skin Cancer Treatment

Nationally recognized skin cancer treatment

Scripps Cancer Center treats more skin cancer patients than any other San Diego health care provider, including rare and aggressive skin cancers. Scripps dermatologists and cancer physicians are national leaders in skin cancer treatments — including Mohs micrographic surgery, the most common treatment for aggressive skin cancer — and have performed more Mohs procedures than any other center in Southern California. In addition, we train physicians nationwide through the Scripps Mohs fellowship program.

Scripps also was the first San Diego health care provider to use interferon to treat basal cell carcinomas. Our specialists are experts in all types of skin cancer, including difficult cases involving intricate areas and cosmetic reconstruction. Our multidisciplinary, collaborative board of cancer specialists reviews complex care plans to ensure patients receive the best possible care from diagnosis to recovery.

How is skin cancer treated?

Most early skin cancers are treated by removing the cancerous cells through various surgical procedures. Radiation therapy, laser treatment, chemotherapy or immunotherapy for skin cancer may be part of treatment if cancer has spread.

Skin cancer treatment options at Scripps

Scripps physicians diagnose skin cancers and treat them using leading-edge methods that may include Mohs surgery, laser therapy, immune response modifiers and more. Your skin cancer treatment plan will depend on the type of skin cancer you have and how early it’s found.

Non-melanoma cancer treatment

The most common non-melanoma skin cancers — basal cell carcinoma and squamous cell carcinoma — may be treated in several ways.

Mohs micrographic surgery

Mohs surgery removes thin layers of skin until only cancer-free tissue remains. The procedure is designed to conserve healthy tissue and minimize scarring — especially for tumors on or near the nose, eyes, ears, forehead or scalp. Most tumors require one to three Mohs layers for complete removal of skin cancer cells. Mohs micrographic surgery provides the best cure rate for basal cell carcinomas, according to the American Cancer Society. It also can be performed for squamous cell carcinomas with good cure rates.

Reconstructive procedures following skin cancer treatment

When cancer is removed from the skin, the affected area may require reconstructive surgery. For example, if skin cancer affected the nose, removal of the cancer may cause a defect that can only be repaired through reconstructive surgery. The type of procedure that will be most beneficial depends on the part of the body affected by skin cancer. Scripps plastic surgeons work closely with Mohs surgeons to repair and reconstruct affected areas, Insurance usually covers both procedures.

Cryosurgery

Cryosurgery (also called cryotherapy) uses liquid nitrogen applied directly to the treatment area to destroy external tumors through extreme cold temperatures.

Photodynamic therapy (PDT)

Photodynamic therapy (PDT) uses a specialized light source in combination with a drug that’s applied to the skin cancer over several hours or days. The drug is activated by the light source and kills the cancer cells. It’s most often used for precancerous growths, such as actinic keratosis, but may also be used in conjunction with skin cancer surgery.

Topical chemotherapy

Topical chemotherapy applies a chemotherapy drug directly to the skin cancer via a cream or ointment. Topical chemotherapy is usually used for very early skin cancers or precancerous artinic keratoses.

Laser surgery

Laser surgery uses of a beam of laser light to eliminate cancer cells. Laser surgery is most commonly an option for very early and superficial basal cell carcinomas and squamous cell carcinomas.

Excision surgery

Excision surgery removes a tumor and an area of tissue surrounding it (referred to as a “safety margin”). Following the surgery, a pathologist examines a sample of the safety margin tissue for cancer cells to make sure they’re no longer present.

Electrodesiccation and curettage

Electrodesiccation and curettage is most frequently used for small basal cell carcinomas that do not require an excision. The physician scrapes away the tumor down to its base using a sharp curette. Then electrodesiccation is performed to seal the wound through the use of a high-frequency electric current. This is a widely used treatment modality.

Immune response modifiers

Immune response modifiers are drugs that boost the body’s ability to fight cancer. In certain cases, an immune response modifier called interferon can be injected directly into a tumor. Other immune response modifiers may be taken by mouth for patients who are not candidates for surgery or radiation therapy.

Melanoma skin cancer treatment

Depending on the location and stage of the tumor, melanoma skin cancer treatment may include surgery, immunotherapy, radiation therapy or chemotherapy.

Melanoma surgery

Physicians perform two different types of procedures, depending on how far the melanoma has spread.

For thin melanoma growths, local wide excisions are performed after a skin biopsy to ensure all cancer cells are gone. This procedure has proven successful in curing most thin melanoma growths.
For melanoma that has a higher risk of spread, a sentinel lymph node biopsy may be performed in addition to local wide incision.

Immunotherapy

Immunotherapy uses drugs that boost the body’s ability to fight cancer.

Ipilimumab is a drug administered intravenously for melanomas that have spread to other parts of the body or cannot be successfully removed by surgery.
Interferon-alfa and interleukin-2 (IL-2) can be injected or given intravenously with the aim of shrinking advanced melanoma.
Interferon-alfa may also be administered as an additional therapy for patients with thicker melanomas, which often have cancer cells that have spread to other parts of the body. The goal is to keep the cells from spreading and growing.
BCG (bacille calmette-guerin) may be used to help treat later-stage melanomas and is injected directly into the tumors.
Imiquimod cream may be used for very early stage melanoma in situ in sensitive areas of the face that could be scarred by surgery.

Targeted therapy for melanoma

Targeted therapy for melanoma uses drugs that target specific proteins or receptors on tumors.

Vemurafenib and dabrafenib attack a mutated gene known as BRAF protein that instructs melanoma cells to grow and quickly divide. About 50% of melanomas have the BRAF protein gene.
Trametinib attacks the MEK protein, which is related to the BRAF protein. The drug may be combined with dabrafenib.

