Photodynamic Therapy: An Alternative to Surgery

Among the methods for removal of basal cell carcinomas (BCC) are simple excision, Mohs surgery, radiotherapy, curettage/electrodessication, and cryosurgery, with the choice of treatment depending on type, size, depth, and location of the lesion. However, some patients are at risk for extensive scarring or otherwise can't tolerate surgery.

In the past few months, evidence has mounted that treatment with methyl aminolevulinate (MAL)-photodynamic therapy (PDT) can be almost as effective as surgery for superficial BCC -- but without the potential for scars. A study done by Rolf-Markus Szeimies, MD of Regensburg University in Germany demonstrated that MAL-PDT was slightly less effective than surgery (92% vs. 99%) and the BCCs came back somewhat more often (9% vs. 0%), but overall MAL-PDT led to a much better cosmetic outcome (94% vs. 60%). A Spanish study, led by Carlos Guillén Barona, MD of the Valencia Oncology Institute, recently showed similar results: 90% of patients had a complete response to MAL-PDT, with 89% of the lesions rated as "good" or "excellent" in terms of cosmetic outcome. The procedure is also easy to do -- just spread the MAL cream on the lesion and then shine a red LED light on it -- and there are few side effects.

If you or a loved one has BCC, ask your doctor if MAL-PDT is right for you.

_Sources:

Barona CG, et al. "Photodynamic Therapy With 5-Methyl Aminolevulinate (MAL-PDT) in Patients With Superficial Basal Cell Carcinoma." 17th Annual Congress of the European Academy of Dermatology and Venereology. 2008. Abstract FP1096. 27 October 2008.

Szeimies RM, et al. "A clinical study comparing methyl aminolevulinate photodynamic therapy and surgery in small superficial basal cell carcinoma (8–20 mm), with a 12-month follow-up." Journal of the European Academy of Dermatology and Venereology. 2008. 22(11): 1302-1311. 27 October 2008.