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Basal and Squamous Cell Skin Cancer
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 when used in appropriate situations. 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: Excision (cutting the tumor out) is often used to remove basal cell carcinomas, along with a margin of normal skin.
Mohs surgery: Mohs surgery is especially useful in treating cancers that are at higher risk for coming back, such as 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. Radiation is also sometimes used after surgery if it’s not clear that all of the cancer has been removed.
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.
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.
If these drugs are no longer working (or if they can’t be taken for some reason), the immunotherapy drug cemiplimab (Libtayo) can sometimes be helpful.
The American Cancer Society medical and editorial content team
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
Aasi SZ. Treatment and prognosis of basal cell carcinoma at high risk of recurrence. UpToDate. 2019. Accessed at https://www.uptodate.com/contents/treatment-and-prognosis-of-basal-cell-carcinoma-at-high-risk-of-recurrence on June 4, 2019.
Aasi SZ. Treatment and prognosis of basal cell carcinoma at low risk of recurrence. UpToDate. 2019. Accessed at https://www.uptodate.com/contents/treatment-and-prognosis-of-basal-cell-carcinoma-at-low-risk-of-recurrence on June 4, 2019.
Christensen SR, Wilson LD, Leffell DJ. Chapter 90: Cancer of the Skin. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2019.
Martins RG. Systemic treatment of advanced cutaneous squamous and basal cell carcinomas. UpToDate. 2019. Accessed at https://www.uptodate.com/contents/systemic-treatment-of-advanced-cutaneous-squamous-and-basal-cell-carcinomas on June 4, 2019.
National Comprehensive Cancer Network (NCCN). Practice Guidelines in Oncology: Basal Cell Skin Cancer. Version 1.2019. Accessed at www.nccn.org/professionals/physician_gls/PDF/nmsc.pdf on June 4, 2019.
Xu YG, Aylward JL, Swanson AM, et al. Chapter 67: Nonmelanoma Skin Cancers. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier; 2020.
Last Revised: February 10, 2021
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