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- Non-melanoma skin cancer
What is non-melanoma skin cancer?
What is non-melanoma skin cancer?
There are two main types of non-melanoma skin cancer:
- Basal cell carcinomas (BCC) – Treatment generally depends on the type, size, and location of the BCC, among other factors at the time of diagnosis.3
- Squamous cell carcinomas (SCC) – Treatment is usually based on the size and location of the SCC. The approach and outcomes may vary if other parts of the body are or have been affected.4
BCCs usually begin in the lower layer of the epidermis, while SCCs typically start in the upper layer.2 Whether a skin cancer is classified as a BCC or SCC depends on the type of skin cells involved and their appearance. Treatment options can vary accordingly.2
The signs and symptoms of skin cancer can vary from person to person.
Basal cell carcinomas (BCC)
Some of the signs and symptoms commonly seen in people diagnosed with BCC include:2,3
- A slight change in the skin, such as a small bump or flat red patch
- A pearly spot or lump
- A scaly, dry area that is shiny and pale or bright pink in colour (some BCCs may appear darker)
- A sore that doesn’t heal
- A sore that bleeds
Squamous cell carcinomas (SCC)
Some signs and symptoms that may be experienced by people with SCC include:4
- A thickened, red, scaly spot that doesn’t heal
- A crusted sore
- A small ulcer or thickened, scaly skin on the lips
- A persistent sore patch
- A firm, red lump
- A sore or rough patch inside the mouth
Basal cell carcinomas (BCC)
BCCs often develop due to overexposure to the sun’s ultraviolet (UV) rays.2 Risk factors for BCC may include:3
- Fair complexion (e.g. skin that burns easily, freckles, light eye colour, light or red hair)
- A personal or family history of skin cancer
- Use of UV light from sun lamps
Squamous cell carcinomas (SCC)
SCCs are also typically caused by overexposure to UV radiation.2 Risk factors for SCC may include:3
- Fair complexion (e.g. skin that burns easily, freckles, light eye colour, light or red hair)
- A history of skin cancer
- Immunosuppression (a weakened immune system)
- Use of solariums
- Presence of multiple solar keratoses
- Certain rare genetic disorders
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Diagnosis
Diagnosis
How is non-melanoma skin cancer diagnosed?
If you have noticed any changes to your skin3,4 and are concerned you may have non-melanoma skin cancer, it is important to make an appointment with your doctor (GP) or a skin specialist for advice. There are tests that doctors may perform to make a diagnosis, which may include:
- A physical exam - skin examination
- Biopsy - If further investigation is needed, they may take a biopsy (a small sample of skin) for testing.3,4
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Treatment options
Treatment options
Non-melanoma skin cancer can be treated in several ways. The choice of treatment is determined by specialist clinicians—such as a dermatologist, plastic surgeon, or radiation oncologist. They will consider factors such as your age, medical history, and specific risk factors related to the cancer.21,22
Read below to learn about some of the treatment options for non-melanoma skin cancer.
Radiation therapy uses measured doses of radiation directed at specific areas of the skin to stop the growth of cancer cells or destroy them completely. For early-stage disease, results are comparable to surgery.5
Find out more about Radiation Therapy, including how it works and who it’s for.
Surgery is a common treatment that involves removing the cancerous area. In some cases, surrounding tissue may also be removed.
Mohs surgery is one of the most effective options (in terms of clearance) for treating BCCs and SCCs.6-10 It involves the step-by-step removal and microscopic examination of thin layers of skin to ensure all cancer cells are removed. This procedure is generally reserved for higher-risk skin cancers. Although it can be time-consuming and more expensive, it may reduce the risk of recurrence or spread, potentially avoiding the need for further treatment.
Simple excision is a common surgical method for removing skin cancer.11 It often involves removing a larger area of skin than Mohs surgery. While the procedure is quicker, it may result in a larger scar. The removed tissue is sent for examination by a histopathologist. If residual cancer cells are found, further treatment may be necessary.
This procedure involves scraping away cancerous cells, followed by using an electric needle to destroy any remaining cancer cells.12-14
Cryotherapy destroys cancer cells by freezing them with extremely cold temperatures.15
Topical creams or gels containing chemotherapy or immunotherapy agents are applied directly to the skin. These treatments work either by directly killing cancer cells or by stimulating the immune system to destroy them.16-18
For patients with advanced disease that has spread beyond the skin, systemic therapies may be used to target cancer cells throughout the body or to help prevent further spread.19,20
If treatment is required, your doctor or healthcare team will help determine the most suitable option. This will depend on several factors, including the location and size of the cancer and any potential side effects.2
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Support services
Support services
Cancer Council Australia
Australia’s leading cancer charity, working to reduce the impact of cancer through prevention, support, and research.
Targeting Cancer
Targeting Cancer seeks to raise awareness about radiation therapy as a treatment option for cancer.
Melanoma Institute Australia (MIA)
Melanoma Institute Australia is dedicated to preventing and curing melanoma through innovative, world-class research, treatment and education programs.
