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

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™.