Skip to main content

Advertisement

Log in

Nonmelanoma skin cancer

  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

Opinion statement

Therapy for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) does not end with treatment of the initial lesion because almost 50% of patients with one nonmelanoma skin cancer (NMSC) develop another NMSC in the next 5 years. An integrated program of skin cancer awareness, sun protection, and prophylactic approaches is critical. The risk profile of the tumor influences which therapies and specialties will be involved. Most NMSCs may be treated with outpatient methods. Primary care physicians may treat low-risk tumors, but dermatologists specially trained in cutaneous oncology and a multidisciplinary team should manage high-risk lesions. Superficial BCC and SCC may be treated adequately with superficial modalities such as electrodesiccation and curettage (EDC) and cryotherapy. Topical 5-fluorouracil is effective for small in situ lesions. Invasive but low-risk lesions may be treated with EDC and cryotherapy provided that the tumor is limited to the papillary dermis, is not recurrent, and does not have high-risk features. High-risk tumors are best treated with excision and histologic examination or Mohs micrographic surgery (MMS). MMS is the therapeutic gold standard for all NMSCs in terms of cure rates, margin control, and tissue conservation. Because of its higher cost and specialized process, MMS is best reserved for specific indications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. American Cancer Society: What is nonmelanoma skin cancer? http://www.cancer.org/eprise/main/docroot/ CRI/content CRI_2_2_1X_How_many_people_get_ nonmelanoma_skin_cancer_51?sitearea=&level=. Accessed March 14, 2002.

  2. Ong CS, Keogh AM, Kossard S, et al.: Skin cancer in Australian heart transplant recipients. J Am Acad Dermatol 1999, 40:27–34.

    Article  CAS  PubMed  Google Scholar 

  3. Jensen P, Hansen S, Moller B, et al.: Skin cancer in kidney and heart transplant recipients and different long-term immunosuppressive therapy regimens. J Am Acad Dermatol 1999, 40:177–186.

    Article  CAS  PubMed  Google Scholar 

  4. Vessen M, Quinn D, Ong C, et al.: Aggressive cutaneous malignancies following cardiothoracic transplantation: the Australian experience. Cancer 1999, 85:1758–1764. This paper is a sobering reminder of the dangers from skin cancers in heart transplant patients.

    Article  Google Scholar 

  5. Wolf R, Tuzun B, Tuzun Y: Sunscreens. Dermatol Ther 2001, 14:208–214. This is a practical review of sunscreens and its role in a sun-safe lifestyle.

    Article  Google Scholar 

  6. DeBuys HV, Levy SB, Murray JC, et al.: Modern approaches to photoprotection. Dermatol Clin 2000, 18:577–590.

    Article  CAS  PubMed  Google Scholar 

  7. Litwin MS, Ryan RF, Ichinose H, et al.: Use of fluorouracil in the topical therapy of skin cancer: a review of 157 patients. Proc Natl Cancer Conf 1972, 7:549–561.

    CAS  PubMed  Google Scholar 

  8. Peck GL: Topical tretinoin in actinic keratosis and basal cell carcinoma. J Am Acad Dermatol 1986, 15:829–835.

    Article  CAS  PubMed  Google Scholar 

  9. Levy S, Furst K, Chern W: A pharmacokinetic evaluation of 0.5% and 5% fluorouracil topical cream in patients with actinic keratosis. Clin Ther 2001, 23:908–920.

    Article  CAS  PubMed  Google Scholar 

  10. Kuflick EG: Cryosurgery updated. J Am Acad Dermatol 1994, 31:925–944.

    Article  Google Scholar 

  11. Spiller WF, Spiller RF: Cryosurgery and adjuvant surgical techniques for cutaneous carcinomas. In Cryosurgery for Skin Cancer and Cutaneous Disorders. Edited by Zacarian SA. St Louis: Mosby; 1985:187-198.

    Google Scholar 

  12. Kuflil EG: The five-year cure rate achieved by cryosurgery for skin cancer. J Am Acad Dermatol 1991, 24:1002–1004.

    Article  Google Scholar 

  13. Sheridan A, Dawber R: Curettage, electrosurgery and skin cancer. Australasian J Dermatol 2000, 41:19–30.

    Article  CAS  Google Scholar 

  14. Kopf AW, Bart R, Schrager D, et al.: Curettageelectrodesiccation treatment of basal cell carcinomas. Arch Dermatol 1977, 113:439–443.

