Basal Cell Carcinoma Treatment

Non-melanoma skin cancer includes basal cell carcinoma. These lesions are often treated in the doctor’s office with relatively minor surgery.1 The specific type of surgery depends on the location of the tumor and likelihood of recurrence.

Excision

Your doctor will cut out (excise) the tumor using a surgical knife. When an elliptical (football shaped) incision is made, the scar will be a flat, thin line. Narrower margins are used for tumors that are unlikely to recur. Wider margins are used for tumors that are more likely to recur (return).2,3 However, for tumors at high risk of recurrence, Mohs surgery is preferred.

Mohs surgery

A specially trained surgeon performs Mohs surgery. The surgeon removes one layer of skin at a time until all the cancer cells have been removed. This surgical procedure has the highest cure rates: the 5-year recurrence rate is approximately 1%.4 It also saves the most healthy skin. Mohs surgery can be a good option for large, invasive tumors, or tumors on very visible places.

Other local treatment procedures

Local procedures that may be used to remove some thin, low-risk non-melanoma skin cancers include curettage and electrodesiccation, cryotherapy, and photodynamic therapy.

Topical medications

Fluorouracil and imiquimod may be used to treat some non-melanoma skin cancers that affect only the very top layers of skin. However, it is more common to use topical medications to treat precancers.1,4

Radiation therapy

Radiation therapy is a treatment option when surgery is not possible. It may be used as adjuvant therapy when the risk of recurrence is high. Adjuvant therapy is a second treatment given after the primary (main treatment, such as surgery). Adjuvant therapy may reduce the risk of recurrence.

Systemic medications

Two targeted therapies are available for people with certain forms of advanced basal cell carcinoma: Erivedge® (vismodegib) and Odomzo® (sonidegib). Cemiplimab-rwlc (Libtayo®) immunotherapy may be used to treat people with certain forms of advanced basal cell carcinoma. These are oral medications taken by mouth. Less often, chemotherapy may be used in certain situations.

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Written by: Sarah O'Brien | Last reviewed: June 2021.