Basal cell skin cancer is the abnormal growth of cells in the skin. It's almost always cured when it's found early and treated.
This cancer grows slowly. Over time, it can damage deeper tissues, such as muscles and bones. But it doesn't usually spread, or metastasize, to other parts of the body.
It's usually caused by too much sun. Tanning beds and sunlamps can also cause it.
Surgery is the most common treatment for basal cell skin cancer.
If the cancer is the low-risk type, you may have a choice between surgery and a medicated cream. The cancer is usually low-risk if it's small, not deep, and has well defined borders. Your doctor will tell you if using a cream is a good option for you.
There are other treatments for this cancer, such as radiation and photodynamic therapy (applying a medicine and then shining a special light on it), and laser treatments. If you don't want to have surgery or use medicated cream, talk to your doctor about what else you might try.
Basal cell skin cancer sometimes comes back, no matter which treatment is used.
The type of surgery you have may depend on where the cancer is and how big it is. Some surgeries cause more scarring than others. The surgeries include:
Surgery for basal cell skin cancer cures 95 to 99 out of 100 cases, depending on the type of surgery.1, 2 That means that in 1 to 5 cases out of 100, the surgery does not cure the cancer.
The creams used to treat basal cell skin cancer are imiquimod and 5-FU (fluorouracil). They contain powerful medicines that cause a painful irritation in the treated area. The skin gets inflamed and crusts over as it heals.
You apply the cream every day or two for several weeks.
5-FU has a cure rate of 90 out of 100 for basal cell cancer that is superficial (only in the top layer of skin).3 That means that in 10 out of 100 cases, the cream does not cure the cancer.
Imiquimod has a cure rate of more than 75 out of 100 for superficial basal cell cancer.4 That means that in 25 out of 100 cases, the cream does not cure the cancer.
Both surgery and medicated creams carry the risks of infection and pain or discomfort.
Both treatments have high cure rates, but the cure rate for creams is not as good as the cure rate for surgery.
Surgery usually leaves a scar. If a skin graft is used, it can tighten as it heals and make movement more difficult. Medicated creams don't leave scars. But there is a risk that they will leave some permanent patches of darker or lighter skin.
No matter which treatment you choose, there's always a risk that the cancer could come back.
| Get surgery | Use medicated cream | |
|---|---|---|
What is usually involved?
| What is usually involved?
| |
What are the benefits?
| What are the benefits?
| |
What are the risks and side effects?
| What are the risks and side effects?
|
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"Several people in my family have died of cancer. It wasn't skin cancer, but still, the word "cancer" just really scares me. I want the best possible cure rate, so I'm going to have surgery."
— Kes, 42
"I know this cancer isn't going to kill me. What really scares me is the whole idea of surgery, even minor surgery. If there's a way for me to avoid it, that's what I want."
— Chad, 57
"I'm not worried about scarring, because my cancer isn't where most people will ever see the scar. And I just want it over with. I'm going with surgery."
— Paula, 68
"I have a lot of my life still ahead of me, and I don't like the idea of carrying around a scar from surgery. I'm going to try a medicated cream. If that doesn't work, I can always try something else later."
— Wesley, 30
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have surgery
Reasons not to have surgery
The idea of having surgery doesn't bother me.
I want to avoid surgery if possible.
I'm not worried about having a scar after treatment.
I worry about having scars on my skin.
I don't want treatment that takes several weeks.
I don't mind if treatment takes a while.
It's important for me to have the treatment with the highest cure rate.
I feel confident that whatever treatment I have will cure the cancer.
My other important reasons:
My other important reasons:
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having surgery
Using medicated cream
1. Using a medicated cream instead of having surgery for basal cell skin cancer means that my skin will look as good as new after treatment is done.
2. Treating my basal cell skin cancer with a medicated cream will take longer than treating it with surgery.
3. The cure rate for treating my cancer with a medicated cream isn't as high as the cure rate for surgery, but it's still very good.
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
| By | Healthwise Staff |
| Primary Medical Reviewer | Patrice Burgess MD - Family Medicine |
| Primary Medical Reviewer | E. Gregory Thompson MD - Internal Medicine |
| Primary Medical Reviewer | Adam Husney MD - Family Medicine |
| Primary Medical Reviewer | Kathleen Romito MD - Family Medicine |
| Primary Medical Reviewer | Martin J. Gabica MD - Family Medicine |
| Primary Medical Reviewer | Randall D. Burr MD - Dermatology |