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Basal Cell Skin Cancer: Should I Have Surgery?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Basal Cell Skin Cancer: Should I Have Surgery?

Get the facts

Your options

  • Have surgery to remove low-risk basal cell skin cancer.
  • Use non-surgical treatments to destroy cancer cells.

This decision aid is for people who have low-risk basal cell skin cancer. If you have high-risk basal cell skin cancer, this decision aid is not for you.

Key points to remember

  • Basal cell skin cancer is almost always cured when it's found early and treated.
  • If the cancer has a low risk for coming back after treatment, you may have a choice between surgery and other, non-surgical, treatments.
  • Surgery and other treatments work well to get rid of low-risk basal cell skin cancer. Surgery works better to keep the cancer from coming back.
  • The side effects of surgery and other treatments may include pain or discomfort, bleeding, and infection. Surgery leaves a scar, but the size of the scar varies from case to case.
  • Non-surgical treatments usually don't leave a scar. But in some cases, they can leave the skin lighter or darker in the treated area.
FAQs

What is basal cell skin cancer?

Basal cell skin cancer is the abnormal growth of cells in the skin. It's almost always cured when it's found early and treated.

This cancer grows slowly. Over time, it can damage deeper tissues. But it doesn't usually spread, or metastasize, to other parts of the body.

It's usually caused by too much sun. Tanning beds and sunlamps can also cause it.

Surgery is usually the recommended treatment for basal cell skin cancer.

If the cancer is the low-risk type, you may have a choice between surgery and other treatments.

  • Low-risk basal cell skin cancer is small and is only on the top part of the skin. It has a clear border. It is located only in certain areas of the body, such as the back, chest, arms, or legs.
  • High-risk basal cell skin cancer is usually larger in size or located on an area of the body such as the face or hands. A skin cancer is also high risk if it has come back again after treatment.

Basal cell skin cancer sometimes comes back, no matter which treatment is used. If it comes back, it can be treated again.

What surgeries are used for treatment?

The type of surgery you have may depend on where the cancer is and how big it is. Some surgeries cause more scarring than others. The surgeries include:

  • Standard surgery. The area is numbed and the doctor cuts out the cancer. A small amount of tissue around the cancer is also removed. This helps to make sure all the cancer is cut out. The wound is closed with stitches.
  • Curettage and electrodessication. The area is numbed. Then the cancer is scraped out using a sharp instrument called a curette. Electrodessication controls the bleeding. It also destroys any cancer cells that may still be there.

Surgery and non-surgical treatments work well to get rid of low-risk basal cell skin cancer. Surgery works better to keep the cancer from coming back.footnote 1

What are other treatment options?

The other treatment options you have may depend on where the cancer is and how big it is. Treatment options may include:

  • Medicated creams. Strong medicine is applied to the skin. It causes redness and irritation in the treated area. The skin gets inflamed and crusts over as it heals. You apply the cream at home for 3 to 6 weeks.
  • Cryosurgery. This destroys the cancer by freezing it. It is also called cryotherapy.
  • Radiation therapy. This destroys cancer cells with high energy rays, such as X-rays. It often requires several visits.
  • Photodynamic therapy. Medicine is put on the skin. Then a special light is used to activate the medicine.

These treatments work well to get rid of low-risk basal cell skin cancer. But surgery works better to keep the cancer from coming back.footnote 1

What are the risks of treatment?

Both surgery and other, non-surgical, treatments carry the risks of infection, bleeding, and pain or discomfort.

Surgery usually leaves a scar. Other treatments usually don't leave scars. But in some cases, they can leave the skin lighter or darker in the treated area.

The risks of non-surgical treatments depend on the type of treatment. For example, medicated cream can cause pain and burning when you put it on. You will likely have redness, irritation, and crusting of your skin during the weeks of treatment. Radiation therapy usually requires repeated visits to the doctor's office. It may cause fatigue. You may have redness, swelling, scaling, and hair loss in the area that is treated.

No matter which treatment you choose, there's always a risk that the cancer could come back.

Compare your options

Compare

What is usually involved?









What are the benefits?









What are the risks and side effects?









