Treatment Options for Non-Melanoma Skin Cancer

With early detection, treatment can be quick + effective.

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Skin cancer is often separated into two groups: melanoma and non-melanoma skin cancers. That’s because non-melanoma skin cancers rarely spread beyond the skin, making them easier to treat. Melanoma, on the other hand, is more likely to spread to other parts of the body. Although it’s less common than other types of skin cancer, melanoma is more dangerous and harder to cure.

There are two main types of non-melanoma skin cancers: basal cell carcinoma and squamous cell carcinoma. These names refer to which layer of skin the cancer has formed:

  • Basal cell carcinoma occurs in the basal layer (the lower part) of the epidermis. This is the most common type of skin cancer, accounting for about 80 percent of all skin cancers, according to the American Cancer Society.
  • Squamous cell carcinoma occurs in the squamous layer (the upper part) of the epidermis. It is also very common, but less common than basal cell carcinoma.

“The most common treatment for the non-melanoma skin cancers are destructive modalities, whether that is surgery or a procedure known as electrodesiccation and curettage,” says Kira Minkis, MD, PhD, dermatologist at Weill Cornell Medicine.

Here are the most common treatments used for non-melanoma skin cancers:

Mohs micrographic surgery is a newer treatment for skin cancer where a thin layer of skin is removed and immediately evaluated under a microscope until the tissue is clear of cancer cells. It’s a skin-sparing surgery meant to reduce the amount of skin removed. “It’s an involved process. There [are] lots of steps involved and because of that, the duration of the procedure is lengthier than for a standard excision,” says Dr. Minkis.

A standard excision “is a procedure where a skin cancer is removed with a standard margin of normal skin around it and typically stitched up immediately afterwards,” says Dr. Minkis. The tissue is then sent to a pathologist, but it can take up to a week for the results. If cancer is found in the margins, an additional surgery may be needed.

Electrodesiccation and curettage is a procedure where the surface of the skin is scraped off, and then an electric needle is used to burn the base of the skin. This is only used for early-stage skin cancers that are only on the very surface of the skin.

Cryotherapy “is a procedure where liquid nitrogen is applied to the skin to freeze the surface of the skin,” says Dr. Minkis.

Topical therapy or cream therapy uses a topically applied cream to attack the skin cancer. These creams are either a topical chemotherapy or a topical immunomodulator.

“These surgeries and procedures are all outpatient procedures, which essentially means that the patient is treated in an office setting, not in a hospital,” says Dr. Minkis. They are “generally a one-day procedure. A patient comes and sees the treating physician, generally a dermatologist in the office. The procedure is performed and the patient can go home immediately afterwards.”

In some cases, doctors may recommend (or patients may choose to receive) radiation therapy. This is performed by a radiation oncologist. A machine is used to deliver external radiation to the area with the skin cancer growth in order to destroy the cancer cells. “It can involve as many as 35 visits in order to safely deliver the radiation,” says Dr. Minkis. Learn more about what radiation therapy is here.

“The great thing about non-melanoma skin cancers is they could be visualized and detected early,” says Dr. Minkis. “The treatments are very low risk and very efficient … so you don’t have to worry about the burden of the disease afterwards.”