SDPA Fall | Live Blog | Skin Cancer: Therapy Overview
Basal cell (BCC) and squamous cell carcinoma (SCC) make up the majority of non-melanoma skin cancer presentations in the U.S. Dr. David Carr related that while rare, it is still important to be knowledgeable of the less common types of non-melanoma skin cancers, such as DFSP, AFX, Extrammary Pagets, and Merkel Cell Carcinoma, and have these on your differential when evaluating patients.
BCCs tend to grow slowly and very rarely metastasize, but if left without treatment can be very destructive. As with all skin cancers, sun exposure is the key etiologic agent and some studies suggest that intense periods of light exposure can be particularly damaging and causative for basal cell carcinomas. In contrast, cumulative sun exposure may be a bigger factor for the development of SCCs. Dr. Carr cautioned “beware of the squamous cell cancers, they can be tricky, particularly the high risk ones.” If left without treatment, SCC can be locally destructive and progress to regional and distant metastases. Higher metastatic rates are typically found among lesions located on the lip, ear and temple. Dr. Carr states there are many treatment modalities for BCC and SCC and “appropriate patient selection will deliver most effective care”. In addition, the rate of local recurrence and metastasis must be considered, and Mohs is indicated for any high risk recurrence sites.
Dr. Carr finished with the clinical pearl that Nicotinamide 500mg BID may be of use in preventing SCC in patients who have a history of numerous squamous cell cancers.
Byline: Sarah Patton, PA-C, MSHS
Posted: November 2, 2016