Photodynamic treatment of skin cancer

At the moment, oncological diseases, unfortunately, are very widespread pathologies, and can affect various organs and structures of the human body. Dermatologists in their practice may also encounter skin cancer, which is why they must have the necessary information regarding these pathologies. For readers of estet-portal.com, a dermatologist of the highest category, candidate of medical sciences, vice-president of the Ukrainian Academy of Dermatovenereology Igor Kutsenko spoke about photodynamic treatment of skin cancer. About how an effective method helps to fight skin cancer – read now.

Igor Vasilievich, tell me how photodynamic therapy is used to treat skin cancers?

Photodynamic therapy has been around for a long time already - in Europe this method is about 20 years old. The method of photodynamic treatment came to us from a large section of oncology, and today we have the opportunity to adapt it to the treatment of skin diseases. Naturally, the technique has its own characteristics, its indications. This is not some magic wand that helps out of all problems. There are clear indications where and when we can apply it.

Today, we can treat many oncological diseases using photodynamic therapy.

Specifically, this is basal cell skin cancer. Even more interesting – It is a treatment for precancerous diseases. These are diseases that, if left untreated, turn into skin cancer. Here it is very important and gives great prospects and, especially, hope to our patients.

What is the basis of the photodynamic treatment method?

The method of photodynamic treatment is based on the fact that there are such preparations – photosensitizers. They accumulate in cells that are changed, that is, not in healthy cells, but in cancer cells. And there is a wavelength, that is, light. Its source can be either a laser or an LED source, but the wavelength is 630-645 nanometers. If the photosensitizer accumulates in tissues affected by cancer cells, a photochemical reaction occurs, that is, only cancer cells are damaged, while the cells of the surrounding skin remain absolutely intact and healthy. This is very important when it comes to hard-to-reach anatomical places, for example, the corner of the eye. In this case, it is extremely difficult to cut, and basal cell carcinoma loves this location, often located there. Having removed it surgically, you will have to leave some kind of defect. On the one hand, there will be one symmetry, on the other hand – another symmetry, and this is a violation of the symmetry of the face. Photodynamic treatment makes it possible not to operate on the patient, but to destroy only those cells that are affected, while healthy skin cells remain healthy.

Does photodynamic treatment help with all forms of basal cell carcinoma?

There are subtleties here, which lie in the fact that not all forms of basal cell carcinoma can be cured in this way. In particular, deep forms are not amenable to such treatment, this is wrong. But superficial forms lend themselves, of which there are quite a lot. For example, actinic keratosis and Bowen's disease, which are precancerous conditions. Many chronic dermatoses can also be treated with photodynamic therapy.

Can photodynamic treatment stop the disease in its early stages?

Of course, when this technique allows us to deliver the drug to target tissues and then act on it with a laser of the required wavelength, the body does not experience those irreversible changes that, in the course of the development of the disease, are formed with any nosological unit. If there is such a disease, let's say scleroderma, and the effectiveness of the treatment of this disease will depend on how early you start the treatment. Of course, this will very much depend on the motivation of the patient.

In order to have early appeals, first of all, we need to improve the literacy of our population.

By starting the treatment in the early stages, we will not allow the body to show irreversible changes. Then the patient remains healthy not temporarily, but permanently. And this is the dream of any doctor – start treating the patient at an early stage of the disease.

What skin cancers do you encounter most often?

The specialty consists of two components: oncology and dermatology. To date, the legislative level so provides that a certified specialist in oncology and a certified specialist in dermatology should be engaged. In our center, we treat non-melanoma skin cancers, precancerous skin diseases and all kinds of benign skin lesions. In modern terms, this is purely dermato-oncology – all neoplasms on the skin, but they are not melanocytic, that is, not melanoma of the skin. Skin melanoma is currently being treated by oncologists.