Treatment

The goal of treatment for basal cell carcinoma is to remove the cancer completely. Which treatment is best for you depends on the type, location and size of your cancer, as well as your preferences and ability to do follow-up visits. Treatment selection can also depend on whether this is a first-time or a recurring basal cell carcinoma.

Surgery

Basal cell carcinoma is most often treated with surgery to remove all of the cancer and some of the healthy tissue around it.

Options might include:

• Surgical excision. In this procedure, your doctor cuts out the cancerous lesion and a surrounding margin of healthy skin. The margin is examined under a microscope to be sure there are no cancer cells.

  Excision might be recommended for basal cell carcinomas that are less likely to recur, such as those that form on the chest, back, hands and feet.

• Mohs surgery. During Mohs surgery, your doctor removes the cancer layer by layer, examining each layer under the microscope until no abnormal cells remain. This allows the surgeon to be certain the entire growth is removed and avoid taking an excessive amount of surrounding healthy skin.

  Mohs surgery might be recommended if your basal cell carcinoma has a higher risk of recurring, such as if it's larger, extends deeper in the skin or is located on your face.

Other treatments

Sometimes other treatments might be recommended in certain situations, such as if you're unable to undergo surgery or if you don't want to have surgery.

Other treatments include:

• Curettage and electrodessication (C and E). C and E treatment involves removing the surface of the skin cancer with a scraping instrument (curet) and then searing the base of the cancer with an electric needle.

  C and E might be an option for treating small basal cell carcinomas that are less likely to recur, such as those that form on the back, chest, hands and feet.

• Radiation therapy. Radiation therapy uses high-energy beams, such as X-rays and protons, to kill cancer cells.

  Radiation therapy is sometimes used after surgery when there is an increased risk that the cancer will return. It might also be used when surgery isn't an option.

• Freezing. This treatment involves freezing cancer cells with liquid nitrogen (cryosurgery). It may be an option for treating superficial skin lesions. Freezing might be done after using a scraping instrument (curet) to remove the surface of the skin cancer.

  Cryosurgery might be considered for treating small and thin basal cell carcinomas when surgery isn't an option.

• Topical treatments. Prescription creams or ointments might be considered for treating small and thin basal cell carcinomas when surgery isn't an option.

• Photodynamic therapy. Photodynamic therapy combines photosensitizing drugs and light to treat superficial skin cancers. During photodynamic therapy, a liquid drug that makes the cancer cells sensitive to light is applied to the skin. Later, a light that destroys the skin cancer cells is shined on the area.

  Photodynamic therapy might be considered when surgery isn't an option.

Treatment for cancer that spreads

Very rarely, basal cell carcinoma may spread (metastasize) to nearby lymph nodes and other areas of the body. Additional treatment options in this situation include:

• Targeted drug therapy. Targeted drug treatments focus on specific weaknesses present within cancer cells. By blocking these weaknesses, targeted drug treatments can cause cancer cells to die.

  Targeted therapy drugs for basal cell carcinoma block molecular signals that enable the cancers to continue growing. They might be considered after other treatments or when other treatments aren't possible.

• Chemotherapy. Chemotherapy uses powerful drugs to kill cancer cells. It might be an option when other treatments haven't helped.