Dermatology-Online

Treatment of skin cancer

The gold standard and therefore the first choice for all forms of skin cancer is the surgical removal of the skin cancer (Excision) with a safety margin.

Basalioma: The Basalioma is surgically removed with a safety margin of a few millimeters. In the face, this excision of the skin cancer is carried out to save tissue (Microsurgery). If there is inoperability, the patient receives radiation (Radiation). In one form, namely superficial basalioma, cryotherapy is also used (icing), Electrocautery (combustion) or the Medication Imiquimod (modulation of the immune system, local application) and 5-fluouracil (Cytostatic) to treat the Skin cancer for use.

Spinalioma: Like basaliomas, spinaliomas are also removed surgically with a safety margin and possibly microsurgically. In the presence of lymph node metastases, the affected ones are also affected Lymph nodes removed and an irradiation initiated. If metastases of the skin cancer already exist or the patient cannot be operated on, the therapy of choice is one chemotherapy. In addition, after the end of therapy, the patient should present for follow-up care every 6 months in order to detect recurrences or new growths of skin cancer at an early stage.

Malignant melanoma: Also at malignant melanoma is treated with excision. The safety distance depends on the thickness of the Tumor (1 to 3 cm). If lymph node involvement is suspected, the first lymph node in the drainage area is examined for metastases of the skin cancer (Sentinel lymph node biopsy). If lymph nodes are affected, they will also be removed. Furthermore, in this case a chemo (with Dacarbazine) as well as immunotherapy (with interferon) began. In the case of distant metastases, treatment is only given palliative, i.e. relieving the symptoms.

Regular check-ups are also important for this type of skin cancer. These are only carried out every 3 months, and then every 6 months, for recurring or newly formed Skin cancer to be recognized early.

Treatment with ointment

According to the latest studies, an American manufacturer has developed an ointment with an active ingredient that can be used in the treatment of skin cancer.

The active ingredient contained in the ointment is intended to treat skin cancer by activating the Immune system drive forward.
The principle of this skin cancer ointment should therefore be based on the body's own reaction against the cancer cells.
So far, the effectiveness of the active ingredient contained in the ointment Imiquimod only in patients with Basal cell carcinoma (White skin cancer) must be proven. At times, the clinical use of ointments containing imiquimod has been limited to the treatment of Genital warts.
Recently, ointments containing this active ingredient have also been used for the treatment of white skin cancer.

It is assumed that the regular application of the ointment causes a significant regression of the skin cancer cells within eight weeks.
Because basal cell carcinomas occur approximately ten times as often within the Federal Republic as the known black skin cancer (malignant melanoma) Imiquimod ointment is considered to be the new miracle weapon in the treatment of skin cancer.

The implementation of further therapeutic measures such as one Chemo- or radiotherapy is not necessary.
The reason for this is the fact that, unlike malignant melanoma, white skin cancer has no tendency to metastasize.

The distinction between white and black skin cancer should, as before, be carried out by a trained specialist (Dermatologist; Specialist in skin diseases) can be made.

Clinically, basal cell carcinoma shows up on the affected skin area hardening.
The color of the white skin cancer roughly corresponds to the color of the surrounding healthy skin surface.
Typically, fine ones are found in the marginal region of the basal cell carcinoma red veins.
According to experts, skin cancer treatment with imiquimod ointment has a number of advantages over the previously selected therapy methods.
Above all, the possibility of treating skin cancer over a wide area of skin without the risk of Damage to healthy cells, is a huge advantage. The extensive studies have shown that the applied ointment only works on diseased skin and leaves healthy skin areas completely untouched.
So far, regular use of ointments containing imiquimod has resulted in a cure rate of around 80 percent.

Treatment with interferon

The treatment of skin cancer with interferon is one of the so-called "adjuvant“Cancer Therapy.

Under the term "adjuvant" (here with interferon) one understands in the medical terminology a precautionary treatment, which is started at a time when no tumor settlements (Metastases) are detectable.

This type of skin cancer treatment enables the creation of an essential better forecast in patients without detectable metastasis.
Nevertheless, it is possible that individual tumor cells have already spread without being able to be detected with the usual imaging methods.

It is precisely these tumor cells that can possibly rest for years before they lead to the formation of metastases elsewhere.
In patients suffering from malignant melanoma (Black Skincancer), preventive treatment with conventional chemotherapeutic agents has not proven effective.

For this reason, chemotherapy is considered pointless if there is no evidence of metastases.
In order to reduce the risk of skin cancer tumor cells settling in other organs in such patients, adjuvant treatment with interferon can be useful.