Get surgeryGet surgery
  • You have the surgery in a clinic and go home afterward.
  • You are usually awake for the surgery, but the area is numbed.
  • You treat the wound at home as it heals.
  • Surgery works better than non-surgical treatments to keep the cancer from coming back.
  • With standard surgery, the cancer and a small amount of tissue around the cancer are removed.
  • Surgery is usually done in one visit.
  • Surgery usually leaves a scar.
  • Side effects may include infection, bleeding, and pain or discomfort.
  • The cancer may come back.
Have a non-surgical treatmentHave a non-surgical treatment
  • You apply medicated cream at home for 3 to 6 weeks.
  • You have cryotherapy and care for the wound at home as it heals.
  • You have radiation treatments several times.
  • You have photodynamic therapy and care for the area at home as it heals.
  • These treatments work well for low-risk basal cell skin cancer.
  • These treatments usually do not leave a scar.
  • The medicated cream can be applied at home.
  • Cryosurgery can usually be done quickly by your doctor.
  • Risks and side effects depend on the treatment.
  • Examples can include infection, skin colour changes, bleeding, and pain or discomfort.
  • The cancer may come back.

Personal stories about considering surgery or medicated cream for basal cell skin cancer

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

Several people in my family have died of cancer. It wasn't skin cancer, but still, the word "cancer" just really scares me. I want the best possible cure rate, so I'm going to have surgery.

Kes, 74

I know this cancer isn't going to kill me. What really scares me is the whole idea of surgery, even minor surgery. If there's a way for me to avoid it, that's what I want.

Chad, 57

I'm not worried about scarring, because my cancer isn't where most people will ever see the scar. And I just want it over with. I'm going with surgery.

Paula, 68

I have a lot of my life still ahead of me, and I don't like the idea of carrying around a scar from surgery. I'm going to try a medicated cream. If that doesn't work, I can always try something else later.

Wesley, 30

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have surgery

Reasons not to have surgery

The idea of having surgery doesn't bother me.

I want to avoid surgery if possible.

More important
Equally important
More important

I'm not worried about having a scar after treatment.

I worry about having scars on my skin.

More important
Equally important
More important

I don't want treatment that takes many weeks.

I don't mind if treatment takes a while.

More important
Equally important
More important

It's important for me to have the treatment that works best to keep the cancer from coming back.

I feel confident that whatever treatment I have will keep the cancer from coming back.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having surgery

Having a non-surgical treatment

Leaning toward
Undecided
Leaning toward

What else do you need to make your decision?

Check the facts

1, Having a non-surgical treatment for basal cell skin cancer means that my skin will look as good as new after treatment is done.
2, Treating my basal cell skin cancer with a medicated cream will take longer than treating it with surgery.
3, Surgery works better than other treatments to keep the cancer from coming back.

Decide what's next

1,Do you understand the options available to you?
2,Are you clear about which benefits and side effects matter most to you?
3,Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure

3. Use the following space to list questions, concerns, and next steps.

Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts

Key concepts that you understood

Key concepts that may need review

Getting ready to act

Patient choices

Credits and References

Credits
AuthorHealthwise Staff
Primary Medical ReviewerPatrice Burgess MD - Family Medicine
Primary Medical ReviewerE. Gregory Thompson MD - Internal Medicine
Primary Medical ReviewerAdam Husney MD - Family Medicine
Primary Medical ReviewerKathleen Romito MD - Family Medicine
Primary Medical ReviewerMartin J. Gabica MD - Family Medicine
Primary Medical ReviewerRandall D. Burr MD - Dermatology
Primary Medical ReviewerLesley Ryan MD - Family Medicine
Primary Medical ReviewerMarco Mannarino MD - Family Medicine

References
Citations
  1. Thomson J, et al. (2020). Interventions for basal cell carcinoma of the skin. Cochrane Database of Systematic Reviews, 11: CD003412. DOI: 10.1002/14651858.CD003412.pub3. Accessed October 31, 2022.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Basal Cell Skin Cancer: Should I Have Surgery?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
  1. Get the facts
  2. Compare your options
  3. What matters most to you?
  4. Where are you leaning now?
  5. What else do you need to make your decision?

1. Get the Facts

Your options

  • Have surgery to remove low-risk basal cell skin cancer.
  • Use non-surgical treatments to destroy cancer cells.

This decision aid is for people who have low-risk basal cell skin cancer. If you have high-risk basal cell skin cancer, this decision aid is not for you.

