From the Guidelines
Treatment options for skin malignancy should be selected based on the type, stage, and location of the cancer, with surgery being the most common treatment, including excision, Mohs surgery, curettage and electrodesiccation, and cryosurgery, as recommended by the most recent guidelines 1.
Overview of Treatment Options
- Surgery: excision, Mohs surgery, curettage and electrodesiccation, and cryosurgery
- Radiation therapy: uses high-energy rays to kill cancer cells, often used when surgery isn't possible or for large tumors
- Topical medications: 5-fluorouracil, imiquimod, or ingenol mebutate for superficial cancers
- Systemic treatments: chemotherapy, targeted therapy, and immunotherapy
- Photodynamic therapy: combines light-sensitive drugs with light exposure to destroy cancer cells
Selection of Treatment
Treatment selection considers cancer type, size, depth, location, patient age, and overall health, as outlined in the guidelines 1.
Advanced Cases
For advanced cases, combination therapy approaches may be necessary to effectively manage the disease, including immunotherapy options like pembrolizumab or nivolumab for melanoma, as recommended by recent studies 1.
Importance of Early Detection
Early detection and treatment significantly improve outcomes, so regular skin examinations and prompt medical attention for suspicious lesions are essential, as emphasized in the guidelines 1.
From the FDA Drug Label
The application frequency for Imiquimod Cream is different for each indication. Imiquimod Cream should be applied 2 times per week for a full 16 weeks to a defined treatment area on the face or scalp (but not both concurrently). Imiquimod Cream should be applied 5 times per week for a full 6 weeks to a biopsy-confirmed superficial basal cell carcinoma.
Treatment options for skin malignancy include:
- Imiquimod Cream for actinic keratosis and superficial basal cell carcinoma
- The cream should be applied as directed by the prescriber, with the frequency and duration of application depending on the specific indication
- Patients should be monitored for local skin reactions and other adverse effects, and the treatment plan should be adjusted as needed 2
- Vemurafenib is also an option, but it is associated with risks of new primary cutaneous malignancies, non-cutaneous squamous cell carcinoma, and other malignancies, and requires regular dermatologic evaluations and monitoring for signs of other malignancies 3
From the Research
Treatment Options for Skin Malignancy
- The treatment options for skin malignancy, particularly for advanced melanoma, include the use of anti-PD-1 antibodies such as pembrolizumab and nivolumab 4, 5, 6.
- Pembrolizumab and nivolumab have been shown to have comparable efficacy and toxicity in the treatment of advanced melanoma, with no significant differences in overall survival, progression-free survival, and overall response rates 4, 5.
- The choice of treatment between pembrolizumab and nivolumab should be based on patient and clinician preferences, as both therapies have been found to be effective in the treatment of metastatic melanoma 4, 5, 6.
Diagnosis and Detection of Skin Malignancy
- Accurate detection of skin cancer is crucial to minimize morbidity and mortality, and can be achieved through full-body skin examination (FSE) and the use of dermoscopy 7, 8.
- Experienced dermatologists have been found to have higher odds of accurate diagnosis of skin cancer, particularly melanoma, using dermoscopy compared to clinical examination alone 7.
- However, there are significant differences in diagnostic accuracy for skin cancer when comparing physician specialty and experience, and examination methods, highlighting the need for standardized approaches to FSE and concealed site examination 7, 8.