Treatment for Basal Cell Carcinoma
Treatment for basal cell carcinoma depends on the stage of the disease (i.e., whether it has spread to surrounding tissue), the size and location of the tumor, and the patient's overall health. Standard treatment may include surgery, radiation therapy, and chemotherapy. In some cases, more than one treatment is used.
Types of surgery include the following:
- Cryosurgery or cryotherapy (an instrument is used to freeze and destroy cancer cells)
- Curettage and electrodessication (a sharp instrument [curette] is used to remove cancer cells and then electric current is applied to control bleeding and destroy remaining cancer cells)
- Dermabrasion (a rotating instrument is used to remove cancer cells)
- Laser surgery (a laser is used to remove cancer cells)
- Mohs micrographic surgery (often used to treat skin cancer on the face because it removes little normal tissue; the lesion is removed in layers and each layer is examined under a microscope for cancer cells)
- Shave excision (cancer cells are shaved off the skin surface)
- Simple excision (cancer cells and surrounding normal tissue is removed)
In some cases, primary superficial BCC that is less than 2 cm in diameter may be treated using imiquimod (Aldara) cream. This treatment may be used in adults on the trunk, neck, arms, or legs. The cream is applied 5 times per week for 6 weeks, usually during regular sleeping hours, and is left on the skin for 8 hours before being washed off with mild soap and water. Common side effects include redness, swelling, flaking, scabbing, itching, and burning at application site.
Radiation therapy uses high-energy x-rays to destroy cancer cells. External beam radiation uses a machine outside the body to direct radiation to the cancer cells and internal radiation (also called brachytherapy or "seed therapy") uses wires, needles, "seeds", or catheters that are placed into or near the cancer to deliver the radiation. The type of radiation used depends on the stage of the BCC.
Chemotherapy, which uses drugs to destroy cancer cells, may be used to treat basal cell carcinoma. In most cases, the chemotherapy drugs are applied directly to the skin in a cream or a lotion (called topical treatment).
Photodynamic therapy also may be used to treat basal cell carcinoma. In this treatment, a drug that is activated by light (called a photosensitizer or a photosensitizing agent) is injected into a vein. This drug is absorbed by all cells in the body, but collects at a higher concentration and remains longer in cancer cells. One to three days after the injection, when most of the drug no longer remains in normal cells, a laser is focused on the lesion, activating the drug and destroying cancer cells.
In January 2012, the U.S. Food and Drug Administration (FDA) approved vismodegib (Erivedge) to treat locally advanced and metastatic basal cell cancer in adults. This medication is administered in pill form and is taken once per day. It should not be used in women who are pregnant or who may be pregnant. Side effects include the following:
- diarrhea or constipation
- hair loss
- muscle spasms
- loss of appetite; weight loss
- loss of sense of smell
- nausea and vomiting
Sonidegib (Odomzo) was approved by the FDA in July 2015 to treat locally advanced basal cell carcinomaBCC that has not spread to other parts of the body, but has recurred after surgery or radiation or cannot be treated with these methods. Odomzo is available in pill form and is taken once daily to stop or reduce the growth of basal cell carcinomas. Odomzo can cause death or severe birth defects in a developing fetus and should not be used during pregnancy.
Side effects of sonidegib include muscle spasms, hair loss, abnormal sense of taste, fatigue, and others. It also can cause serious musculoskeletal problems, such as the break down of muscle tissue (rhabdomyolysis).
Updated by Remedy Health Media