Nonmelanoma skin cancers such as basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the most common type of cancer around the world. Fortunately, they are also the most curable, especially when the tumors are relatively small and thin. Treatment depends on how large the cancer is and where it is found on the body. Here is an overview of some of the more rarely used treatment options (an introduction to the more common methods is also available):
Radiation therapy is effective in treating basal cell and squamous cell carcinomas, but it is rarely used because of its side effects, expense and complexity. It is most often used in patients who are not surgical candidates, in older patients, or in those with complex, disfiguring lesions or lesions on their lower legs, feet, hands or genitalia. It can also have a role as an adjuvant (after surgery) therapy in cases of aggressive SCC with metastases in the lymph nodes. The cure rate for radiation treatment is 90% to 93% but the resulting cosmetic appearance was judged as good by only 63% of patients.
Photodynamic Therapy (PDT)
PDT is a relatively new outpatient option for treating basal cell and squamous cell carcinomas that has been shown to be as effective as 5-flourouracil cream but the recurrence rate is higher. Treatment consists of two phases: first, a light-sensitive chemical is applied to the tumor, then the treated area is exposed to a light. The light switches on the drug, destroying the cancerous cells without damaging the surrounding tissue. It is most effective in treating superficial lesions versus the thicker, more invasive ones. Currently, PDT is useful for those patients whose topical treatments failed or who cannot undergo surgery.
Laser Ablation Therapy
In this treatment, a carbon dioxide laser is focused on a small skin lesion to destroy it. The area is numbed with a local anesthetic first. It is used for thin superficial basal and squamous cell lesions and not for deeper tumors since the recurrence rate is higher than surgery. Since laser surgery does not destroy cancer cells found deeper in the skin, close follow-up with a dermatologist is important.
Cryosurgery is a method that destroys cancerous tissue by freezing it. The cold is introduced through a probe that has liquid nitrogen at -195 degrees Celsius (-319 degrees Fahrenheit) circulating through it. Small, early stage basal and squamous cell tumors can be destroyed by cryosurgery in a physician's office using only local anesthesia. Cryosurgery is useful for treating tumors with well-defined borders in elderly or debilitated patients not able to withstand surgery. The reported 5-year cure rates for BCC and SCC treated by cryosurgery are 93% and 96%, respectively.
A description of the more common treatment methods for basal and squamous cell carcinoma is also available.
"Treating Nonmelanoma Skin Cancer." American Academy of Dermatology. 3 December 2008.
"How is Squamous and Basal Skin Cancer Treated?" American Cancer Society. June 2008. 23 December 2008.
Neville JA, Welch E, Leffell DJ."Management of nonmelanoma skin cancer in 2007." Nat Clin Pract Oncol 2007 4(8):432-469. 7 December 2008.