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Basal cell carcinomas are highly curable with both surgical and non-surgical therapy. Depending on the tumor's location and size; the patient's general health, medical history, and preferences; and whether the tumor has been treated before, treatment options may include curettage and electrodesiccation, radiation therapy, standard excision, Mohs' surgery, and other individualized approaches.

Curettage & Electrodesiccation

The surgeon uses a semi-sharp instrument with spoon-shaped edge (called a curette) to scrape away tumor tissue. Then the area is treated with an electric needle to control bleeding and destroy any cancer cells that remain around the edge of the wound. The wound usually heals within a few weeks. Curettage and electrodesiccation -- which is most effective for small, well-defined, nonaggressive tumors typically found on the trunk and extremities -- is currently the most common treatment for basal cell carcinoma. Because curettage and electrodesiccation destroys tissue, the procedure provides no tumor sample for examination by a pathologist.

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Radiation Therapy

Sometimes treatments with x-rays or high-energy particles are used to kill skin cancers. Radiation therapy can be useful for tumors that are very large or in areas that are difficult to reach surgically (such as the eyelid, tip of the nose, or the ear). Radiation therapy may also be used when surgery poses a high risk for complications, such as when a patient has multiple medical problems in addition to cancer. Because radiation exposure is also a risk factor for skin cancer many years after treatment, and because the appearance of irradiated skin can deteriorate over time, radiation therapy is not often used in young patients.

Standard Excision

The tumor is cut from the skin along with a "safety margin" of normal skin, and the wound is often closed with sutures. Excision is most effective for primary tumors with well-defined borders, and can be performed virtually anywhere on the body. An advantage is that the surgeon can send tissue obtained by excision for microscopic evaluation by a pathologist, who will verify that the entire tumor has been removed along with a sufficient safety margin.

Mohs' Surgery

In this highly specialized technique, a trained Mohs' surgeon removes tumor tissue surgically layer by layer, mapping each layer and examining the tissue layer for tumor cells under a microscope before proceeding to the next layer. An exquisitely precise, complex, and time-consuming process, Mohs' surgery ensures that the entire tumor is removed and minimizes scarring by preserving as much normal skin as possible. Mohs' surgery has the highest cure rate of all therapies for basal cell carcinomas, and is particularly effective for large tumors, tumors that have recurred after other treatments, and tumors in areas (such as the face) that require preservation of as much normal skin as possible.

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March 22, 2007 -- Drs. Hadley Claire King, Kishwer Nehal, and Jedd Wolchok present "The latest developments in the screening and treatment of skin cancer." Total Run time: 55 minutes

Other Therapies

To remove selected, very superficial, and small lesions, doctor and patient may elect to use cryosurgery. Using liquid nitrogen, the surgeon freezes the tumor, killing the cancer cells, which then slough off as the underlying skin heals.

Also for very superficial lesions, laser surgery (which vaporizes tumor tissue with a highly focused beam of light) is sometimes used to treat basal cell carcinoma in certain limited circumstances. Because laser surgery does not kill cells under the surface of the skin, close follow up is essential after therapy.

Reconstruction after Surgery for Skin Cancer

Any form of surgery may leave a scar, some more noticeable than others. When removal of a basal cell carcinoma leaves a wound that is too large to close with simple sutures, skin grafts and other reconstructive procedures can help heal the skin and restore its appearance.


Last Updated: May. 24, 2001
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