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1. Surgery
First-line treatment for most resectable skin cancers. Mohs micrographic surgery enables margin-controlled excision with maximal preservation of normal tissue, especially in cosmetically or functionally critical areas.
2. Minimally invasive/local destructive therapies
Cryotherapy, photodynamic therapy (PDT), curettage and electrodessication, and other lesion-directed approaches can be effective for carefully selected superficial or low-risk lesions, with faster recovery and limited tissue loss.
3. Radiotherapy
An option for patients who are not surgical candidates, for anatomically challenging sites, or as adjuvant therapy in high-risk disease. Modern techniques improve dose conformity and reduce toxicity to adjacent structures.
4. Topical/local pharmacologic therapy
Agents such as 5-fluorouracil and imiquimod may treat superficial cancers or precancerous fields (e.g., actinic keratoses, selected superficial BCC), via cytotoxic or immune-mediated mechanisms.
5. Immunotherapy
Immune checkpoint inhibitors (e.g., PD-1/PD-L1 blockade) are important for advanced melanoma and can be used for advanced cSCC. Selection depends on stage, prior therapy, comorbidities, and toxicity risk.
6. Targeted therapy
For mutation-defined populations—most notably BRAF-mutant melanoma—BRAF inhibitors combined with MEK inhibitors can improve response rates and outcomes; genomic testing is required for appropriate selection.
7. Photothermal therapy (experimental)
Nanomaterial-assisted near-infrared photothermal approaches are under investigation. Reported efficacy figures vary by study model and are not standard-of-care; these methods should be described as research-stage.
8. Perioperative (neoadjuvant/adjuvant) immunotherapy
For selected high-risk cases, immunotherapy before and/or after surgery may improve pathological response and reduce recurrence risk, but requires careful patient selection and toxicity management.
9. Systemic chemotherapy
Generally limited benefit in many skin cancers compared with immunotherapy/targeted options; may be considered in specific advanced settings or when other options are unsuitable, often in combination strategies.
10. Microneedle-based drug delivery (experimental)
Microneedle arrays for local delivery of cytotoxic or immune-modulating agents aim to reduce systemic toxicity and enhance local immune activation. Currently investigational and not routine clinical practice.
11. Combination strategies
Sequencing or combining surgery, radiotherapy, targeted therapy, and immunotherapy is common in advanced or high-risk disease. Regimens should be individualized to maximize efficacy and minimize resistance and toxicity.
Jinshazhou Hospital of Guangzhou University of Chinese Medicine emphasizes that the incidence of skin cancer is rising and poses a growing health threat. Without timely and standardized treatment, skin cancer may cause extensive local destruction or distant metastasis. Early diagnosis, guideline-concordant therapy, and longitudinal management are central to improving outcomes. Patients should work with a multidisciplinary team to select an individualized plan based on tumor type and stage. With advances in surgery and systemic therapies, many skin cancers can be effectively controlled, and selected cases may be managed as a chronic condition with ongoing surveillance.
1. Surgery
First-line treatment for most resectable skin cancers. Mohs micrographic surgery enables margin-controlled excision with maximal preservation of normal tissue, especially in cosmetically or functionally critical areas.
2. Minimally invasive/local destructive therapies
Cryotherapy, photodynamic therapy (PDT), curettage and electrodessication, and other lesion-directed approaches can be effective for carefully selected superficial or low-risk lesions, with faster recovery and limited tissue loss.
3. Radiotherapy
An option for patients who are not surgical candidates, for anatomically challenging sites, or as adjuvant therapy in high-risk disease. Modern techniques improve dose conformity and reduce toxicity to adjacent structures.
4. Topical/local pharmacologic therapy
Agents such as 5-fluorouracil and imiquimod may treat superficial cancers or precancerous fields (e.g., actinic keratoses, selected superficial BCC), via cytotoxic or immune-mediated mechanisms.
5. Immunotherapy
Immune checkpoint inhibitors (e.g., PD-1/PD-L1 blockade) are important for advanced melanoma and can be used for advanced cSCC. Selection depends on stage, prior therapy, comorbidities, and toxicity risk.
6. Targeted therapy
For mutation-defined populations—most notably BRAF-mutant melanoma—BRAF inhibitors combined with MEK inhibitors can improve response rates and outcomes; genomic testing is required for appropriate selection.
7. Photothermal therapy (experimental)
Nanomaterial-assisted near-infrared photothermal approaches are under investigation. Reported efficacy figures vary by study model and are not standard-of-care; these methods should be described as research-stage.
8. Perioperative (neoadjuvant/adjuvant) immunotherapy
For selected high-risk cases, immunotherapy before and/or after surgery may improve pathological response and reduce recurrence risk, but requires careful patient selection and toxicity management.
9. Systemic chemotherapy
Generally limited benefit in many skin cancers compared with immunotherapy/targeted options; may be considered in specific advanced settings or when other options are unsuitable, often in combination strategies.
10. Microneedle-based drug delivery (experimental)
Microneedle arrays for local delivery of cytotoxic or immune-modulating agents aim to reduce systemic toxicity and enhance local immune activation. Currently investigational and not routine clinical practice.
11. Combination strategies
Sequencing or combining surgery, radiotherapy, targeted therapy, and immunotherapy is common in advanced or high-risk disease. Regimens should be individualized to maximize efficacy and minimize resistance and toxicity.
Jinshazhou Hospital of Guangzhou University of Chinese Medicine emphasizes that the incidence of skin cancer is rising and poses a growing health threat. Without timely and standardized treatment, skin cancer may cause extensive local destruction or distant metastasis. Early diagnosis, guideline-concordant therapy, and longitudinal management are central to improving outcomes. Patients should work with a multidisciplinary team to select an individualized plan based on tumor type and stage. With advances in surgery and systemic therapies, many skin cancers can be effectively controlled, and selected cases may be managed as a chronic condition with ongoing surveillance.