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Treatments and drugs
By Mayo Clinic staffA number of therapies exist for treating basal cell carcinoma; the most appropriate one depends on the type, location and severity of the tumor. Some commonly used basal cell carcinoma treatments include:
- Electrodesiccation and curettage (ED and C). This treatment can successfully remove new basal cell carcinomas, but is less effective for recurring tumors. It's often used for tumors located on your trunk, arms or legs. During the procedure, your dermatologist removes the surface of the skin cancer with a scraping instrument (curette) and then sears the base of the tumor with an electric needle.
- Surgical excision. In this procedure, which is used for both new and recurring tumors, your doctor cuts out the cancerous tissue and a surrounding margin of healthy skin. In some cases, you may have a wide excision, which involves removing additional normal skin around the tumor. To minimize scarring, especially on your face, consult a doctor skilled in skin reconstruction.
- Freezing. This involves removing cancerous cells by freezing them with liquid nitrogen (cryosurgery). It's useful for tumors on certain parts of your body and for people with more than one tumor, but it has definite drawbacks, including crusting, slow healing and scarring.
- Mohs' surgery. This is an effective treatment for recurring basal cell carcinomas and those that are large, deep, fast-growing, morpheaform or on your face. During the procedure, your doctor removes the tumor layer by layer, examining each layer under the microscope until no abnormal cells remain. This allows the entire growth to be removed without taking an excessive amount of surrounding healthy tissue. Because it requires particular expertise, Mohs' surgery should only be performed by doctors specifically trained in the procedure.
- Laser surgery. In this relatively new therapy, a laser is used to vaporize superficial basal cell carcinomas. To minimize bleeding, lasers are sometimes used instead of scalpels during surgical excisions.
- Topical treatments. Some superficial basal cell carcinomas are treated with creams or ointments. Tazarotene (Tazorac), a prescription cream normally used for acne, appears to be effective in preventing basal cell tumors. It may have a role in treatment as well, but it hasn't yet been approved for this use, as tests are ongoing. Other, approved topical treatments include imiquimod (Aldara) and 5-fluorouracil. These prescription medications require careful supervision because both can cause severe skin irritation as well as systemic side effects.
References
- Wood GS, et al. Nonmelanoma skin cancers: Basal cell and squamous cell carcinomas. In: Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone; 2008. http://www.mdconsult.com/das/book/body/119479231-3/0/1709/83.html?tocnode=55017273&fromURL=83.html#4-u1.0-B978-0-443-06694-8..50078-6--cesec29_2759. Accessed Feb. 6, 2009.
- Basal cell carcinoma. American Academy of Dermatology. http://www.aad.org/public/publications/pamphlets/sun_basal.html. Accessed Feb. 6, 2009.
- Detailed guide: Skin cancer - basal and squamous cell. American Cancer Society. http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_is_skin_cancer_51.asp. Accessed Feb. 6, 2009.
- Urist MM, et al. Melanoma and cutaneous malignancies. In: Townsend CM, et al. Townsend: Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa.: W.B. Saunders; 2007.http://www.mdconsult.com/das/book/body/119479231-5/0/1565/1.html?tocnode=54736195&fromURL=1.html#4-u1.0-B978-1-4160-3675-3..X5001-1--TOP_1. Accessed Feb. 6, 2009.
- Burns J. Bartter's syndrome and basal cell carcinoma. In: Ferri FF. Ferri's Clinical Advisor 2009. St. Louis, Mo.: Mosby; 2008. http://www.mdconsult.com/das/book/body/119515236-9/801847095/1701/79.html#4-u1.0-B978-0-323-04134-8..50005-7--cesec92_1598. Accessed Feb. 9, 2009.
- Sunscreen. The Skin Cancer Foundation. http://www.skincancer.org/the-scfs-guide-to-sunscreens.html. Accessed Feb. 6, 2009.
- Basal cell carcinoma of the skin. National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/treatment/skin/HealthProfessional/page5. Accessed Feb. 6, 2009.
- Ridky TW. Nonmelanoma skin cancer. Journal of the American Academy of Dermatology. 2007;57:484.
- Neoplasia. In: Kumar V, et al. Robbins and Cotran's Pathologic Basis of Disease. 7th ed. Philadelphia, Pa.: Saunders Elsevier; 2005. http://www.mdconsult.com/das/book/body/119515236-4/801835407/1249/66.html#4-u1.0-B0-7216-0187-1..50011-0--cesec92_600. Accessed Feb. 6, 2009.
- Arsenic toxicity exposure pathways. U.S. Department of Health and Human Services. http://www.atsdr.cdc.gov/csem/arsenic/exposure_pathways.html. Accessed Feb. 6, 2009.
- Common questions about diet and cancer. American Cancer Society. http://www.cancer.org/docroot/PED/content/PED_3_2X_Common_Questions_About_Diet_and_Cancer.asp?sitearea=PED. Accessed Feb. 6, 2009.
- Food Groups to Encourage. In: U.S. Department of Health and Human Services and U.S. Department of Agriculture. Dietary Guidelines for Americans. 6th Edition. Washington, D.C.: U.S. Government Printing Office; 2005. http://www.health.gov/DietaryGuidelines/dga2005/document/html/chapter5.htm. Accessed Feb 6, 2009.
- Premalignant and malignant nonmelanoma skin tumors. In: Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 4th ed. New York, N.Y.: Mosby; 2004. http://www.mdconsult.com/das/book/body/119515236-5/0/1195/157.html?tocnode=51442435&fromURL=157.html#4-u1.0-B0-323-01319-8..50023-6_2588. Accessed Feb. 6, 2009.
