Dermatology - Photodynamic Therapy

Speaker key

AM Alan Milligan

IV Interviewer

AM My name's Alan Milligan and I'm the clinical nurse specialist for non-melanoma skin cancer at the Royal Free Hospital in London. My talk today is about photodynamic therapy, which is a treatment for certain types of non-melanoma skin cancers.

IV What is photodynamic therapy?

AM Photodynamic therapy treatment is a therapy for non-melanoma skin cancers using a light source and a photosensitizer to cause a photochemical reaction leading to cell death in skin cancer lesions.

IV Is this treatment available in secondary care only?

AM It is available in secondary care only because certain specialist equipment and expertise is needed to do it.

IV Could you describe the treatment of photodynamic therapy?

AM We commonly use photodynamic therapy to treat the thin non-melanoma skin cancers such as Bowman's disease, actinic keratosis, superficial basal cell carcinoma. The treatment involves a light source, a photosensitizer. You create a photochemical reaction. It's an outpatient treatment, it's generally very well tolerated, and we see very good results.

IV Are there any new protocols in photodynamic therapy?

AM There is now a new protocol in photodynamic therapy which may be more suitable just for actinic keratosis, especially where you get field change. This is something which is usually treated with, say, topical chemotherapy and the treatment is quite protracted. With daylight PDT, it is a simple, two-hour treatment which the patient carries out themselves.

IV Is the treatment curative?

AM The treatment is intended to be curative and it generally is. Occasionally, some of these lesions do recur, but they can be treated again in the same way with good results, or an alternative treatment could be tried.

IV Are there any side effects of the treatment?

AM Some people experience pain and discomfort during the actual light application in photodynamic therapy, but this can be helped by using local anaesthetic. Afterwards, there is always a degree of inflammation, but it's generally not protracted and is usually tolerated very well.

IV How is your service accessed?

AM GPs can refer patients to our skin cancer clinics, which take place regularly at the Royal Free Hospital. We generally carry out skin biopsies for diagnosis and then we proceed to give patients options for treatment, if indicated.

IV How can GPs get in touch?

AM We can be contacted via our internet site, for the Royal Free Hospital, or GPs are very welcome to contact me directly. My name's Alan Milligan, and my e-mail address is .

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