Skin cancer is the most common cancer in the United States, with more than 4 million cases of basal cell and cutaneous squamous cell carcinoma – which are both non-melanoma skin cancers – being diagnosed each year. Thankfully, with early detection and treatment, outcomes tend to be good.
Dr. Meredith McKean, associate director of the melanoma and skin cancer research program at the Sarah Cannon Research Institute, recently discussed basal cell carcinoma and cutaneous squamous cell carcinoma during a presentation at the CURE® Educated Patient Skin Cancer Summit.
“We know for both of these types of skin cancer, the primary treatment is surgical resection, and that is curative,” McKean said. Skin cancers are commonly caught during yearly checkups with a primary care physician or dermatologist. If a suspicious spot is noticed on the patient’s skin, the patient may be sent to have it biopsied to determine if it is cancerous.
“It’s really important for all adults to be able to go in (to their doctor) once a year and get their skin checked, because we know that if we’re able to remove the tumor and remove all of those cells, the long-term outcomes after a diagnosis of basal cell carcinoma or squamous cell carcinoma is very good,” McKean said. “The earlier it’s diagnosed, the smaller the lesion is, the easier that surgical removal is and the lower the risk of the cancer coming back elsewhere.”
After a patient is diagnosed with basal cell or squamous cell carcinoma, it is important that they continue to undergo regular skin exams – as should their family members, who likely share risk factors, such as skin coloring, sun exposure and lifestyle habits.
The earliest stage of basal cell carcinoma can be treated with superficial (on top of the skin) therapy. Also, if a patient does not want surgery as their first line of treatment, or if the skin cancer is too large or deep to be completely removed, they may undergo radiation therapy.
If needed, patients may also undergo adjuvant (post-surgery) radiation treatment or be given an immunotherapy agent or enroll on a clinical trial.
Finally, in advanced cancer that is not eligible for surgery and/or has spread, a doctor may prescribe a targeted therapy agent (which finds and blocks certain pathways in cancer cells), chemotherapy, immunotherapy (which helps the immune system to fight the cancer) or consider a clinical trial.
Hedgehog pathway inhibitors are also being used to treat basal cell carcinoma. These block the hedgehog signaling pathway, which controls cell division, in hopes that cancer cells will not multiply.
“I think for future treatments, we might end up using these medications even earlier to say, ‘(For) patients who can go to surgery, can we make that surgery easier for them?’” McKean said.
While new treatments continue to be investigated, McKean said that the best way to ensure good outcomes is prevention and early detection.
“Prevention starts at a young age with sunscreen and sun health,” she said. “And the earlier these tumors are diagnosed, the best chance of survival.”