Treatment Options for Nonmelanomas

Basal Cell Carcinoma & Squamous Cell Carcinoma

At Scott & White, we explore every treatment option, considering surgical and nonsurgical alternatives. In many cases, your skin cancer treatment will include a combination of approaches.

Surgery is often the first treatment choice for nonmelanomas. In some cases, your physician may recommend one or more alternate therapies for your skin cancer if you are a good candidate for these approaches.

At Scott & White, treatment goals for nonmelanomas generally are centered on skin-preserving treatments. Our philosophy is to remove as much cancer as reasonable while preserving as much of your cosmetic appearance as possible.

Surgery

Surgery is often the first treatment approach for:

  • Basal cell carcinoma
  • Squamous cell carcinoma that has not spread (metastasized) to other organs

Your physician will discuss which option is best for you. As with all operations, there are some risks. Your surgeon will discuss those risks with you.

Excision

In this surgical procedure, your dermatologist will remove your tumor and a small area of healthy skin and tissue around your tumor. The healthy area around your tumor is called a margin. Generally speaking, the bigger the tumor, the wider the margin.

Electric Desiccation Curettage

In this surgical procedure, your dermatologist will remove your lesion and a small margin around it with a sharp spoon-like instrument (curette). Then, using a thin needle-like instrument, your dermatologist will then apply a high-frequency electric current to the lesion base, thereby cauterizing the tissue.

This procedure is used in some cases for small lesions in non-cosmetically important areas.

Mohs Micrographic Surgery

In some cases, your dermatologist may recommend Mohs micrographic surgery for your nonmelanoma skin cancer.

In this procedure, your Mohs surgeon will cut away skin and immediately check it under a microscope for cancerous cells. The process is repeated until the skin sample is free of cancer.

Mohs surgery removes all the roots of skin cancer with the highest cure rates of any form of treatment. Mohs surgery makes the smallest possible surgical wound.

Mohs surgery is used only for certain skin cancers:

  • Very aggressive cancers
  • Those that have grown back after previous treatment
  • Cancers at risk of returning
  • Those located where preserving normal skin is important

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Alternate Therapies

Your Integrated Care Team may recommend one or more alternate therapies for your nonmelanoma skin cancers if you are a good candidate for these approaches.

Laser Surgery

In this procedure, your physician will vaporize your cancer cells with a powerful beam of light. It’s most commonly used for basal cell carcinomas on the surface of your skin or for squamous cell carcinoma in situ (on the top layer of your skin).

Cryosurgery

In this procedure, your physician will destroy your cancerous lesion by freezing it. Cryosurgery often has good cosmetic results, as it leaves little scarring.

Photodynamic Therapy (PTD)

In this treatment, you’ll apply a cream containing a chemical that’s absorbed into your skin. Your physician will shine a special light onto your skin that activates the medication to destroy cancerous cells in a broad area, not just on the lesion.

This treatment is often used with widespread pre-cancerous areas before they become cancers.

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Radiation Therapy

Radiation therapy is infrequently used to treat basal cell carcinoma or squamous cell carcinoma.

However, your physician team may recommend radiation therapy if:

  • Your tumor covers a large area of skin, making surgery difficult.
  • You are not a good candidate for surgery.
  • You have a type of skin cancer called Merkel cell carcinoma.

Radiation therapy for nonmelanomas is used in some cases:

  • To destroy any remaining cancer cells after surgery.
  • To help reduce the chances of your cancer returning.
  • To treat any cancer that has spread to your lymph nodes or other parts of your body.

Radiation Therapy Patient Education

Chemotherapy

Basal cell carcinoma is infrequently treated with chemotherapy.

However, chemotherapy is used in some cases to treat squamous cell carcinoma or Merkel cell carcinoma that have spread to other parts of your body.

Chemotherapy is used in some cases:

  • To shrink the size of your tumor before surgery or radiation therapy; this kind of chemotherapy is called neoadjuvant therapy
  • To kill any remaining cancer cells after surgery or radiation therapy; this kind of chemotherapy is called adjuvant chemotherapy
  • To treat metastatic cancer (cancer that has spread)
  • To treat recurrent cancer (cancer that has returned)
  • As a palliative — to relieve the symptoms caused by cancer, such as bone pain

 

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