Edit Photodynamic Therapy for skin cancer

<p><strong>How does PDT - photodynamic therapy, work?</strong></p> <p>A specially prepared chemical cream called methyl aminolevulinate (MAL) is applied to the target area and then covered with a dressing which keeps out light. This remains on the skin for a variable period - usually, a few hours and the patient is free to leave the clinic and return later.</p> <p>The MAL will cause the production of porphyrins in the rapidly growing and dividing cancer cells. By exposing the target area which had previously been covered by the MAL cream to a specific red or blue wavelength light, the porphyrins will create oxygen-free radicals within the cells which will then kill the cancer cells.</p> <p>Typically two treatments are needed at a 7-day interval. During the application of the cream and also the application of the red or blue light source there is usually no pain.</p> <p>After the light exposure has finished there can be quite an intense discomfort localised to the target area which a few patients have likened to a hot "fizzing" sensation. This is generally anticipated and controlled by painkillers ahead of the use of the light treatment.</p> <p>So in summary, the skin cancer is confirmed and identified by the biopsy specimen; the patient returns when the histology result is available; the first application of the cream is used and then three or so hours later the red or blue light is applied for a few minutes. The patient is then free to go home and rest and to return in 7 days for the second treatment.</p> <p>Ongoing surveillance does need to be carried out over a lifetime. Patients with basal cell carcinoma tend to be either genetically susceptible e.g., with Celtic skin colouring and to have been heavily sun-exposed and so usually the first basal cell carcinoma is just that - the first, and others can be expected.</p> <p>The very definite advantage for basal cell cancers, Bowen's Disease or actinic keratoses which fall into this treatment category is that the treatment avoids fairly substantial surgery. With Amanda Platell's skin cancer, she had a big surgical excision over her eyebrow with a recurrence of cancer some years later at the same site. Standard surgical treatment the second time around would likely have resulted in her eyebrow being removed as part of the surgery. This would not be a desirable outcome for anyone.</p>

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