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Written for dermatologists by dermatologists. Indexed by the US National Library of Medicine.
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Basal Cell Carcinoma - Treatment

Most basal cell carcinomas may be treated by one of the following methods. The choice of treatment is influenced by:

  • size, location, type, and grade of tumour
  • person's age and health
  • whether the tumour is primary or has come back after treatment (recurred)
  • availability of the treatment
The following represent the range of treatments of available for basal cell carcinoma:

Curettage and Electrodesiccation (C & E)

  • used for small lesions that are less than 2 cm
  • not used for lesions on areas where the cancer is likely to recur (nose, lips, eyelids, ears, scalp, temple)

Surgery (Wide Excision)

  • the tumour is removed along with a margin of cancer-free skin

Mohs Micrographic Surgery

  • used for all types of basal cell cancers
  • commonly used for:
    • - areas that are at high risk of recurrence (eyelids, nose, ears, forehead, scalp), as well as lesions that have already recurred
      - lesions that are larger than 2 cm, as well as lesions with poorly defined borders
      - areas where maintaining function and appearance are important
      - invasive lesions that have spread to underlying cartilage or bone
      - tumours that have been left untreated for a long time
      - people with nevus basal cell carcinoma syndrome
  • it involves a meticulous study of tissues removed by a pathologist at the time of surgery

Radiation Therapy

  • used for:
    • - small to medium sized primary basal cell carcinoma lesions
      - ensuring cancer free margins after surgery
      - lesions that have recurred after surgery
      - relief or to control symptoms of very large tumours
      - people who are unable or unwilling to undergo surgery
  • not used for:
    • - people with nevus basal cell carcinoma syndrome
      - sclerosing or morpheaform Basal Cell Carcinoma

Chemotherapy

  • topical chemotherapy (5-Fluorouracil (5-FU)) may be used for:
    • - superficial tumours
      - people who are unwilling or unable to undergo surgery or radiation
      - people with nevus basal cell carcinoma syndrome
      - the elderly who can’t tolerate other treatments
  • systemic chemotherapy may be used for basal cell carcinoma that has spread to other parts of the body

Immune Response Modifiers

  • Imiquimod 5% Cream (Aldara™) has recently been approved in Canada and the US to treat Superficial Basal Cell Cancer (sBCC)
    • - Imiquimod’s novel mechanism of action stimulates the body’s own natural defenses to target diseased tissue
      - It stimulates the innate immune response through interferon-a production, as well as acquired immunity by activating T-helper 1 cells
  • Click here to view the A-Detail™ on Aldara™.