Skin Cancer, Nonmelanoma - Treatment Overview

Treatment Overview

The goals of treatment for nonmelanoma skin cancer are to:

• Remove the entire skin cancer and a margin of skin tissue around the cancer to reduce the chance of recurrence.
• Preserve nearby skin tissue that is free of cancer and minimize scarring after surgery.

Initial treatment

Treatment for nonmelanoma skin cancer depends on the size and location of the cancer, whether it is basal cell or squamous cell, and your age and overall health. Because skin cancer usually grows slowly, it often can be detected and successfully treated early in its development.

The most common treatment is surgery to destroy or remove the entire skin growth, including a margin of cancer-free tissue around the growth. Most surgical treatments are very effective, with cure rates from 85% to over 95%.³

The main types of surgery are:

• Complete excision. Excision removes the skin cancer along with some healthy skin tissue around it (margin).
• Curettage and electrosurgery. Curettage uses a spoon-shaped instrument (curet) to scrape off the skin cancer. Electrosurgery with an electric current may be done after curettage to burn the skin tissue to control bleeding and destroy any remaining cancer cells.
• Mohs micrographic surgery. The Mohs procedure removes skin cancer one layer at a time and examines these layers under a microscope immediately after they are removed. This method allows for a close examination of each layer of skin to identify skin margins that are free of cancer during the surgery. It has a cure rate of over 95% for basal cell skin cancer and over 92% for squamous cell skin cancer.^{7, 8}
• Cryosurgery. Cryosurgery destroys the skin cancer by freezing it with liquid nitrogen.

Each of these treatments has advantages and disadvantages. Discuss your options with your health professional.

Laser surgery is not commonly used for nonmelanoma skin cancers. Lasers destroy surface (superficial) nonmelanoma skin cancers and actinic keratoses with an intense beam of light. The laser beam can also be used as a scalpel to remove (excise) a skin cancer. Currently, laser surgery is an expensive form of treatment.

Radiation therapy may be recommended for people who may not be able to have surgery.

Ongoing treatment

Follow-up treatment for nonmelanoma skin cancer includes skin self-exams and regular exams by your health professional. These exams are extremely important to reduce the risk of the cancer returning (recurrence).

Treatment for recurrent skin cancer is usually less successful than treatment for primary skin cancer. Most recurrences happen in the first 2 to 5 years. Your health professional may schedule you for exams as often as every 3 to 6 months for the first 2 years and yearly after that, especially for squamous cell carcinoma.

Treatment if the condition gets worse

Surgery is usually very effective treatment for both basal and squamous cell carcinoma. Chemotherapy may be used to destroy cancer cells in the small number of people who have skin cancer that has spread (metastasized) to other organs in the body.

What To Think About

Precancer skin growths, such as actinic keratoses that grow slowly, should be treated early to reduce the risk of developing squamous cell skin cancer.⁹

For more information about specific skin cancer treatment, see the following topics:

• Skin Cancer, Nonmelanoma — Health Professional Information [NCI PDQ]
• Skin Cancer, Nonmelanoma — Patient Information [NCI PDQ]