- Cancer Council Australia. Skin Cancer. January 2020. [cited Apr. 2023].Available: https://www.cancer.org.au/cancer-information/types-of-cancer/skin-cancer
- Cancer Council Australia. Non-melanoma skin cancer. January 2022. [cited Apr. 2023].Available: https://www.cancer.org.au/cancer-information/types-of-cancer/non-melanoma-skin-cancer
- National Comprehensive Cancer Network. NCCN Guidelines; Basal Cell Skin Cancer. Version 1.2023 — Last updated March 10, 2023 [cited Apr. 2023]. Available from: https://www.nccn.org
- National Comprehensive Cancer Network. NCCN Guidelines; Squamous Cell Skin Cancer. Version 2020 — Last updated 2020 [cited Apr. 2023]. Available from: https://www.nccn.org
- Ashby MA, Smith J, Ainslie J, McEwan L. Treatment of nonmelanoma skin cancer at a large Australian center. Cancer 1989 May 1;63(9):1863-71
- Leibovitch I, Huilgol SC, Selva D, Hill D, Richards S, Paver R. Cutaneous squamous cell carcinoma treated with Mohs micrographic surgery in Australia I. Experience over 10 years. J Am Acad Dermatol 2005 Aug;53(2):253-60
- Lansbury L, Bath-Hextall F, Perkins W, Stanton W, Leonardi-Bee J. Interventions for non-metastatic squamous cell carcinoma of the skin: systematic review and pooled analysis of observational studies. BMJ 2013 Nov 4;347:f6153
- Pugliano-Mauro M, Goldman G. Mohs surgery is effective for high-risk cutaneous squamous cell carcinoma. Dermatol Surg 2010 Oct;36(10):1544-53
- Chren MM, Linos E, Torres JS, Stuart SE, Parvataneni R, Boscardin WJ. Tumor recurrence 5 years after treatment of cutaneous basal cell carcinoma and squamous cell carcinoma. J Invest Dermatol 2013 May;133(5):1188-96
- Stuart SE, Schoen P, Jin C, Parvataneni R, Arron S, Linos E, et al. Tumor recurrence of keratinocyte carcinomas judged appropriate for Mohs micrographic surgery using Appropriate Use Criteria. J Am Acad Dermatol 2017 Jun;76(6):1131-1138.e1
- Ferry AM, Sarrami SM, Hollier PC, Gerich CF, Thornton JF. Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery. Plast Reconstr Surg Glob Open. 2020 Dec 22;8(12):e3300.
- Ahmed I, Berth-Jones J, Charles-Holmes S, O'Callaghan CJ, Ilchyshyn A. Comparison of cryotherapy with curettage in the treatment of Bowen's disease: a prospective study. Br J Dermatol 2000 Oct;143(4):759-66
- Kuijpers DI, Thissen MR, Berretty PJ, Ideler FH, Nelemans PJ, Neumann MH. Surgical excision versus curettage plus cryosurgery in the treatment of basal cell carcinoma. Dermatol Surg 2007 May;33(5):579-87
- Lindemalm-Lundstam B, Dalenbäck J. Prospective follow-up after curettage-cryosurgery for scalp and face skin cancers. Br J Dermatol 2009 Sep;161(3):568-76
- Zacarian SA. Cryosurgery of cutaneous carcinomas. An 18-year study of 3,022 patients with 4,228 carcinomas. J Am Acad Dermatol 1983 Dec;9(6):947-56
- Jansen MHE, Mosterd K, Arits AHMM, Roozeboom MH, Sommer A, Essers BAB, et al. Five-Year Results of a Randomized Controlled Trial Comparing Effectiveness of Photodynamic Therapy, Topical Imiquimod, and Topical 5-Fluorouracil in Patients with Superficial Basal Cell Carcinoma. J Invest Dermatol 2018 Mar;138(3):527-533
- Jansen MHE, Kessels JPHM, Nelemans PJ, Kouloubis N, Arits AHMM, van Pelt HPA, et al. Randomized Trial of Four Treatment Approaches for Actinic Keratosis. N Engl J Med 2019 Mar 7;380(10):935-946
- Morton C, Campbell S, Gupta G, Keohane S, Lear J, Zaki I, et al. Intraindividual, right-left comparison of topical methyl aminolaevulinate-photodynamic therapy and cryotherapy in subjects with actinic keratoses: a multicentre, randomized controlled study. Br J Dermatol 2006 Nov;155(5):1029-36
- Sekulic A, Migden MR, Oro AE, Dirix L, Lewis KD, Hainsworth JD, et al. Efficacy and safety of vismodegib in advanced basal-cell carcinoma. N Engl J Med 2012 Jun 7;366(23):2171-9
- Migden MR, Rischin D, Schmults CD, Guminski A, Hauschild A, Lewis KD, et al. PD-1 Blockade with Cemiplimab in Advanced Cutaneous Squamous-Cell Carcinoma. N Engl J Med 2018 Jul 26;379(4):341-351
- Marcu LG. The first Rs of radiotherapy: or standing on the shoulders of giants. Australas Phys Eng Sci Med 2015 Dec;38(4):531-41
- Rong Y, Zuo L, Shang L, Bazan JG. Radiotherapy treatment for nonmelanoma skin cancer. Expert Rev Anticancer Ther 2015;15(7):765-76
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This website is provided for information purposes only. Nothing on this website is intended to be used as medical advice, or to diagnose, treat, cure or prevent any disease. It should not be used as a substitute for your own health professional's advice. Any medical procedure or treatment carries risks. Before proceeding with treatment, you should discuss the risks and benefits of the treatment with an appropriately qualified health practitioner. Individual treatment outcomes and experiences will vary.