Skin Cancer Treatment Options

The first step in skin cancer treatment is obtaining a diagnosis through a biopsy. During a biopsy, Dr. Freedman will take a small tissue sample and send it to a pathologist who will determine the type and stage of the cancer. The results will determine the available treatment options.

Surgery is the most common and effective way to remove skin cancers. Several surgical techniques are available, depending on the size, depth, and location of the tumor.

• Excisional surgery involves cutting out the cancerous tissue along with a margin of surrounding healthy skin to ensure the cancer cells are completely removed. This is often used for both small and larger lesions.
• Mohs micrographic surgery is a highly precise surgical technique often performed by dermatologists with advanced training. It is especially useful for cancers in delicate areas such as the face, ears, or hands, where preserving healthy tissue is important. With Mohs surgery, the cancer is removed layer by layer, and each layer is examined under a microscope immediately. This continues until no cancer cells remain, ensuring the highest cure rate while minimizing scarring. Mohs surgery is available for basal cell and squamous cell carcinomas and certain other types of skin cancer.
• Curettage and electrodessication is a technique commonly used for small basal or squamous cell carcinomas that are superficial in nature. The tumor is scraped away with a special tool, and the area is treated with an electric current to destroy remaining cancer cells. It is generally quick, cost-effective, and performed in the office.

Not every case of skin cancer requires surgical removal. For some patients, non-surgical treatments are appropriate.

• Cryotherapy uses liquid nitrogen to freeze and destroy abnormal cells. This approach may be recommended for very superficial skin cancers or precancerous lesions such as actinic keratoses.
• Topical treatments involve applying prescription creams directly to the cancer. Two of the most commonly used are imiquimod (which stimulates the immune system to attack cancer cells) and 5-fluorouracil (a type of chemotherapy cream that kills abnormal cells). These treatments are often used for superficial skin cancers or in cases where surgery is not preferred.
• Photodynamic therapy (PDT) combines a light-sensitive medication with a special light source to target and destroy cancerous or precancerous cells. PDT is typically used for superficial cancers or widespread precancerous lesions on sun-damaged skin.

In cases where melanoma or other advanced skin cancers have spread beyond the skin, treatment may involve therapies beyond the skin itself.

• Lymph node surgery may be required if melanoma has spread to nearby lymph nodes.
• Radiation therapy uses targeted energy beams to destroy cancer cells and is sometimes recommended when surgery is not possible, or as an additional treatment after surgery.
• Systemic therapies such as targeted therapy or immunotherapy may be used for advanced melanoma. Targeted therapies focus on genetic changes within melanoma cells, while immunotherapies boost the body’s immune system to fight cancer. These treatments are often coordinated with oncology specialists but may be guided by your dermatologist as part of a comprehensive care team.

Skin cancer treatment, especially surgical removal, may leave scars or changes in appearance. As an aesthetically minded surgical dermatologist, Dr. Freedman focuses not only on curing skin cancer but also on restoring the natural look and function of the treated area. Reconstructive procedures, careful suturing techniques, and advanced cosmetic dermatology approaches can minimize scarring and promote excellent cosmetic outcomes. This is particularly important when treating cancers on the face, scalp, or other visible areas. Dr. Joshua Freedman holds to a very high standard for optimizing every patient surgical outcome.