How do you treat malignant lesions?

In treating cancers, we need to be very sure we treat them adequately. Most importantly, you should be able to clinically identify the margins of the lesion. Second, you must know the histology of the cancer to be sure cryosurgery is appropriate. Third, you must have equipment that ensures you reach a temperature of −50° C to −60° C beyond the peripheral extent and depth of the cancer. Malignant lesions require longer freeze times than benign lesions. Most malignant tumors require at least a 30-second freeze with two freeze-thaw cycles. Curetting or shaving tumors first to delineate and debulk the lesion prior to cryosurgery can permit more effective treatment. For large tumors, multiple treatments are often required. Repeat biopsies after cryosurgery can histologically confirm the resolution of the tumor.

Graham GF: Cryosurgery in the management of cutaneous malignancies, Clin Dermatol 19:321–327, 2001.