Cancer arising from the different cells found in the skin is basically of three types: basal cell carcinoma, squamous cell carcinoma or melanoma. Lymphoma of the skin arises from lymphoid tissue in the skin. Chemotherapy, the use of drugs to kill cancer cells or stop their multiplication, is one of the treatment options for skin cancers and lymphoma. Drugs for chemotherapy differ amongst the different types of cancer, with basal cell carcinoma and squamous cell carcinoma using the same agents.
Chemotherapy for Squamous and Basal Cell Cancers
Squamous and basal cell cancers of the skin arise from cells that make up the layers of the skin and so appear to have certain common properties. Thus, they appear to have the same spectrum of response to chemotherapy drugs.
According to the American Cancer Society, ACS, locally invasive squamous or basal cell cancers that have not yet spread to the lymph nodes can be treated with local chemotherapy. This is the direct application of the chemotherapy drug as a topical application like a lotion, cream or gel to the cancerous growth. The drug usually applied in this form of treatment is 5-flourouracil. The ACS adds that this type of treatment, called topical chemotherapy, is only effective when the cancer is still very superficial.
Squamous or basal cell cancers that have spread deeper into the skin or elsewhere in the body are treated by systemic chemotherapy, involving the use of tablets or injections that carry the drug all over the body. The drugs used in systemic chemotherapy for squamous and basal cell cancers, mentioned by the ACS, are cisplatin, 5-flourouracil, doxorubicin and mitomycin. These drugs may be used alone or in combination.
Chemotherapy Drugs for Melanomas
Melanoma is skin cancer arising from melanocytes, cells that produce the skin pigment melanin, which is responsible for the distinctive color of the skin. According to the ACS, melanomas do not respond as well to chemotherapy as other types of cancer, but chemotherapy is still useful to slow the progress of the disease and prolong life.
There are many chemotherapy drugs used in the treatment of melanomas. Some of them may be used alone or in well-known combinations. One such combination called the Dartmouth regimen is made up of dacarbazine, carmustin, cisplatin and the hormonal drug, tamoxifen. Cisplatin, vinblastine and dacarbazine are also combined in the CVD regimen. Temozolomide may be used alone or in combination with interferon-alpha, an immune-therapy agent. Paclitaxel, another drug, may also be used alone or in combination with cisplatin or carboplatin.
Isolated limb perfusion is a form of regional chemotherapy, described by the ACS as an option in the chemotherapy of melanoma. It involves the temporary tying off of the limb affected by melanoma and injection of the chemotherapy agent into the arterial supply to that limb. This allows high doses of drugs to be given without exposing the rest of the body to the toxic effects of the drug. The drug used for this procedure is melphalan.
Chemotherapy for Skin Lymphomas
Topical chemotherapy is used on early lesions of skin lymphoma. The drugs used for topical treatment of skin lymphoma, according to the ACS, include carmustine, mechlorethamine or nitrogen mustard, corticosteroids and bexarotene.
More advanced skin lymphoma, with deeper spread or spread to the lymph nodes and/or other organs in the body is treated with systemic chemotherapy. The drugs used in systemic chemotherapy of skin lymphomas mentioned by the ACS are gemcitabine, liposomal doxorubicin and methotrexate. Combinations of drugs, normally used for lymphomas elsewhere in the body, are also used in the treatment of skin lymphomas. One such combination is the CHOP regimen, made up of cyclophosphamide, doxorubicin, vincristine and prednisolone.
