Skin Cancer, Nonmelanoma

The goals of treatment for nonmelanoma skin cancer are to:

• Remove the entire skin cancer and a margin of skin tissue around the cancer to reduce the chance of recurrence.
• Preserve nearby skin tissue that is free of cancer and minimize scarring after surgery.

Initial treatment

Treatment for nonmelanoma skin cancer depends on the size and location of the cancer, whether it is Reference basal cell Opens New Window or Reference squamous cell Opens New Window, and your age and overall health. The type of treatment will also depend on whether you have had skin cancer at that place before and whether the cancer is in a place where you have had radiation therapy. Because skin cancer usually grows slowly, it often can be detected early and successfully treated.

The most common treatment is surgery to destroy or remove the entire skin growth, including a margin of cancer-free tissue around the growth. Most surgical treatments are very effective, with high cure rates.

The main treatment options are:

• Reference Mohs micrographic surgery. This surgery removes the skin cancer one layer at a time, checking each layer for cancer cells right after it is removed.
• Reference Excision. Excision removes the skin cancer along with some healthy skin tissue around it (margin).
• Reference Radiation therapy Opens New Window. Radiation therapy uses X-rays or other types of radiation to kill cancer cells. It may done if surgery isn't an option.
• Reference Curettage and electrosurgery. Curettage uses a spoon-shaped instrument (curette) to scrape off the skin cancer, and electrosurgery controls the bleeding and destroys any remaining cancer cells.
• Reference Cryosurgery. Cryosurgery destroys the skin cancer by freezing it with liquid nitrogen.

Each of these treatments has Reference advantages and disadvantages. Discuss your options with your doctor.

Basal cell carcinoma may also be treated with:

• Reference Photodynamic therapy.
• Medicines put on the skin, such as Reference topical fluorouracil (5-FU) and Reference topical imiquimod.
• Reference Laser surgery.

Ongoing treatment

Follow-up treatment for nonmelanoma skin cancer includes Reference skin self-exams Opens New Window Reference Opens New Window and regular exams by your doctor. These exams are extremely important to reduce the risk of the cancer coming back (recurrence).

Almost half of people who have a nonmelanoma skin cancer will develop another one within 5 years.^{Reference 1} Your doctor may schedule you for exams as often as every 3 to 6 months for the first 2 years and yearly after that, especially for Reference squamous cell carcinoma Opens New Window.

Treatment if the condition gets worse

Surgery is usually very effective for both Reference basal Opens New Window and Reference squamous cell Opens New Window carcinoma. But sometimes the cancer can come back (recur). Or in rare cases, it may spread (metastasize). Metastasis is more likely with squamous cell carcinoma than with basal cell.

If basal cell carcinoma comes back, treatment is usually Mohs surgery. But for squamous cell carcinoma that comes back, treatment may include surgery (excision or Mohs surgery) or radiation therapy.

If the cancer does spread, Reference chemotherapy Opens New Window may be used. If basal cell carcinoma spreads after treatment with surgery and radiation, it may be treated with the medicine vismodegib. Your doctor may suggest that you enroll in a Reference clinical trial Opens New Window if one is available.

What to think about

Precancer skin growths, such as Reference actinic keratoses and Reference Bowen's disease Opens New Window, can develop into squamous cell skin cancer if they are not treated.

Additional information about skin cancer is provided by the National Cancer Institute at www.cancer.gov/cancertopics/pdq/treatment/skin/Patient.

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