Treatment options for skin cancer

There are different treatment options for skin cancer. Your treatment depends on:

• the type of skin cancer
• how far it's grown or spread
• where the cancer is
• the stage of the cancer (if relevant)

Your doctor will discuss your treatment, its benefits and the possible side effects with you.

Deciding what treatment you need

A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT).

You may only see one specialist. But the team will have discussed your test results and case notes to work out the best treatment for you. 

Some GPs have had special training and are part of the local hospital skin cancer MDT. They are able to treat a type of skin cancer called basal cell carcinoma (BCC). So you might not need a referral to see a specialist at the hospital.

Treatment overview

The main treatment for skin cancer is surgery. Most people only have surgery and don't need further treatment. But some people might not be able to have surgery, or need another treatment after surgery.

Other treatments include:

• radiotherapy
• immunotherapy cream
• photodynamic therapy
• chemotherapy cream

You might have one or more of these treatments, depending on your situation.

Surgery

Surgery is usually minor. You usually have an injection of local anaesthetic in the area and then the doctor removes the cancer and a small amount of the surrounding tissue. You might have a skin graft depending on where the cancer is in the body, or if it covers a larger area.

There are different types of surgery. The surgery you have depends on where the cancer is, how many areas of cancer you have and how big the cancer is.

Radiotherapy

Radiotherapy uses high energy rays to destroy cancer cells.

Radiotherapy is a treatment for basal cell carcinoma (BCC) or squamous cell carcinoma (SCC). You're most likely to have radiotherapy if:

• your cancer covers a wide area
• it's in an area that's difficult to operate on
• surgery isn't suitable for you
• it's to reduce the risk of the cancer coming back after surgery
• your cancer has spread to the lymph nodes

Immunotherapy

Immunotherapy treatment uses your body’s natural defences (immune system) to help kill the skin cancer cells. 

For skin cancer you might have:

• immunotherapy cream
• immunotherapy into your bloodstream

Immunotherapy cream (imiquimod)

You put imiquimod cream on to the affected area of skin. It makes cells produce more chemicals such as interferon and these destroy the skin cancer cells.

You might have imiquimod cream as a treatment if you have BCC in the top layer of skin or actinic keratosis. Actinic keratosis is a skin condition that can develop into a SCC over time.

Immunotherapy into your bloodstream 

Cemiplimab is a type of immunotherapy called a monoclonal antibody. 

You might have cemiplimab for SCC if:

• it has spread to deeper layers of skin, nearby lymph nodes or other parts of the body 
• you can’t have surgery or radiotherapy

Photodynamic therapy

Photodynamic therapy (PDT) uses a drug to make your skin sensitive to light. Once you have had the drug your doctor focuses a special type of light on the area where the cancer is. This destroys the cancer cells. 

PDT is a treatment for some types of BCC, Bowen's disease and actinic keratosis.

Chemotherapy

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. 

For skin cancer, you might have chemotherapy as:

• a cream (topical treatment) directly onto your skin cancer

It is rare to treat skin cancer with chemotherapy into the vein (intravenously). 

Chemotherapy cream

Chemotherapy cream is a treatment for:

• actinic keratosis (solar keratosis), to prevent it turning into SCC
• skin cancers that are only on the top layer of the skin
• Bowen's disease

You usually have a cream containing the chemotherapy drug Fluorouracil (5FU). If you have actinic keratosis you might have 5FU cream or tirbanibulin cream. 

Clinical trials

Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to make existing treatments better and develop new treatments.