Key Insights: Nonsurgical Treatments for Skin Cancer

On the third day of Spring Dermatology Week 2023, Emily Ruiz, MD, MPH, discussed the use of nonsurgical treatments for skin cancer and when physicians should consider them during her session, “Nonsurgical Treatments for Skin Cancer.”

Dr Ruiz opened with the question, “When can physicians use nonsurgical treatments?”

“I think when we think about when to implement nonsurgical treatments, we are looking at different spectrums of disease,” she stated.

She shared that physicians can start thinking about nonsurgical treatments both in early and advanced cancers; however, it is especially important to consider these treatments for patients with multiple skin cancers. She also added that there is a middle zone where invasive cancers should just be treated surgically because this is the gold standard approach.

She continued by introducing a list of treatments typically used, which include:

• Lesion-directed treatment
• Field treatment
• Systemic therapies
• Chemoprevention

She noted that lesion-directed treatments are used for early skin cancers and in patients who have multiple skin cancers where there is a need to augment other treatments. Field treatments are used primarily for early skin cancers, as well as multiple skin cancers.

“It is important for you to remember that when I am saying early skin cancers, I am meaning superficial skin cancers, such as squamous cell carcinoma in situ and superficial basal cell carcinoma,” she indicated.

She transitioned to systemic therapies, which she stressed should be considered in patients with either multiple or advanced skin cancers. Additionally, chemo prevention can be used for patients with multiple and advanced skin cancers.

Regarding lesion-directed treatments, the first of this kind of treatment that is readily available to all physicians is cryotherapy, which is significantly useful for squamous cell carcinoma in situ or superficial basal cell carcinoma in select patients. Although topical therapies and surgery do have higher cure rates, cryotherapy can be used for patients who have multiple skin cancers, especially in areas where they cannot reach for field treatment.

“I use it most often for elderly patients on their back or even just elderly patients where you worry about compliance with other therapies,” she concluded.

For more meeting coverage, visit the Spring Dermatology Week 2023.

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Reference
Ruiz E. Nonsurgical treatments for skin cancer. Presented at: Dermatology Week 2023; May 3-6, 2023; Virtual.