Understanding Non-Surgical Treatment Options

When you’re diagnosed with skin cancer, you may assume that surgery will automatically be the next step. For many skin cancers, surgery is an effective and appropriate treatment. But for some people with certain low-risk skin cancers, there may be other options to consider.

In a recent AIM at Skin Cancer educational presentation, Timothy Deng, MD, dermatologist and Director of Oncodermatology at UC San Diego, discusses non-surgical approaches for selected low-risk skin cancers and the factors that can help patients and their healthcare providers decide which approach makes sense.

What Does “Low Risk” Mean?

Not every basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) behaves the same way.

When determining the risk associated with a skin cancer, healthcare providers consider several factors, including the type and subtype of cancer, its size, and where it is located on the body. These details help determine which treatment options may be appropriate for an individual patient.

For example, Dr. Deng explains that smaller cancers located on areas such as the trunk, arms or legs may be considered lower risk in certain circumstances, while cancers in more sensitive locations may require a different approach.

This distinction matters because some patients with appropriately selected low-risk skin cancers may have options beyond traditional surgical treatment.

Treatment Is About More Than the Cancer

One of the most important points Dr. Deng makes is that choosing a treatment means considering the whole person, not simply the diagnosis.

Age and overall health may matter. So can cosmetic concerns, recovery time, the effect treatment could have on daily activities, the time required for treatment, and cost.

For one patient, achieving the highest possible cure rate may be the overriding priority. Another patient may have other health concerns or place greater importance on avoiding surgery or minimizing recovery time.

That is why treatment decisions should be made through a conversation between the patient and dermatologist, taking into account the characteristics of the cancer as well as the patient’s individual circumstances and priorities.

What Are the Non-Surgical Options?

Depending on the type of skin cancer and the individual situation, Dr. Deng discusses several approaches that may be considered.

One is clinical surveillance, in which a dermatologist monitors the area rather than immediately providing additional treatment. This may be considered in selected situations, including when a biopsy appears to have removed the cancer. Surveillance does not mean ignoring the cancer; it means continuing to watch the area carefully and intervening if necessary.

Other options discussed in the presentation include topical medications, cryotherapy, electrodesiccation and curettage (ED&C), photodynamic therapy and radiation therapy.

Each approach has its own potential benefits, limitations and appropriate uses. Not every treatment is suitable for every skin cancer or every patient.

Follow-Up Still Matters

Choosing a non-surgical approach does not mean treatment ends when the procedure or medication is finished.

Ongoing dermatologic follow-up is an important part of care. Your dermatologist will continue to examine previously treated areas to determine whether the cancer remains in remission or has returned. Dr. Deng emphasizes that this monitoring continues whether a patient chooses surveillance, cryotherapy, topical treatment or radiation.

If a cancer does return, the treatment plan can be reconsidered.

The Right Treatment Is an Individual Decision

Perhaps the most useful takeaway is that there may not always be one approach that is right for every person with a low-risk skin cancer.

The characteristics of the cancer matter. So do your health, your lifestyle, your priorities and how you feel about the benefits and tradeoffs of different treatments.

If you have been diagnosed with basal cell carcinoma or squamous cell carcinoma, ask your dermatologist how your cancer is classified and why a particular treatment is being recommended. If your cancer is considered low risk, you can also ask whether there are appropriate alternatives to surgery and what the benefits and limitations of those options would be for you.

Understanding your options can help you take a more active role in making decisions about your care.

Questions to Ask Your Dermatologist

• Is my skin cancer considered low risk or high risk, and why?
• What treatment options are appropriate for my particular cancer?
• Is surgery recommended, and are there non-surgical alternatives?
• What are the benefits and limitations of each option?
• How likely is the cancer to return with each approach?
• What kind of follow-up will I need after treatment?

This article and video are for educational purposes only and are not intended to replace individualized medical advice. Treatment options vary based on the type and characteristics of the skin cancer and individual patient factors. Talk with your healthcare provider about the treatment options appropriate for you.