Photodynamic therapy for multiple skin cancers

Photodynamic therapy is a new treatment modality under trial in a number of centers for use in both early and late tumors of the aerodigestive tract, bladder, brain, and skin. The theory behind its application relies on the selective uptake by a tumor bed of a photosensitizing agent such as hematoporphyrin derivative (HPD) and subsequent exposure of the tumor-bearing area to coherent laser light of suitable frequency. Following exposure, necrosis of tumor occurs to a variable degree depending on the amount of sensitizing agent absorbed by the tumor, the wavelength of laser light applied, the depth of penetration of light into the tumor, and the quantum of light energy delivered. Lack of controlled clinical data on the use of photodynamic therapy in multiple cancers of the skin led us to perform a pilot clinical study in patients. The results of this study were poor enough for us to abandon, on ethical grounds, a planned full clinical trial of the modality. The results are presented and possible reasons for failure of the method are discussed.