Surgical and Pharmacological Treatments
Surgical Treatments:
Non-pharmacological interventions are typically completed at an outpatient clinic and only require local anesthesia. Below you will find surgical treatment options with their corresponding rates of non-recurrence (or likelihood that the cancer is cured following treatment).
Mohs micrographic surgery (99% non-recurrence)
Electrodesiccation & curettage (>95% non-recurrence)
Excision (>95% non-recurrence)
Radiation (90% non-recurrence)
Cryosurgery (85-90% non-recurrence)
Laser Surgery (70-90% non-recurrence)
Non-pharmacological interventions are typically completed at an outpatient clinic and only require local anesthesia. Below you will find surgical treatment options with their corresponding rates of non-recurrence (or likelihood that the cancer is cured following treatment).
Mohs micrographic surgery (99% non-recurrence)
- Large lesion (>2 cm) , visible area, difficult to reach, high recurrence, poorly defined margins (Rubin et al., 2005; Telfer, Colver, & Morton, 2008).
- Remove skin cancer one layer at a time, leaving as much healthy tissue as possible. Examined under microscope immediately in order to define where the cancer is and if any still present in each layer excised (Skin Cancer Foundation, 2019).
- No scarring. Pain, tenderness, burning sensation, swelling, bleeding; bruising, infection, scarring, nerve damage possible (Canadian Cancer Society, 2019).
Electrodesiccation & curettage (>95% non-recurrence)
- Lesion smaller than 2cm with regular borders in an easy to access and not visible location (Skin Cancer Foundation, 2019; Rubin et al., 2005).
- Once the area is numbed, the top layer is scraped off and then heat is used to control bleeding and destroy remaining cancer cells (Skin Cancer Foundation, 2019).
- Can be repeated up to 3 times, a scab will form and heal within 6 weeks (Canadian Cancer Society, 2019). A white round scar can be expected (Skin Cancer Foundation, 2019).
Excision (>95% non-recurrence)
- Full growth is removed with surrounding border of healthy tissue as well. Specimen of healthy issue is sent to the lab to ensure full growth removed (Rubin et al., 2005).
- Sutured closed (Skin Cancer Foundation, 2019). Risk of infection, redness, soreness (Canadian Cancer Society, 2019).
Radiation (90% non-recurrence)
- Used in elderly clients or those/sites difficult for surgery (Rubin et al., 2005).
- Xray directly to site. Potential for many treatments across a month (Rubin et al., 2005; Skin Cancer Foundation, 2019)
- Keeps surrounding tissue healthy, but long term radiation effects possible (Rubin et al., 2005).
Cryosurgery (85-90% non-recurrence)
- Best for those with a bleeding complications (Skin Cancer Foundation, 2019).
- Liquid nitrogen applied directly to the site (Telfer, Colver, & Morton, 2008).
- Growth blisters, scabs, then falls off (Skin Cancer Foundation, 2019). Redness, swelling, loss of pigmentation possible (Canadian Cancer Society, 2019).
Laser Surgery (70-90% non-recurrence)
- Adjuvant treatment when resistant to others - not yet approved as a treatment method (Skin Cancer Foundation, 2019).
- Specific light wave to ablate or heat to the tumour cells to destroy them (Skin Cancer Foundation, 2019).
- Redness or hypopigmentation possible (Canadian Cancer Society, 2019).
Pharmacological Treatments:
Below are the topical and oral treatment options. While topical agents are best used for local and superficial BCC, oral agents are used for locally aggressive or metastatic BCC. |
Topical Agents:
5-Fluorouracil
Imiquimod
Vismodegib (Erivedge®)
Sonidegib (Odomzo®):
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Nursing Implications for Topical Agents:
Nursing Implications for Vismodegib:
Nursing Implications for Sonidegib:
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