Chemotherapy

While chemotherapy is not as effective for melanoma as it is for other types of cancer, it may be recommended to help lessen symptoms or extend the life of patients who have late-stage melanoma. Chemotherapy can be combined with other immunotherapy drugs.

Radiation therapy

Radiation therapy is not a common treatment for a melanoma tumor that started on the skin, but it may be used on nearby lymph node areas after surgery to try to prevent the cancer from coming back. Radiation therapy may also be used to treat recurring melanoma, in either the skin or lymph nodes if the cancer can’t be completely removed by surgery.

Skin cancer clinical trials

Some skin cancer treatment plans may involve clinical trials. Talk with your physician about whether a clinical trial is right for you.

For a list of clinical trials that are currently enrolling patients, see our current list of clinical trials.

Our approach to treating skin cancer

Our multidisciplinary teams of dermatologists, oncologists, surgeons, pathologists, nurses and clinicians provide the most appropriate and personalized course of treatment for you. Should you need reconstructive surgery after treatment, our specialists are board certified. Learn more about how Scripps puts you at the center of care.

Your custom cancer treatment plan

Your Scripps cancer team will develop a customized treatment plan outlining the treatments and therapies we recommend for your care. Before you begin treatment, you and your physician will review your plan together and discuss any questions or concerns you may have.

Your skin cancer treatment plan generally includes:

Family and medical history
A summary of your cancer diagnosis and staging information
Diagnostic testing completed (e.g., imaging, biopsy, lab tests)
Plans for surgery, radiation, chemotherapy and/or other treatments
Potential side effects of treatments
Contact information for your cancer care team members

Along with helping you understand your course of treatment and encouraging discussion between you and your physician, your plan helps your team coordinate your care. You also can share your treatment plan with other providers who may be involved in your medical care.

Your cancer care team

Your skin cancer care team includes health and medical professionals from a wide range of specialties. Scripps will customize your team to ensure you have the expertise and support you need. Your team may include:

Dermatologists
Mohs surgeons
Surgical oncologists
Radiation oncologists
Medical oncologists
Registered nurses
Nurse navigators
Dietitians
Oncology social workers

Visit your cancer care team for more on our multidisciplinary approach to treatment.

Skin cancer treatment locations

Scripps diagnoses and treats skin cancer at numerous locations throughout San Diego County. From Chula Vista and La Jolla to Encinitas and beyond, our extensive network of Southern California cancer care centers includes:

Four Scripps hospitals on five campuses
Outpatient clinics
Bighorn Mohs Surgery and Dermatology Center at Torrey Pines
Specialty cancer treatment centers

We are now offering Video Visits for some specialty care appointments. If you are interested in scheduling a Video Visit, contact the provider’s office directly. The doctor’s office will work with you to determine if this is the right type of visit for you.

For details on specific centers and their services, visit cancer care locations.

Support groups, services and resources

As leaders in skin cancer care, we know what it takes to fight a winning battle. That’s why we equip our patients with the support and resources necessary to achieve their best possible outcome. From connecting you with support groups and services to empowering you with the latest resources and research, Scripps offers a comprehensive lineup to help you along every step of your cancer journey.

Skin cancer support groups for patients, family members and survivors

In support of our patients, survivors, their family members and the community, we host a handful of cancer support groups as well as a range of free workshops and health and wellness events on a number of topics, such as:

Nutrition
Expressive writing
Yoga
Meditation

Check the current list of support offerings or contact your oncology social worker or cancer care coordinator.

For info about other cancer support groups in the San Diego community, call the American Cancer Society at 800-227-2345.

Support services for cancer patients

We are here for you — not only as your oncologists, but as a robust multidisciplinary team of experts who understands that your cancer journey is about much more than your medical treatment. Specifically, Scripps Cancer Center offers a variety of patient support services to ensure your physical, psychological and emotional well-being as well as resources for dealing with the logistical and financial aspects of cancer care. Our services and resources include:

Oncology nurses and nurse navigators with extensive clinical expertise in cancer care to help guide you and your caregivers to make informed decisions and ensure your optimal care.
Palliative care to provide an extra layer of supportive care to manage pain and relieve symptoms, offer emotional and spiritual support, and improve your quality of life.
Oncology social workers specially trained to provide counseling, connect you with community and medical resources, assist with transportation and housing and coordinate care after discharge.
Our registered dietitian nutritionists offer individualized nutrition support for patients whose efforts to optimize their nutrition may be affected by cancer symptoms or treatment side effects.
Referrals and professional care from experts in psychology, psychiatry and emotional health, including individual and family counseling to help with the emotional challenges of cancer.
Physical rehabilitation and occupational therapy services, including wound care, voice therapy and swallowing therapy, lymphedema therapy, balance and vestibular rehabilitation, yoga and more.
Scripps Center for Integrative Medicine for patients interested in mind-body healing through acupuncture, biofeedback, herbal nutrition, massage therapy, integrative cancer care and more.
Nondenominational spiritual care offered by our chaplains to help coordinate spiritual care with your own clergy, rabbi or spiritual advisor.
Visiting patient services if you reside beyond San Diego and want help arranging appointments or learning more about short-term lodging.

For the full spectrum of offerings, please visit our cancer patient support services section.

Additional resources for patients, caregivers and family members

Patient education is an integral part of understanding and coping with your cancer diagnosis and treatment. To stay informed, we encourage our patients, along with their caregivers and family members, to:

Bookmark the Scripps glossary of cancer terms for easy referencing.
Download the appointment form and list of medications form on our resources page.
Consult your oncology team for educational materials and a list of trusted online sources beyond the Scripps site.

Navigating cancer might seem overwhelming — especially with so much information online. To ensure you receive the most accurate details, always look to your multidisciplinary team of cancer care experts first.

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