Key points to remember

  • Basal cell skin cancer is almost always cured when it's found early and treated.
  • If the cancer has a low risk for coming back after treatment, you may have a choice between surgery and other, non-surgical, treatments.
  • Surgery and other treatments work well to get rid of low-risk basal cell skin cancer. Surgery works better to keep the cancer from coming back.
  • The side effects of surgery and other treatments may include pain or discomfort, bleeding, and infection. Surgery leaves a scar, but the size of the scar varies from case to case.
  • Non-surgical treatments usually don't leave a scar. But in some cases, they can leave the skin lighter or darker in the treated area.
FAQs

What is basal cell skin cancer?

Basal cell skin cancer is the abnormal growth of cells in the skin. It's almost always cured when it's found early and treated.

This cancer grows slowly. Over time, it can damage deeper tissues. But it doesn't usually spread, or metastasize, to other parts of the body.

It's usually caused by too much sun. Tanning beds and sunlamps can also cause it.

Surgery is usually the recommended treatment for basal cell skin cancer.

If the cancer is the low-risk type, you may have a choice between surgery and other treatments.

  • Low-risk basal cell skin cancer is small and is only on the top part of the skin. It has a clear border. It is located only in certain areas of the body, such as the back, chest, arms, or legs.
  • High-risk basal cell skin cancer is usually larger in size or located on an area of the body such as the face or hands. A skin cancer is also high risk if it has come back again after treatment.

Basal cell skin cancer sometimes comes back, no matter which treatment is used. If it comes back, it can be treated again.

What surgeries are used for treatment?

The type of surgery you have may depend on where the cancer is and how big it is. Some surgeries cause more scarring than others. The surgeries include:

  • Standard surgery. The area is numbed and the doctor cuts out the cancer. A small amount of tissue around the cancer is also removed. This helps to make sure all the cancer is cut out. The wound is closed with stitches.
  • Curettage and electrodessication. The area is numbed. Then the cancer is scraped out using a sharp instrument called a curette. Electrodessication controls the bleeding. It also destroys any cancer cells that may still be there.

Surgery and non-surgical treatments work well to get rid of low-risk basal cell skin cancer. Surgery works better to keep the cancer from coming back.1

What are other treatment options?

The other treatment options you have may depend on where the cancer is and how big it is. Treatment options may include:

  • Medicated creams. Strong medicine is applied to the skin. It causes redness and irritation in the treated area. The skin gets inflamed and crusts over as it heals. You apply the cream at home for 3 to 6 weeks.
  • Cryosurgery. This destroys the cancer by freezing it. It is also called cryotherapy.
  • Radiation therapy. This destroys cancer cells with high energy rays, such as X-rays. It often requires several visits.
  • Photodynamic therapy. Medicine is put on the skin. Then a special light is used to activate the medicine.

These treatments work well to get rid of low-risk basal cell skin cancer. But surgery works better to keep the cancer from coming back.1

What are the risks of treatment?

Both surgery and other, non-surgical, treatments carry the risks of infection, bleeding, and pain or discomfort.

Surgery usually leaves a scar. Other treatments usually don't leave scars. But in some cases, they can leave the skin lighter or darker in the treated area.

The risks of non-surgical treatments depend on the type of treatment. For example, medicated cream can cause pain and burning when you put it on. You will likely have redness, irritation, and crusting of your skin during the weeks of treatment. Radiation therapy usually requires repeated visits to the doctor's office. It may cause fatigue. You may have redness, swelling, scaling, and hair loss in the area that is treated.

No matter which treatment you choose, there's always a risk that the cancer could come back.

2. Compare your options

Get surgeryHave a non-surgical treatment
What is usually involved?
  • You have the surgery in a clinic and go home afterward.
  • You are usually awake for the surgery, but the area is numbed.
  • You treat the wound at home as it heals.
  • You apply medicated cream at home for 3 to 6 weeks.
  • You have cryotherapy and care for the wound at home as it heals.
  • You have radiation treatments several times.
  • You have photodynamic therapy and care for the area at home as it heals.
What are the benefits?
  • Surgery works better than non-surgical treatments to keep the cancer from coming back.
  • With standard surgery, the cancer and a small amount of tissue around the cancer are removed.
  • Surgery is usually done in one visit.
  • These treatments work well for low-risk basal cell skin cancer.
  • These treatments usually do not leave a scar.
  • The medicated cream can be applied at home.
  • Cryosurgery can usually be done quickly by your doctor.
What are the risks and side effects?
  • Surgery usually leaves a scar.
  • Side effects may include infection, bleeding, and pain or discomfort.
  • The cancer may come back.
  • Risks and side effects depend on the treatment.
  • