Excision of Biopsy Proven Basal Cell Carcinoma. Excisional Pathology showed clear margins s/p procedure.
Treating Basal Cell Carcinoma
Several types of treatment can be used to remove or destroy basal cell skin cancers. The options depend on factors such as the tumor size and location, and a person’s age, general health, and preferences. These cancers very rarely spread to other parts of the body, although they can grow into nearby tissues if not treated.
All of the treatments listed here can be effective. The chance of the cancer coming back (recurring) ranges from less than 5% after Mohs surgery to up to 15% or higher after some of the others, but this depends on the size of the tumor. Small tumors are less likely to recur than larger ones. Even if a tumor does recur, it can often still be treated effectively.
Different types of surgery can be used to treat basal cell cancers.
Curettage and electrodesiccation: This is a common treatment for small basal cell carcinomas. It might need to be repeated to help make sure all of the cancer has been removed.
Excision: (cutting the tumor out) is often used to remove basal cell carcinomas, along with a margin of normal skin.
Mohs surgery: Mohs surgery has the best cure rate for basal cell carcinoma. It’s especially useful in treating large tumors, tumors where the edges are not well-defined, tumors in certain locations (such as on or near the nose, eyes, ears, forehead, scalp, fingers, and genital area), and those that have come back after other treatments. However, it’s also usually more complex and time-consuming than other methods.
Radiation therapy is often a good option for treating patients who aren’t able to have surgery and for treating tumors on the eyelids, nose, or ears – areas that can be hard to treat surgically – especially in older patients where cure may not be as important as control over the long term. It’s also sometimes used after surgery if it’s not clear that all of the cancer has been removed.
Immune response modifiers, photodynamic therapy, or topical chemotherapy
These treatments are sometimes options for treating very superficial tumors (tumors that have not grown too deeply into the skin). Close follow-up is needed because these treatments do not destroy any cancer cells that have grown deep below the surface.
Cryotherapy (cryosurgery) can be used for some small basal cell carcinomas, but it’s not usually recommended for larger tumors or those on certain parts of the nose, ears, eyelids, scalp, or legs.
Cryotherapy can also be used to treat large tumors in one treatment session to relieve symptoms from the cancer. The site of treatment often takes a month or two to heal.
Targeted therapy for advanced basal cell cancers
In rare cases where basal cell cancer spreads to other parts of the body or can’t be cured with surgery or radiation therapy, a targeted drug such as vismodegib (Erivedge) or sonidegib (Odomzo) can often shrink or slow its growth.