Cancer

To diagnose non-melanoma carcinomas, a doctor will take your medical history and perform a physical exam. If cancer is suspected, your doctor may take a skin biopsy, which will be used to confirm the diagnosis. A biopsy can be taken in one of four ways:

• The entire growth is removed.
• A sample of the area of concern is removed because the tumour goes into deeper layers of the skin. This technique is called “Shave and Punch”
• A “shave and punch” biopsy takes a sample through multiple skin layers.

A biopsy can be done in the doctor’s office or in a hospital’s outpatient department. It requires a local anesthetic and sometimes stitches, depending on how much skin is removed. The tissue sample will then be checked with a microscope to determine the diagnosis. .

Generally, the earlier non-melanoma skin cancers are caught, the more successfully they can be treated. Visit your doctor if you develop a new skin lesion that does not heal, notice a change in a pre-existing skin lesion (such as a mole), or have any of the symptoms or signs of non-melanoma carcinoma.

Treatment

Basal cell carcinoma treatments include the following:

• Surgery is often the primary treatment for basal cell carcinoma, and there are several different methods that can be used. An excision removes the tumour and surrounding skin. Curettage and electrodessication involves scraping the tumour from the skin and using an electric current to destroy any remaining tumour cells. Mohs surgery is a specialized technique that removes the visible tumour as well as an additional layer of tissue around the tumour.  This layer of tissue is examined with a microscope to identify any remaining cancer cells.  If this layer of tissue contains cancer cells the process is repeated until no tumour cells remain.  Lymph node removal is not usually required for basal cell carcinoma.
• Radiation therapy uses high energy rays or particles to kill cancer cells. It is primarily used for older people who cannot tolerate surgery. It is not the preferred treatment for younger patients because radiation may cause long-term damage. In external beam radiation therapy, a machine directs radiation to the tumour and surrounding area. Radiation therapy is often used for tumours on the ear, eyelid, lip and nose because it doesn’t remove normal tissue like surgery does. Topical drugs are most commonly used in chemotherapy for basal cell carcinoma. Topical 5-fluorouracil (5-FU) cream is applied directly to the tumour for several weeks or injected directly into the tumour. Only superficial tumours are treated this way as treatment does not reach tumours in the deeper layers of skin.
• Systemic drug treatments are rarely used for basal cell carcinoma. When they are used, the most common systemic agent injected intravenously is cisplatin.
• Biological therapy (immunotherapy) uses natural or manufactured agents to strengthen the immune system. Biological therapy is used only on low-risk, superficial basal cell carcinoma. Imiquimod is the most common biological drug used to treat basal cell carcinoma.

Nevoid basal cell carcinoma syndrome can be treated through:

• Surgery
• Photodynamic therapy has been used in some cases

Squamous cell carcinoma treatments include:

• Surgery
• Radiation therapy
• Chemotherapy
• Systemic drug treatments for squamous cell carcinoma are injected intravenously and include cisplatin, 5-FU, doxorubicin and mitomycin.

Actinic keratosis treatments involve:

• Lesion-directed: removal of a single or multiple skin lesions using procedures such as cryotherapy (freezing)
• Field-directed: treatment of an area of skin affected by AK through the application of topical creams or gels, or using photodynamic therapy

In addition to the treatments above, Canadian researchers are continually exploring new ways to treat non-melanoma skin cancers. Some may be conducting research studies known as clinical trials, which test new medications and treatments that are being developed. To learn about new research on all types of non-melanoma cancers happening in Canada, visit the clinical trials section [link to clinical trials section].

Footnote

*All information on medical treatments on this site is provided as an overview only. For a complete and up-to-date list of side effects, warnings and precautions, read the product’s package insert and consult your doctor or a pharmacist.