Non-Melanoma Skin Cancer Treatment Options

Patients diagnosed with non-melanoma skin cancer have several treatment options to choose from.  

In some cases, when the cancer is small and early-stage, the biopsy procedure to remove the area is all the treatment that is needed. However, if the dermatologist feels there could still be cancer cells remaining, they will recommend you see an oncologist for additional treatments. 

The oncologist will review the type and size of the non-melanoma skin cancer and may request some additional tests to see if the cancer has spread any further than the original site. This process is also known as staging non-melanoma skin cancer. Based on this information, the oncologist can recommend a treatment plan. 

It is often beneficial to make a list of questions before your appointment. To better help remember what the doctor says, you can take notes or ask to use a recording device. Most smartphones have an app for recording voice conversations. Additionally, you may want to invite a family member or friend to accompany you during the consultation to participate in the discussion, take notes, or simply listen.

Treatment for non-melanoma may include one or more of the following:

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Surgery to Remove Skin Cancer

Surgery to treat skin cancer may be done in one of several ways. Quite often, it’s done by the dermatologist who diagnosed it. The surgical method your doctor uses depends on the size and place of the growth and other factors. Some of the more common surgeries include:

  • Wide-local excision (WLE) or excisional skin surgery - The surgeon removes the growth, as well as a border of skin around the growth, with a scalpel. This skin, which is the margin, is examined under a microscope to be certain that all the cancer cells have been removed. The size of the margin depends on the size of the growth. Some of the lymph nodes may also be removed.

  • Mohs surgery (also called Mohs micrographic surgery) - A specially trained surgeon shaves away thin layers of the growth after the area is numbed. Each layer is immediately examined under a microscope. The surgeon continues to shave away tissue until no cancer cells can be seen under the microscope. In this way, the surgeon can remove all the cancer and only a small bit of healthy tissue.

  • Curettage and electrodesiccation - This procedure begins with the doctor numbing the area to be treated. The cancer is then removed with a sharp tool shaped like a spoon. This tool is a curette. An electric current is sent into the treated area to control bleeding and kill any cancer cells that may be left. Electrodesiccation and curettage is usually a fast and simple procedure.

Photodynamic Therapy

Photodynamic therapy (PDT) is a treatment that uses a chemical in combination with a special light source, such as a laser light, to destroy cancer cells. This chemical is known as a photosensitizing agent, which is either applied as a cream or injected into the body. It stays inside the cancer cells for a longer time than in healthy cells. After several hours or days, the special light is focused on the cancerous growth. At this point, the chemical becomes active and destroys the nearby cancer cells.

PDT is used to treat surface-level cancer or cancer that is very close to the surface of the skin. It’s usually performed by the dermatologist in their office.

Topical Chemotherapy for Skin Cancer

Chemotherapy is a treatment that uses anticancer drugs to either kill or prevent the division of skin cancer cells. For some non-melanoma skin cancers the drug is applied directly to the skin, called topical chemotherapy. This treatment is typically used when the skin cancer is too large to be removed through surgery or when new cancers keep appearing.

Topical chemotherapy typically involves the application of a cream or lotion to the affected area one or two times a day for several weeks. Basal cell and squamous cell cancers that are present only in the top layer of the skin can be treated with a drug called fluorouracil (5-FU). Basal cell cancer located only in the top layer of the skin can also be treated with a drug called imiquimod, which stimulates the immune system.

Systemic chemotherapy, given through a vein or in pill form, is less common for non-melanoma skin cancer.

Radiation Therapy for Skin Cancer

Radiation therapy (also called radiotherapy) uses high-energy x-rays or other types of radiation to kill cancer cells. 

Radiation therapy may be used for skin cancer in areas where surgery could be difficult or leave a bad scar, such as the eyelid, ear, top of the head, or nose. It’s also recommended for patients who: 

  • Had surgery, but the doctor feels there could still be cancer cells in the area
  • Have a larger area to be treated
  • Had non-melanoma skin cancer return in the same spot
  • Don't want surgery or are not able to be given general anesthesia

There are two types of radiation therapy for skin cancer: external beam radiation therapy (EBRT) and brachytherapy.

  • External beam radiation therapy delivers beams of radiation from a machine outside the body to the precise location where the cancer is located or to the surgery site. Treatments last a few minutes each session, with treatment given five days a week for several weeks.

  • High dose-rate brachytherapy involves placing the radiation source on top of the skin cancer for short periods of time. HDR brachytherapy can be used for basal cell or squamous cell skin cancers. An applicator is filled with the radioactive material and then placed where it can deliver radiotherapy to the affected area. This can be repeated a couple times a week for several weeks to be sure the cancer cells are destroyed.
skin cancer patient consulting with skin oncologists on best treatment plan - will it include radiation therapy? WVCI answers

Related Reading

How Radiation Therapy Is Used to Treat Skin Cancer

Targeted Therapies for Skin Cancer

Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells while minimizing damage to healthy cells. 

It’s important to note that different skin cancers have different targets, and your doctor may conduct tests to identify the genes, proteins, and other factors present in the cells to determine the most effective treatment. Discovering more about particular molecular targets and developing new treatments that target them continue to remain a part of ongoing clinical research. 

Two FDA-approved drugs known as hedgehog pathway inhibitors may be used to treat large or advanced basal cell cancers that cannot be treated with surgery or radiation therapy. These drugs are designed to block the PTCH1 genetic mutation, which seems to drive the growth of basal cell carcinoma. 


Immunotherapy uses the patient’s immune system to fight cancer by improving its ability to attack cancer cells.

There are different kinds of immunotherapy used to treat cancer. In particular, non-melanoma skin cancer is treated with a type of immunotherapy that belongs to a class of drugs called checkpoint inhibitors. These drugs work by turning the immune checkpoints back “on” so that they can identify cancer cells and destroy them. 

The Latest in Non-Melanoma Skin Cancer Treatment is Available in Willamette Valley

If you were diagnosed with skin cancer, the specialists at Willamette Valley Cancer Institute are available to discuss the best treatment plan for you based on many different factors. Request a consultation with a skin cancer specialist at one of our locations in Willamette Valley or the Oregon Coast area, including Albany, Corvallis, Eugene, Florence, Lincoln City, and Newport

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