Basal cell carcinoma (BCC) is the most common type of skin cancer. It usually develops on sun-exposed areas of the skin, such as the face and neck. BCC rarely metastasizes but can cause disfigurement if not treated promptly.

Over the years, there have been significant advances in the treatment approaches for BCC, leading to improved patient outcomes. This article explores some of the advanced treatment approaches for basal cell carcinoma.

1. Mohs Micrographic Surgery

Mohs micrographic surgery (MMS) is a highly effective technique for treating BCC while preserving healthy tissue. It involves removing layers of cancerous tissue and examining them under a microscope to ensure complete removal.

This process is repeated until no cancer cells remain. MMS offers high cure rates and is particularly beneficial for treating BCC in delicate areas such as the face, where tissue preservation is crucial.

2. Photodynamic Therapy (PDT)

Photodynamic therapy (PDT) is a non-invasive treatment option for certain types of BCC. It involves applying a photosensitizing agent to the affected area, which is then activated by light. This activation leads to the destruction of cancerous cells.

PDT is often used for superficial BCC and can be an effective alternative to surgery, especially for patients with multiple lesions or those who are not surgical candidates.

3. Topical Treatments

A variety of topical treatments are available for certain types of BCC. These treatments include creams and gels containing specific medications such as imiquimod, 5-fluorouracil, or ingenol mebutate.

These medications work by targeting and destroying cancer cells. Topical treatments are typically used for superficial BCC or as adjunctive therapy following surgical removal.

4. Cryotherapy

Cryotherapy involves freezing the cancerous cells using liquid nitrogen or another freezing agent. This technique is particularly effective for treating superficial BCC or small nodular BCC.

Cryotherapy destroys the cancer cells by causing cell death due to extreme cold. The procedure is often quick, relatively painless, and leaves minimal scarring.

5. Radiation Therapy

Radiation therapy uses high-energy X-rays to kill cancer cells. It is often employed when surgery is not an option or if the tumor is in a challenging location.

Radiation therapy may be administered externally through a machine called a linear accelerator or internally through implantable devices. The choice of radiation therapy depends on several factors, including tumor size, location, and overall health of the patient.

6. Laser Surgery

Laser surgery is a minimally invasive treatment option for certain types of BCC. It involves using a high-energy laser to precisely remove cancerous tissue.

Laser surgery offers a bloodless procedure, minimal scarring, and a shorter recovery time compared to traditional surgical methods. It is often used for superficial BCC or as an alternative to surgery in specific cases.

7. Hedgehog Pathway Inhibitors

Hedgehog pathway inhibitors are a class of medications that target the abnormal signaling pathway involved in BCC formation. These inhibitors, such as vismodegib and sonidegib, work by blocking the activity of a protein called Smoothened.

Hedgehog pathway inhibitors are typically used for advanced or metastatic BCC or when surgery or radiation therapy is unsuitable. They have shown promising results in shrinking tumors and slowing the progression of the disease.

8. Immunotherapy

Immunotherapy works by stimulating the body’s immune system to recognize and attack cancer cells.

In the case of BCC, immune checkpoint inhibitors, such as pembrolizumab and nivolumab, have shown remarkable success in treating advanced or metastatic BCC. These inhibitors prevent cancer cells from evading the immune system’s surveillance, leading to tumor regression. Immunotherapy is changing the treatment landscape for many types of cancer, including BCC.

9. Targeted Therapy

Targeted therapy involves using drugs that specifically target cancer cells based on their unique characteristics.

In the case of BCC, the targeted therapy drug vismodegib has shown significant efficacy in treating advanced or metastatic BCC with specific genetic mutations. Targeted therapy offers a more personalized approach to treatment and has shown promising results for patients who cannot undergo surgery or radiation therapy.

10. Prevention and Regular Skin Checks

While advancements in treatment approaches for BCC have improved patient outcomes, prevention and early detection remain crucial.

Protecting the skin from excessive sun exposure, using sunscreen, wearing protective clothing, and avoiding tanning beds can significantly reduce the risk of developing BCC. Regular skin checks and self-examinations help identify any suspicious skin lesions early, enabling timely treatment and better prognosis.