    Article  CAS  PubMed  Google Scholar 

  15. Wolf DJ, Zitelli JA: Surgical margins for basal cell carcinoma. Arch Dermatol 1987, 123:340–344.

    Article  CAS  PubMed  Google Scholar 

  16. Brodland DG, Zitelli JA: Surgical margins for excision of primary cutaneous squamous cell carcinoma. J Am Acad Dermatol 1992, 27:241–248.

    Article  CAS  PubMed  Google Scholar 

  17. Rowe DE, Carroll RJ, Day CL Jr: Prognostic factors for local recurrence, metastasis, and survival rates in squamous cell carcinoma of the skin, ear, and lip: implications for treatment modality selection. J Am Acad Dermatol 1992, 26:976–990.

    Article  CAS  PubMed  Google Scholar 

  18. Rowe DE, Carroll RJ, Day CL Jr: Mohs surgery is the treatment of choice for recurrent (previously treated) basal cell carcinoma. J Dermatol Surg Oncol 1989, 15:424–431.

    Article  CAS  PubMed  Google Scholar 

  19. Chiller K, Passaro D, McCalmont T, et al.: Efficacy of curettage before excision in clearing surgical margins of nonmelanoma skin cancer. Arch Dermatol 2000, 136:1327–1332.

    CAS  PubMed  Google Scholar 

  20. Martinez JC, Otley CC: The management of melanoma and nonmelanoma skin cancer: a review for the primary care physician. Mayo Clin Proc 2001, 76:1253–1265.

    Article  CAS  PubMed  Google Scholar 

  21. Drake LA, Dinehart SM, Goltz RW, et al.: Guidelines of care for Mohs micrographic surgery. J Am Acad Dermatol 1995, 33:271–278.

    Article  CAS  PubMed  Google Scholar 

  22. Cook J, Zitelli JA: Mohs micrographic surgery: a cost analysis. J Am Acad Dermatol 1998, 39:698–703.

    Article  CAS  PubMed  Google Scholar 

  23. Gloster HM, Harris KR, Roenigk RK: A comparison between Mohs micrographic surgery and wide surgical excision for the treatment of dermatofibrosarcoma protuberans. J Am Acad Dermatol 1996, 35:82–87.

    Article  PubMed  Google Scholar 

  24. Hall EJ: The oxygen effect and reoxygenation. In Radiobiology for the Radiologist, edn 5. Philadelphia: JB Lippincott; 1994:91-111.

    Google Scholar 

  25. Mendenhall NP, Million RR, Cassisi NJ: Parotid area lymph node metastases from carcinomas of the skin. Int J Radiat Oncol Biol Phys 1985, 11:707–714.

    Article  CAS  PubMed  Google Scholar 

  26. Marks R, Gebauer K, Shumack S, et al.: Imiquimod 5% cream in the treatment of superficial basal cell carcinoma: results of a multicenter 6-week doseresponse trial. J Am Acad Dermatol 2001, 44:807–813.

    Article  CAS  PubMed  Google Scholar 

  27. Fink-Puches R, Soyer HP, Hofer A, Kerl H, Wolf P: Long-term follow-up and histological changes of superficial nonmelanoma skin cancers treated with topical delta-aminolevulinic acid photodynamic therapy. Arch Dermatol 1998, 134:821–826.

    Article  CAS  PubMed  Google Scholar 

  28. Bickers DR, Athar M: Novel approaches to chemoprevention of skin cancer. J Dermatol 2000, 27:691–695.

    CAS  PubMed  Google Scholar 

  29. Stratton SP, Dorr RT, Alberts DS: The state-of-the art in chemoprevention of skin cancer. Eur J Cancer 2000, 36:1292–1297.

    Article  CAS  PubMed  Google Scholar 

  30. Lotan R: Retinoids. In Cutaneous Oncology. Edited by Miller S, Maloney M. Oxford, UK: Blackwell Science; 1998:87-91.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nguyen, T.H., Ho, D.QD. Nonmelanoma skin cancer. Curr. Treat. Options in Oncol. 3, 193–203 (2002). https://doi.org/10.1007/s11864-002-0009-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11864-002-0009-0

Keywords

Navigation