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Once a diagnosis of CTCL has been made it is important to find out if cancer has spread from the skin to any other part of the body. This process is called staging, and will determine the proper choice of treatment and long-term outlook. There are five categories of standard treatments:

  • Photodynamic therapyA drug that is activated by laser light is injected into a vein. The drug accumulates in cancer cells. When laser light is shined onto the skin, the drug kills cancer cells.
  • Extracorporeal photophoresis: Another treatment that involves light. The patient’s blood is drawn. White blood cells are culled out and mixed with a drug that makes cancerous T-cells sensitive to ultraviolet (UV) light. When exposed to UV light, these cells die. The treated white blood cells are then returned to the patient.
  • Radiation therapy: X-rays or other sources of radiation directed at cancer cells can kill them or slow their growth. External radiation sources include a radiation therapy machine, which can direct electrons (subatomic particles with a negative charge) or photons to diseased areas of skin.
  • Chemotherapy: Chemotherapy may be given by mouth, injection, or as gels, creams or lotions spread directly onto the skin. Examples of chemotherapy drugs include methotrexate and gemcitabine.
  • Other drug therapy:
    • Corticosteroids are applied directly to the skin to treat red, swollen and inflamed skin.
    • Retinoids such as bexarotene are vitamin A-related drugs that can slow the growth of cancer cells.
    • Histone deacetylase inhibitors like vorinostat and romidepsin keep tumor cells from dividing.
    • Lenalidomide provides a boost to the body’s own immune system to help kill diseased cells, and prevent the growth of new blood vessels in tumors.
  • Biologic therapy: Substances made by the body or in a laboratory add to the patient’s immune system’s ability to battle disease. Interferons, for example, interfere with cancer cell division and can slow the growth of tumors.