Several other techniques can be used to treat basal and squamous cell skin cancers that have not spread to lymph nodes or other parts of the body. Some of these treatments are described as types of surgery since they destroy a targeted area of body tissue. But these techniques don't involve using scalpels or cutting into the skin.
Cryosurgery (cryotherapy)
For this treatment, liquid nitrogen is applied to the tumor to freeze and kill abnormal cells. After the dead area of skin thaws, it may swell, blister and crust over. The wound may take a month or 2 to heal and will leave a scar. The treated area may have less color after treatment.
Cryosurgery is often used for pre-cancerous conditions such as actinic keratosis and for small basal cell and squamous cell carcinomas.
Photodynamic therapy (PDT)
This treatment uses a special drug that is either applied to the skin or injected into the blood. It collects in the tumor cells over the course of several hours or days and makes the cells sensitive to certain types/colors of light. A light source is then focused on the tumor(s), which causes the cells to die. A possible side effect of PDT is that it can make a person's skin very sensitive to sunlight for a period of time (often several weeks), so precautions may be needed to avoid severe burns.
PDT can be used to treat actinic keratoses. But its exact role in treating non-melanoma skin cancers, if any, still needs to be determined. For more information on this technique, see our document called Photodynamic Therapy.
Topical chemotherapy
Chemotherapy uses drugs that kill cancer cells. Topical chemotherapy means that an anti-cancer medicine is placed directly on the skin (usually in a cream or ointment) rather than being given by mouth or injected into a vein. The drug most often used in topical treatment of basal and squamous cell skin cancers is 5-fluorouracil (5-FU).
When applied directly on the skin in the form of a cream, 5-FU reaches cancer cells near the skin surface, but it cannot reach cancer cells that may have invaded deeply into the skin or spread to other organs. For this reason, treatment with 5-FU generally is used only for pre-cancerous conditions such as actinic keratosis and for some very superficial skin cancers.
Because it is only applied to the skin, the drug does not spread throughout the body, so it doesn't cause the same side effects that can occur with systemic chemotherapy (treatment that affects the whole body). But it can cause the treated skin to become red and very sensitive for a few weeks, which can be quite bothersome for some people. Other topical medicines can be used to help relieve this. Fluorouracil also increases the skin's sensitivity to sunlight, so treated areas must be protected from the sun for a few weeks after use of this cream to prevent sunburn.
A gel containing the drug diclofenac is sometimes used to treat actinic keratoses. This drug belongs to the non-steroidal anti-inflammatory drugs (NSAIDs), a group that includes pain relievers such as aspirin and ibuprofen.
Immune response modifiers
Certain drugs can boost the body's immune system response against the cancer, causing it to shrink and go away.
Imiquimod is a cream that can be applied to actinic keratoses and some basal cell cancers. It is not a chemotherapy drug. Instead, it causes the immune system to react to the skin lesion and cause its destruction.
Interferon is a man-made version of an immune system protein. It can be injected directly into the tumor to boost the immune response against it. It may be used occasionally when surgery is not possible, but it may not be as effective as other treatments.
Laser surgery
This relatively new approach uses a beam of laser light to vaporize cancer cells. It is sometimes used for squamous cell carcinoma in situ (involving only the epidermis) and for very superficial basal cell carcinomas (those only on the surface of the skin). It is not yet known if this type of treatment is as effective as standard methods of treatment, and it is not widely used.
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