The stimulation of the immune system goes in these cases with a significant Lowering the risk for the development of skin cancer recurrences.
The adjuvant interferon therapy can be used in primary skin cancer with a tumor thickness of more than 1.5-2 mm and in the case of tumor cell colonization regional lymph nodes be applied.

In most cases, the preparation "interferon“Applied under the surface of the skin about three times a week.
Patients starting adjuvant interferon treatment for skin cancer often suffer within the first few weeks fever, chills and Flu-like Symptoms.

This fact is due to the fact that the release of interferon by the organism is normally a reaction to viral infections.
The interferon used in this form of skin cancer treatment is a cytokine, which is produced by various cells in the body and a protective key role occupies.

In general, a distinction is made between three different forms of interferon, the Interferon alpha, beta and gamma.
Both through the influence of the body's own as well as the effect of externally substituted interferon T lymphocytes and NK cells (natural killer cells) stimulates.
The medical use of interferon is not limited to the treatment of skin cancer. Also in the therapy of patients who are under Hepatitis C, multiple sclerosis, or lymphoma sufferers show considerable benefits from the supply of interferon.

After about three to four weeks, the patient's body begins to get used to the increased levels of interferon.
At this point, the fever, chills, and flu-like symptoms usually subside.

During the entire treatment of the skin cancer with interferon, however, there is a significant one Reduced performance to be expected.
However, normal work activities should no longer be restricted after three weeks.

Chemotherapy for skin cancer

Chemotherapy is necessary in patients suffering from skin cancer when daughter tumors have formed in internal organs.

Black skin cancer primarily has a tendency to metastasize to the lungs, bones, liver, or brain.
Under the term "chemotherapy“In medical terminology, one understands the use of cell growth inhibitors (cytostatic) Substances.

In general one can assume that cancer cells have a distinctly higher division rate than normal body cells.
For this reason, malignant tumor cells in particular are particularly badly damaged when chemotherapy is used to treat skin cancer.

A significant decrease in tumor diameter can be observed in the majority of patients treated with chemotherapy.
In some cases, even complete regression of metastases caused by skin cancer can be observed.

In these cases one speaks of a complete remission.
Despite the clear differences in the rate of cell division, the effect of chemotherapy is not limited to tumor cells.
Also body cells in the area of Mucous membranes (especially within the gastrointestinal tract) are affected by chemotherapy.

In addition, most chemotherapy drugs used to treat skin cancer will affect that Hair growth out. As a result, it occurs in many of the patients Hair loss, nausea and vomiting.

Other typical side effects of chemotherapy are changes in the blood count which lead to an increased Susceptibility to infection, a bigger one Bleeding tendency and a pronounced Anemia (anemia) being able to lead. In patients suffering from malignant melanoma (Black Skincancer) suffer and demonstrably have distant metastases, the first chemotherapy can stabilize the course of the disease with a 50% probability.

Complete regression of the skin cancer metastases is also not uncommon.
However, there are no parameters that allow a prognosis of a patient's response to chemotherapy to be determined before treatment begins.

In the event of non-response, another form of treatment should be selected as soon as possible. The typical chemotherapy drugs that are used in patients with black skin cancer are Dacarbazine (DTIC), Cisplatin, BCNU, Vinca- Alkaloids and temozolomide.
The various active ingredients can be administered independently of one another or in combination with one another.

Cost of skin cancer treatment

Skin cancer is a serious disease.
If the tumor is discovered early, there is an almost 100% chance of cure, but if it is undetected, malignant melanomas in particular tend to metastasize quickly.

For this reason, in addition to the treatment of skin cancer, early detection also plays a crucial role.
If a suspicious area of skin is discovered, this is undoubtedly an indication for surgical removal of the abnormality.

The costs for the presentation to the dermatologist and the surgical removal of the skin cancer are fully covered by both private and statutory health insurances.
For the patient concerned, there are no costs for surgical tumor removal.

Skin cancer discovered late may make it necessary to initiate further treatment measures.
In this context, radiotherapy and chemotherapy play an important role.

Even if it is necessary to initiate one of these forms of therapy alone or in combination with one another, all costs incurred are borne by the health insurance companies.

Only patients who opt for alternative treatment methods for skin cancer may incur costs that must be paid independently.

Patients with an increased risk of skin cancer should have skin cancer early detection at regular intervals, even if their own findings are normal.
In this way, the condition of the skin can be documented and abnormalities identified at an early stage.
All costs that are incurred for the regular implementation of this early detection examination are covered by both private and statutory health insurance companies.