Keratinocyte cancer treatments

Surgical excision is the most commonly used treatment for many KC cases. The aim is to remove the tumour together with a margin of healthy skin, which helps ensure that no cancer cells remain. The removed tissue is then examined to confirm clear margins. For many suitable tumours, surgery provides excellent long-term control.

For high-risk or complex cases, there is the option of a more specialized surgical method, known as micrographic or Mohs surgery.  This technique involves examining each layer of tissue during the procedure, allowing the surgeon to remove only what is necessary. It is particularly useful for areas where preserving as much healthy tissue as possible matters, such as the face, ears or hands. 

This technique involves freezing the tumour, usually with liquid nitrogen. It is a less invasive option and can be considered for small, superficial lesions or when surgery is not ideal, for instance in older individuals or those with other health concerns.

Some studies report strong outcomes for certain types of BCC treated with cryotherapy. However, evidence also shows that cryotherapy may not be as effective as surgery or radiotherapy in reducing the risk of recurrence for some tumours. Careful selection of appropriate cases is therefore essential. 

These types of treatment for keratinocyte cancer are useful for early-stage and superficial lesions. These therapies involve applying creams or gels containing anticancer or immune-stimulating medicines directly to the skin. Established options include agents such as 5-fluorouracil or imiquimod for certain superficial BCCs.

Recent research has explored the use of innovative skin patch technologies that deliver treatment more precisely, although these approaches are still emerging. Topical therapy tends to be cost-effective for small and low-risk lesions, but it is not suitable for deeper, high-risk or more advanced tumours. It is also less useful when accurate margin control is required. 

Also known as curettage and cautery, this treatment involves scraping away the tumour and using an electrical current to treat the remaining tissue. It is often chosen for small, low-risk lesions in easily accessible areas. The technique is straightforward and less expensive than excision, though recurrence rates may be higher if used for inappropriate cases.  Electrosurgery is generally reserved for selected low-risk tumours because control of margins is limited. 

Radiotherapy delivers targeted radiation to destroy cancer cells. It is especially valuable for patients who cannot undergo surgery due to age, other medical issues or tumour location. It may also be used for lesions where surgery could cause significant cosmetic or functional impact.

Modern radiotherapy techniques offer excellent results in many suitable cases. They can be used as the main treatment for keratinocyte cancer when surgery is not possible, as an additional treatment after surgery when margins are close, or as palliative care in more advanced disease. It plays an important role within a multidisciplinary approach to managing KC. 

Systemic treatment affects the whole body and is generally reserved for advanced or metastatic KC. This may include cancers that are too large for local treatment, those that have spread, or cases where immunotherapy or targeted medicines may be beneficial.

Traditional chemotherapy is used less commonly than in the past, as newer systemic treatments continue to evolve. Advances in immunotherapy and targeted therapies have significantly improved management options for complex or aggressive forms of KC, offering additional hope for patients with higher-risk disease.