Basal Cell Carcinoma: A Comprehensive Review of Existing and Emerging Nonsurgical Therapies

Abstract

Basal cell carcinoma is the most commonly occurring cancer in the world and overall incidence is still on the rise. While typically a slow-growing tumor for which metastases is rare, basal cell carcinoma can be locally destructive and disfiguring. Given the vast prevalence of this disease, there is a significant overall burden on patient well-being and quality of life. The current mainstay of basal cell carcinoma treatment involves surgical modalities, such as electrodessication and curettage, excision, cryosurgery, and Mohs micrographic surgery. Such methods are typically reserved for localized basal cell carcinoma and offer high five-year cure rates, but come with the risk of functional impairment, disfigurement, and scarring. Here, the authors review the evidence and indications for nonsurgical treatment modalities in cases where surgery is impractical, contraindicated, or simply not desired by the patient.

Figure 1.

A) Before: Patient with basal cell carcinoma and local lymph node involvement status post surgical excision, Mohs surgery, and radiation therapy. B) Patient status post two 3-month cycles of vismodegib 150mg daily with a 1-month break in between

Figure 1.

A) Before: Patient with basal cell carcinoma and local lymph node involvement status post surgical excision, Mohs surgery, and radiation therapy. B) Patient status post two 3-month cycles of vismodegib 150mg daily with a 1-month break in between