Treatment Options for Basal Cell Carcinoma
The most common type of skin cancer is basal cell carcinoma. According to the American Cancer Society, 75% of all skin cancers are basal cell carcinomas. Individuals most likely to get basal cell carcinomas are over 45 years of age, have fair skin and have had long term exposure to the sun during their lifetime. It is estimated that up to 90% of these types of lesions occur between the hairline and the upper lip but they can develop elsewhere on the body. Basal cell carcinomas are rarely lethal but they can cause great disfigurement if left untreated. The good thing to remember is that most basal cell carcinomas can successfully be cured if treated early. These skin cancers can reoccur even after treatment so an annual skin exam by a dermatologist is strongly recommended if you have been diagnosed with basal carcinoma.
Treatment for this type of skin cancer greatly depends on the size, location, and severity of the lesion and also your general health. You will need to discuss all your treatment options with your doctor following your diagnosis.
Here are some of the current methods to treat basal cell carcinomas: -** Surgical Excision:** This is one of the most common ways to treat skin cancers in general. The area of the skin lesion is numbed with local anesthesia and then your doctor would use a scalpel to cut out the entire tumor along with a border of healthy skin to be safe. The wound is then sutured with stitches and the tissue sample is sent to the lab to be examined under a microscope. The lab will then tell the doctor if all the cancer cells have been removed. One advantage of this method is that the wound usually heals quickly. One disadvantage is that if the lab report says that the skin around the tumor is not completely free of cancer cells, you would have to come back for a re-excision. Basal cell carcinomas can come back despite having this type of surgery. Simple surgical excision is said to be less effective than Mohs surgery and has cure rates of about 90%.
- Electrodessication and Curettage: This procedure is done with local anesthesia. The doctor uses a sharp instrument called a curette to scrape off the lesion. An electrocautery device is then used to destroy any cancer cells with heat. This procedure is most easily performed on lesions found on flat areas of skin. One advantage to using this method is that the procedure can usually be completed in one visit. Another advantage is that many patients show no scar after 6-12 months following the procedure. In some cases a small white mark may remain.
It may not be as beneficial to use this procedure for aggressive basal cell carcinomas. The cure rate greatly depends upon the size of the tumor. The National Cancer Institute provides an estimate that lesions with diameters ranging from 2mm to 5mm have a 15% recurrence rate after this treatment while lesions greater than 3 cm have a 50% recurrence rate within 5 years.
- Cryosurgery: This procedure uses liquid nitrogen to freeze the cancerous tissue and destroy it so anesthesia and cutting are not necessary. Patients with bleeding disorders or who have an intolerance to anesthesia may choose this procedure as a treatment option. Patients who have smaller well-defined common tumors may be good candidates for cryosurgery.
This method is can have somewhat lower cure rates than other treatment options. The Skin Cancer Foundation reports that the cure rate for using cryosurgery is around 85-90 percent depending on the physician’s expertise. Some of the other possible disadvantages of this method as reported in the literature include: A higher recurrence rate than surgery, pain, leaking, and wound infection are not infrequent, possible scarring, and there is a risk of motor and sensory neuropathy.
- Mohs Surgery: Moh’s micrographic surgery has become a popular surgical procedure to treat some skin cancers including basal cell carcinomas. This type of surgery is used for large, aggressive, or recurrent lesions. It also may be the preferred method to use for tumors located on the face where there may be cosmetic concerns. Mohs surgery is a specialized skin surgery where the surgeon will examine each piece of skin tissue under a microscope immediately as it is removed. If cancer cells are found then the surgeon goes in to re-excise more tissue until the border around the lesion is cancer free.
The advantages of this technique are many and include: Everything is usually done within one office visit, all the cancer is removed but as much normal skin surrounding the lesion is spared, rates of recurrence of facial basal cell carcinoma are reported to be lower after Mohs surgery than some other treatments, and the cure rates also exceed other types of treatment, generally at 98% or better.
Some of the disadvantages of Mohs surgery include: You may need to follow up with plastic surgery following the procedure depending upon the size and depth of the wound, it requires a specially trained surgeon, and is more time consuming and expensive than surgical excision.
In order to keep up with the demand of requests for information about this type of surgery we have many articles about Mohs surgery for you to read.
Other types of treatment for basal cell carcinomas include laser surgery, radiation, topical chemotherapy, and photodynamic therapy. These treatment options will be discussed in a future article.
The best thing to do when you have just been diagnosed with a skin cancer is to discuss your options for treatment with your doctor. Then you can research the information about each option in order to make the most informed choice.
To find out more about skin cancer treatment options and more please visit our skin cancer treatment guide.