Like many diseases in our world today, cancer is becoming more resilient to our methods of treatment. Many of the drugs we used to use to help treat cancer in earlier decades aren’t as effective any more, which necessitates the need to create new, more powerful drugs. Additionally, technological advancements have enabled us to envision new, more effective treatments to rid ourselves of cancer and even precancer before it can turn into cancer.
One of the newest methods of dealing with precancerous skin lesions is a combination treatment. A combination treatment, also known as “combination therapy,” is essentially a combination of different precancer treatments.1 This can include any or all of the following forms of precancer treatments:
- Topical treatments
- Cryosurgery
- Chemical peeling
- Laser surgery
- Photodynamic therapy (PDT)
The advancements in science and technology have made this type of treatment possible in our world today. In past decades, many of these types of treatments didn’t exist, which prevented doctors from combining different treatments to form a new type of “super” treatment for precancerous skin lesions such as actinic keratoses. They had to stick with one type of treatment for the most part, which was only effective to an extent for so long.
How Does Combination Treatment Work?
The doctor can determine whether the patient has precancer or not. If it’s determined that the patient does have precancer, the main goal is to help eradicate that precancer before it causes skin cancer.
The doctor may take a very aggressive approach and attack the precancerous growth or growths with a combination treatment of various precancer treatments. A typical combination treatment would be laser surgery or cryosurgery to remove the growth or growths from the skin, then have the patient apply a topical cream on the skin near the area where the precancerous growth or growths were located.
This combination treatment will not only eliminate the actual growth or growths via the laser surgery or cryosurgery, but the topical cream will increase the chances that that area of the skin will not be conducive to producing more growths in the future, thereby severely limiting the chances that the patient will have skin cancer in that area in the future.
Benefits of Combination Treatment
One major benefit of combination treatment is that the precancerous skin growth is not likely going to be resistant to the treatment, since it is highly unlikely that the growth will be able to resist all of the treatments included in the combination treatment.
For instance, relating to the example mentioned in the last section, if the doctor had only used laser surgery or cryosurgery, any microscopic traces of the precancerous growth would have been left in the skin, since laser surgery and cryosurgery can only really eliminate cancer on the surface of the skin, such actinic keratoses.2
However, because the doctor had the patient regularly use a topical treatment for a specified period (usually a few weeks), the microscopic traces of that growth would also be eliminated thanks to the cream that was rubbed on the affected skin. This increases the chances that the precancer is totally eliminated so that it does not progress into cancer as compared to just using either laser surgery/cryosurgery or topical applications alone.
In addition, combination treatment can also reduce the amount of scarring and recovery time it would take if just one individual precancer treatment was used. Some studies show that using imiquimod cream before operating on a precancerous skin growth can cause for less scarring than if no cream was applied or if cream was applied after the operation.
Combination treatment really provides doctors with an effective countermeasure to the cancer’s ability to become more resistant to a specific drug or treatment. As mentioned above, it’s unlikely that cancer or precancer can counteract all measures in a combination treatment.
Disadvantages of Combination Treatment
Essentially, the only real disadvantages of combination treatment lie in the disadvantages of the individual methods. For instance, there are questions whether cryosurgery is effective as a long-term treatment.3 Those questions are also a concern when it’s used as part of a combination treatment, though the questions are answered to an extent in the fact that other, more proven treatments are used in combination with the cryosurgery to treat a patient’s cancer or precancer.
Just as the main disadvantage of topical cream applications is the fact that a patient must reapply them continuously over a specified period of time, this disadvantage is addressed to an extent by the fact that the applications are combined with other forms of treatment in a combination treatment, such as the removal of the precancerous skin growth via laser surgery or chemical peeling.
The one legitimate disadvantage of combination treatment is the prohibitive cost of applying this type of treatment to a patient. Since there are several different types of treatments being used at the same time, the cost will be much higher than if just one type of treatment was being used. Additionally, if a type of treatment does not have a track record of being effective, insurance companies may not cover the cost, such as is often the case with cryosurgery.4
Combination Treatment May Be the Best Treatment Against Skin Cancer
Due to its multi-method approach, combination treatment may be the best treatment against skin cancer, since it applies several kinds of treatments against the skin cancer. This can help to make up for the weaknesses of any one individual treatment, plus the combination treatment makes it less likely that cancer cells can adapt to all of the treatments as they often can with an individual treatment or drug.
As a result, combination treatment of many different precancer treatments can provide the greatest chance for patients to eliminate their precancers before they turn into more deadly skin cancers.
References
1 Treatments and Drugs (2011). From Mayo Clinic: www.mayoclinic.com/health/skin-cancer/DS00190/DSECTION=treatments-and-drugs
2Lasers in Cancer Treatment(2011). Retrieved from National Cancer Institute.
3Cryosurgery in Cancer Treatment: Questions and Answers. (2011). Retrieved from National Cancer Institute: www.cancer.gov/cancertopics/factsheet/Therapy/cryosurgery
4Treatments and Drugs, op.cit.
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