Basal Cell and Squamous Cell Carcinoma
Numerous treatment options are available for basal cell and squamous cell carcinoma. Your therapy will depend upon the type of skin cancer you have and its stage.
- Surgery Many skin cancers can be cut from the skin quickly and easily. In fact, the cancer is sometimes completely removed at the time of the biopsy, and no further treatment is needed.
- Curettage and Electrodesiccation Doctors commonly use a type of surgery called curettage. After a local anesthetic numbs the area, the cancer is scooped out with a curette, an instrument with a sharp, spoon-shaped end. The area is also treated by electrodesiccation. An electric current from a special machine is used to control bleeding and kill any cancer cells remaining around the edge of the wound. Most patients develop a flat, white scar.
Extreme cold may be used to treat pre-cancerous skin conditions, such as actinic keratosis — a scaly or crusty bump on the skin that can be a precursor or first step in the development of skin cancer — as well as certain small skin cancers. In cryosurgery, liquid nitrogen is applied to the growth to freeze and kill abnormal cells. After the area thaws, dead tissue falls off. More than one freezing may be needed to remove the growth completely. Cryosurgery usually doesn't hurt, but you may have pain and swelling after the area thaws. A white scar may form in the treated area.
Laser therapy uses a narrow beam of light to remove or destroy cancer cells. This approach is sometimes used for cancers that involve only the outer layer of skin.
Mohs' technique is a special type of surgery used for skin cancer. Its purpose is to remove all of the cancerous tissue and as little of the healthy tissue as possible. It is especially helpful when the doctor isn't sure of the shape and depth of the tumor. This method is used to remove large tumors, those in hard-to-treat places and cancers that have recurred. After being given a local anesthetic, the cancer is shaved off one thin layer at a time. Each layer is checked under a microscope until the entire tumor is removed. The degree of scarring depends on the location and size of the treated area.
Skin cancer responds well to radiation therapy, also called radiotherapy, that uses high-energy rays to damage cancer cells and stop them from growing. Doctors often use this treatment for cancers that occur in areas that are hard to treat with surgery. Radiation therapy might be used for cancers of the eyelid, the tip of the nose or the ear. Several treatments may be needed to destroy all cancer cells. Radiation therapy may cause a rash or make skin dry or red. Changes in skin color or texture may develop after the treatment and may become more noticeable later.
Topical chemotherapy is the use of anticancer drugs in a cream or lotion applied to the skin. Actinic keratosis, a scaly or crusty bump on the skin that can be a precursor or first step in the development of skin cancer, can be treated effectively with the anticancer drug fluorouracil, also called 5-FU. This treatment is also useful for cancers limited to the top layer of skin. The 5-FU is applied daily for several weeks. Intense inflammation is common during treatment, but scars usually do not occur.
Reconstruction after surgery
When a large cancer is removed, a skin graft sometimes is needed to close the wound and reduce scarring. For this procedure, your doctor takes a piece of healthy skin from another part of the body to replace skin that was removed.
UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.
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