Skin cancer which is detected early can usually be cured by conservative surgery, requiring only a local anesthetic and day hospitalization. Careful scientific studies over recent years have shown that radical surgery is rarely beneficial. Long gone are the days when all melanomas were removed by extensive surgery, leaving large deformities on the body.
The prognosis for ‘thin melanomas’, that is, those with a thickness of less than one millimeter, is good to excellent, irrespective of the extent of the surgery. ‘Thick melanomas’ have a poor prognosis which is not improved by radical removal.
The best treatment for most skin cancers is complete removal. Radiotherapy is reserved for elderly people or those who cannot tolerate surgery. Certain varieties of basal cell carcinomas can be treated with curettage, liquid nitrogen or laser. In the more advanced stages, melanoma may require additional treatment, such as surgical removal of the lymph nodes, chemotherapy or immunotherapy. Chemotherapy is often rather ineffective, whereas immunotherapy looks promising for certain ‘intermediate’ (between thin and thick) melanomas.
Moh’s microscopically controlled surgery is a relatively new development in the field of skin cancer surgery. Here the skin cancer is removed and checked by frozen section. This allows the cancer to be excised without removing the good skin around it.
Another new development is the use of an injectable drug called Interferon for treating basal cell carcinomas. Most studies demonstrate a high cure rate, without subjecting the patient to surgery. This therapy may turn out to be invaluable for treating skin cancers in cosmetically prominent positions such as the eyelids and nose.
Because we know what causes skin cancer, we can prevent it. As the ozone layer becomes thinner, diligent use of shade and sunscreens becomes even more important. As individuals we need to re-evaluate our current lifestyles and our admiration of sun-bronzed bodies. Sun-bronzed bodies are not ‘healthy’ bodies. There has been a drift in the fashion industry to have models looking much paler, and hopefully this trend will catch on. Parents should encourage their children to avoid overexposure to the sun and to use shade and sunscreens as much as possible.