Basal cell carcinoma, the most common type of skin cancer, accounts for approximately 8 out of 10 cases of skin cancer as reported by the American Cancer Society. Basal cell carcinoma begins in the basal cells, those cells found in the deepest layer of the epidermis---the outer layer of skin cells. Although basal cell carcinoma grows slowly and rarely spreads to the lymph nodes or distant organs, treatment prevents further damage to surrounding tissues. Several types of treatment can eliminate the tumor, depending on size, location and depth of the tumor.
MOHS Micrographic Surgery
Basal cell carcinoma can recur, often in the exact same spot. MOHS micrographic surgery effectively treats recurrent tumors, large or deep tumors and tumors appearing on the face. MOHS uses a local anesthetic to allow the doctor to remove the tumor layer by layer. As the doctor removes a layer, he checks it under a microscope for the presence of cancer cells. The presence of abnormal cells prompts the doctor to remove another layer. The process repeats until a layer of tissue contains no tumor cells. MOHS micrographic surgery saves the greatest amount of healthy tissue while providing a 98 percent cure rate, as reported by the Skin Cancer Foundation.
Excision Surgery
Although excision surgery is not as effective as the MOHS procedure, it does boast a 90 percent cure rate, according to the Skin Cancer Foundation. Excision surgery requires the doctor to use a scalpel to cut out the entire tumor and surrounding tissue. Doctors examine the tissue to ensure the removal of all tumor cells. Although the site of excision often requires stitches, the entire procedure only needs a local anesthetic. Excision surgery can cause scarring that may require reconstruction, especially when performed on the face.
Electrodessication and Curettage
Electrodessication and curettage, often called ED&C, effectively treats basal cell carcinoma, but is less effective for treating recurring tumors, according to MayoClinic.com. ED&C uses a curette, a ring-shaped scraping instrument, to remove the surface of the tumor. Doctors then use an electrocautery needle to sear the base of the tumor, therefore, destroying the cells. Although the cure rates approach those of excision surgery, according to the Skin Cancer Foundation, doctors usually perform ED&C on easy-to-reach tumors such as those on the trunk, arms or legs.
Cryosurgery
Cryosurgery, using liquid nitrogen to freeze the cancer cells, provides the advantage of not needing anesthesia. Doctors choose this procedure less these days because the cure rate, according to the Skin Cancer Foundation, remains at 85 to 90 percent. Surgical procedures boasting better cure rates often win out in the choice of treatments.
Topical Creams
Several creams approved by the U.S. Food and Drug Administration (FDA), including imiquimod and 5-fluorouracil, can effectively eliminate superficial basal cell carcinomas. Although the Skin Cancer Foundation reports cure rates between 80 to 90 percent, these creams can cause skin irritation to surrounding tissues so patients and doctors should carefully monitor their use.
