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01-01-2015 | Non-melanoma skin cancer | Article

4. Non-melanoma Skin Cancer: Primary Non-surgical Therapies and Prevention Strategies

Authors: BSc, MBChB, PhD, FRCS Malcolm A. Buchanan, BMedSci, MBBS, MMedSci, FRACS Brett Levin, MBBS, MMed, MD, MD, FRANZCR Michael Veness

Publisher: Springer India

Abstract

Patients with non-melanoma skin cancer (NMSC) may be managed non-surgically on the basis of relevant tumour and patient factors. This chapter presents non-surgical treatment options for the two most common NMSCs—basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). The management of Merkel cell carcinoma (often non-surgically) is discussed in Chap. 6. Excision, although considered the gold standard, is not always possible or considered the best option (Box 4.1). Numerous topical (e.g. 5-fluorouracil [5-FU], imiquimod) and intralesional (e.g. methotrexate, interferon) [1] options, as well as other modalities are widely available, often with ill-defined criteria for using them. Additionally, because the evidence to support these treatments is predominantly low-level with long-term follow-up (≤5 years) lacking, clinicians need to consider various issues before using any recommendation.

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