Exams and Tests

Nonmelanoma skin cancer is diagnosed by:

• Your medical history. Your doctor will ask when the skin change occurred, whether you have been exposed to substances (such as arsenic) that can cause skin cancer, and whether you have any personal or family history of skin cancer.
• A physical exam of the skin growth. Your doctor can often tell what a skin growth is by looking at it. He or she may decide to monitor changes in the skin growth or take a sample of the skin growth for further testing.
• A skin biopsy. This is usually done when an area of skin has changed color, shape, size, or appearance or has not healed and skin cancer is suspected. A skin biopsy also may be done if the cause of a skin problem is not easily identified.

Early detection

Take steps to detect skin cancer early:

• Examine your skin once a month, and ask your doctor to look at any suspicious skin growths.
• Talk to your doctor about your own personal risk for skin cancer so that you understand the precautions that you need to take.
• Have your doctor look for any suspicious skin growths during any health examination.

Treatment Overview

The goals of treatment for nonmelanoma skin cancer are to:

• Remove the entire skin cancer and a margin of skin tissue around the cancer to reduce the chance of recurrence.
• Preserve nearby skin tissue that is free of cancer and minimize scarring after surgery.

Initial treatment

Treatment for nonmelanoma skin cancer depends on the size and location of the cancer, whether it is basal cell or squamous cell, and your age and overall health. The type of treatment will also depend on whether you have had skin cancer at that place before and whether the cancer is in a place where you have had radiation therapy. Because skin cancer usually grows slowly, it often can be detected early and successfully treated.

The most common treatment is surgery to destroy or remove the entire skin growth, including a margin of cancer-free tissue around the growth. Most surgical treatments are very effective, with high cure rates.

The main treatment options are:

• Mohs micrographic surgery. This surgery removes the skin cancer one layer at a time, checking each layer for cancer cells right after it is removed.
• Excision. Excision removes the skin cancer along with some healthy skin tissue around it (margin).
• Curettage and electrosurgery. Curettage uses a spoon-shaped instrument (curette) to scrape off the skin cancer, and electrosurgery controls the bleeding and destroys any remaining cancer cells.
• Cryosurgery. Cryosurgery destroys the skin cancer by freezing it with liquid nitrogen.

Each of these treatments has advantages and disadvantages. Discuss your options with your doctor.

Other treatments that are used include radiation therapy, carbon dioxide laser, topical fluorouracil (5-FU), and photodynamic therapy.

Ongoing treatment

Follow-up treatment for nonmelanoma skin cancer includes skin self-exams and regular exams by your doctor. These exams are extremely important to reduce the risk of the cancer coming back (recurrence).

Almost half of people who have a nonmelanoma skin cancer will develop another one within 5 years.¹ Your doctor may schedule you for exams as often as every 3 to 6 months for the first 2 years and yearly after that, especially for squamous cell carcinoma.

Treatment if the condition gets worse

Surgery is usually very effective for both basal and squamous cell carcinoma. But in rare cases, the cancer can spread to other parts of your body. This is more likely with squamous cell cancer than with basal cell.

If the cancer does spread, chemotherapy may be used. Your doctor may suggest that you enroll in a clinical trial if one is available.

What To Think About

Precancer skin growths, such as actinic keratoses and Bowen's disease, can develop into squamous cell skin cancer if they are not treated.

For more information about specific skin cancer treatment, see the following topics:

• Skin Cancer — Health Professional Information [NCI PDQ]
• Skin Cancer — Patient Information [NCI PDQ]