Basal cell carcinoma Treatment

Basal cell carcinoma
Treatment
Medical therapy. Local chemotherapy and immunomodulatory therapy is useful in some cases of carcinoma. In particular small and superficial carcinomas may respond to these compounds. In addition they can be used for prophylaxis and maintenance in patients who are predisposed to develop multiple carcinomas such as those in basal cell nevus syndrome.
Imiquimod 5% cream successfully used to treat superficial tumors. Its antitumor effects that induce apoptosis in tumor regression. We recommend using five times a week for six weeks but the frequency and duration must be addressed according to each patient.
Topical Cream 5% 5-fluorouracil is sometimes used for small superficial tumors btrata. It has a cure rate of 80%. Apply twice daily for at least six weeks. Percutaneous absorption of 5-fluorouracil is the main limiting factor. Penetrates only 1 mm into the skin. One advantage is that it works on tumors that are not large enough to be seen with the naked eye. Therefore it can be used in patients with basal cell nevus syndrome or those prone to develop subclinical forms. Cosmetic results vary from good to excellent.
Treatment with interferon alfa-2b has shown some success in treating small nodular and superficial tumors. Intralesional is administered 3 times per week, three weeks. Cure rate is 80%. Interferon did not become a practical therapy because of its cost carcinoma, the frequent visits to the doctor, the discomfort of administration and no adverse effects. Flu-like symptoms are common. Cardiovascular side effects, myelosuppression and neurological uncommon with this treatment. Because interferon is an immune stimulant treatment should not be used for transplantation or carcinoma in patients with autoimmune diseases.
Photodynamic therapy, PDT has been used for over 20 years. It uses different wavelengths to excite porphyrins that have been applied and paraneoplazice elulelor cancer. The energy released is quickly absorbed into the tissue adjacent to destroy you. 5-aminolevulinic acid is used to excite cells. It is administered for one hour and then fotoactiveaza labastra light.
Surgical therapy. The purpose of this therapy is to destroy or remove such a tumor is not malignant tissue left to proliferate further. Factors that are considered to choose a therapy include histological subtype, tumor location and size, patient age, its ability to withstand surgery and cost. Recurrent tumors are generally more aggressive than primary lesions and subclinical extension tends to increase. Tumors that are aggressive and which are located near the vital organs are best treated by methods that allow examination of tissue margins.
Curettage with electrodesicare. Use a scoop to remove the tumor from the skin. This technique works better in nodular and superficial subtypes of carcinoma because these tumors tend to be loose and not contained in the fibrous stroma. Curettage followed by electrodesicare, and the entire process can be repeated 1-2 times. Cure rate is 90% for low risk carcinoma. The method is simple, fast and less expensive.
Curettage is a blind technique which can examine specimens from the edge of control. Aggressive subtypes such as the morfeaform, infiltrative, micronodular and appellant are loose and can not be removed by curette. Healing leaves atrophic scars.
Surgical excision. The excised tumor can also apparently normal appearance of the skin edge. This method can be performed in an outpatient setting and allows for pathological examination control edges. Healing time is shorter than the granulation by suturing and has a good cosmetic appearance.
Surgical excision is more expensive and requires more time than chiretajul. This method requires the killing of normal tissue to obtain an acceptable healing of. At least 4 mm margins are necessary even in the less aggressive carcinomas, to achieve 95% healing.
Mohs micrographic surgery. It involves removal of clinically apparent tumor and a thin ring surrounding normal skin. The entire edge of the excised tumor is examined microscopically to minimize errors. It uses a freezing-sectioning technique to assess tissue when the patient is still a doctor. Microscopic tissue will present a map that will mark the remaining tumors to be excised. The Mohs technique 100% of the tissue margins are examined compared with the rest of techniques that are considered less than 1%. Excision and repair can be done in one day. This technique has the cure rate of cure is highest in the long term.
Radiotherapy. It is effective as primary treatment for a variety of carcinomas. For most of the cure rate is 90%. It is especially useful in patients who can not tolerate surgery, such as the elderly or debilitated. It can be useful when patients have aggressive tumors that have failed surgical treatment. It is an excellent option for avoiding vital structures adjacent. Initial cosmetic results tend to be better, and this therapy is less disfiguring than surgical excision. However long term results can be disfiguring. Another disadvantage is that the edges of the tumor can not be considered. Tumors that recur in irradiated areas tend to be more aggressive and difficult to treat.
Cryotherapy. It is an effective method for nonagresive carcinomas, with a cure rate of 90%. However, treatment success is dependent on operator experience. Patients must be able to pottratament swelling, necrosis and scarring of treated areas. This method is not used frequently.
Basal cell carcinoma Treatment Prognosis. Incompletely treated basal cell carcinoma can recur. All treated areas should be monitored after therapy. Persons with basal cell carcinoma have a 30% risk of developing other carcinomas combined with the previous comparable general population.