Skin Cancer Treatment Options

The Ultimate Guide for Patients & Caregivers

You have treatment options.

When you’ve just received a diagnosis of non-melanoma skin cancer, your next conversation likely focuses on how to treat it. It may be jarring, as it’s a choice you didn’t know you had to make.

The best treatment isn’t a universal truth. It is a personalized choice based on the type of cancer, its location, your overall health, and your personal priorities regarding scarring and recovery.

This guide breaks down the five primary treatment paths to help you lead an informed conversation with your dermatologist or oncologist.

WHAT’S IN THIS GUIDE
Mohs Surgery
Superficial Radiotherapy
Standard Excision
C&E Method
Topical Therapies

Mohs Micrographic Surgery

The Gold Standard for Precision

Mohs surgery is widely considered the most effective technique for removing the two most common forms of skin cancer. It was developed by Dr. Frederic Mohs in the 1930s and has been refined into the precise micrographic process used today.

Unlike standard surgery, Mohs is performed in stages while you wait.

  1. The surgeon numbs the area and removes the visible tumor along with a very thin layer of surrounding tissue.
  2. While the patient waits with a temporary bandage, the surgeon color-codes the tissue and examines it under a microscope in an on-site lab.
  3. If cancer cells are seen at the edges, the surgeon knows exactly where they are and removes another thin layer of tissue only from that specific spot.
  4. This process repeats until the microscope shows no remaining cancer.

Superficial Radiation Therapy (SRT)

The Modern Non-Invasive Alternative

For patients who want to avoid surgery or for whom surgery is medically risky, Superficial Radiation Therapy (SRT) has emerged as a high-efficacy, non-surgical alternative. Unlike the high-energy radiation used for internal organs, SRT uses low-energy X-rays that only penetrate the surface of the skin.

SRT delivers a precise dose of radiation to the site of the cancer. This energy disrupts the DNA of the cancer cells, preventing them from dividing and eventually causing them to die off, while the surrounding healthy skin cells are able to repair themselves.

  1. No cutting or numbing is required.
  2. The treatment is delivered in short sessions (usually under 5 minutes) over several weeks.
  3. Over the course of the treatment, the cancer spot slowly disappears as healthy tissue takes its place.

Standard Surgical Excision

The Traditional Approach

Standard excision is the most common surgical method for treating all types of skin cancer. It is simpler and faster than Mohs surgery, but less precise in its preservation of healthy tissue.

The doctor numbs the area and uses a scalpel to remove the entire growth plus a “safety margin” of healthy-looking skin around it. The wound is closed with stitches, and the removed tissue is sent to an off-site pathology lab. You usually receive your “clear margins” results several days later.

Key considerations:

  • Efficiency: The procedure itself is relatively quick (usually under 30 minutes).
  • Margins: Because the tissue isn’t checked in real-time, the surgeon must take a wider margin of healthy skin to ensure the cancer is gone. If the lab report comes back showing cancer at the edges, a second surgery is required.
  • Best For: Cancers on the trunk (chest, back) or limbs where a slightly larger scar is less of a cosmetic concern.

Curettage and Electrodesiccation (C&E)

The “Scrape and Burn” Method

This is an effective, fast treatment for very early-stage or superficial basal cell and squamous cell carcinomas.

As a non-invasive method, C&E includes several steps.

  1. After numbing the site, the doctor uses a “curette” (a sharp, spoon-shaped tool) to scrape away the soft, cancerous tissue.
  2. An electric needle is then used to apply heat (electrodesiccation) to the area to kill any remaining cancer cells and stop the bleeding.
  3. This cycle is typically repeated two or three times in one visit.

Topical Therapies and Photodynamic Therapy

For very thin, superficial skin cancers that have not yet grown deep into the dermis, non-invasive creams or light treatments may be an option.

Topical Creams:

These are prescription creams applied at home over several weeks. They work by stimulating your immune system to attack the cancer cells or by interfering with the cells’ ability to grow.

  • Pros: Non-invasive and done at home.
  • Cons: They can cause severe redness, crusting, and discomfort at the site for the duration of the treatment.

Photodynamic Therapy (PDT):

A light-sensitizing liquid is applied to the skin and allowed to “soak in” to the cancer cells. The doctor then shines a specific wavelength of blue or red light on the area, which activates the liquid and destroys the cancer.

  • Pros: Good for treating large areas with “pre-cancerous” spots (actinic keratoses).
  • Cons: Requires strict avoidance of sunlight for 48 hours after treatment; less effective for deep-rooted tumors.

The Critical Comparison: Surgery vs. Non-Invasive (SRT)

The highest cure paths are Mohs Surgery and SRT. Mohs Surgery has a cure rate of 99%, while SRT has been proven to have a cure rate of 98.9% in clinical studies. When comparing between the two, patients should take into consideration critical factors about their diagnosis, lifestyle, and treatment goals.

Mohs Surgery

Superficial Radiotherapy (SRT)

Invasiveness

Surgical (cutting, numbing)

Non-invasive (low-energy radiation)

Pain

Numbing shots required, post-op soreness

Painless during and after

Time Commitment

One long day (3-8 hours)

Up to 12 short visits (5 minutes each)

Wound Care

Stitches, bandages, potential grafts

No wound; daily moisturizing only

Scarring

Linear or flap scar

Minimal to no visible scarring

Downtime

Restrict activity for 1-2 weeks

No restrictions on activity

Treatment Decisions:
Which Path is Yours?

Choosing a treatment is a collaborative process between you and your care team. Use this matrix to help guide your thinking:

You might prefer Mohs Surgery if:

  • You want the treatment done and over with in a single day.
  • You are comfortable with surgery and stitches.
  • You want the absolute highest level of margin verification.

You might prefer SRT if:

  • Your cancer is on your nose, ear, or a visible area where you want to avoid a surgical scar.
  • You are on blood thinners or have high-risk health conditions.
  • You have a phobia of needles or scalpels.
  • You don’t want to restrict your exercise or social life while healing.

Key Resources

Take the Next Step in
Your Care

Get connected with a board-certified dermatologist or skin specialist in our network who offers advanced, non-invasive treatment choices near you.

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