Basal cell carcinomas may be treated in several different ways, depending on their size, location, and depth.
If the cancer is superficial, it may be treated with topical medications, such as imiquimod or 5-fluorouracil. This is a form of chemotherapy, but unlike many other types of chemotherapy, the medicine is applied to the skin rather than being taken orally or injected.
Another type of topical treatment is photodynamic therapy, in which the doctor applies a topical medication that is activated by strong light.
Some basal cell carcinomas are treated by curettage and electrodessication, which means that the doctor scrapes off the growth and then dries the site with an electrocautery needle. This technique is commonly used for small basal cell carcinomas (less than one-quarter of an inch or 5 millimeters in diameter).
In another technique, called cryosurgery, liquid nitrogen is applied to the tumor to freeze it. The treated area becomes dry and crusty-looking and eventually falls off. The procedure may need to be repeated several times until all of the abnormal tissue is gone.
Sometimes, basal cell carcinomas are treated by excisional surgery, in which a surgeon removes the tumor along with an area of normal skin around it. The tissue that has been removed is sent to a laboratory for examination to make sure that the cancer has been removed completely.
In another type of surgery, called micrographic surgery, the doctor removes the tumor and then removes surrounding skin one layer at a time, checking each layer under a microscope to make sure that all the cancer has been removed. This technique works very well, and it is often used for cancers on parts of the body where it is important to save as much healthy tissue as possible, such as the fingers.
Laser surgery is often used to treat basal cell carcinomas that are located on the lips, face, or scalp or cancers that have come back after having been treated in other ways.
Radiation therapy, involving high-energy x-rays directed at the specific abnormal area, is occasionally used to treat basal cell carcinoma. However, other types of treatment are more common.
It is a good idea for patients to discuss treatment options for basal cell carcinoma with their doctors to find out why a particular treatment is recommended, what its pros and cons are, and what side effects there might be. Some patients may want to get a second opinion before agreeing to a particular type of treatment.
After treatment for basal cell carcinoma, patients are usually told to examine their skin once a month and protect themselves from the sun. Follow-up exams by a doctor are also recommended. Basal cell carcinoma can recur, making further treatment necessary. Also, people who have had one basal cell carcinoma have an increased risk of developing a second skin cancer at another location. Therefore, it is important for the patient to be on the lookout for changes in the skin on all parts of the body, not just in the area where the first cancer occurred, and for the doctor to perform a complete skin examination at follow-up visits.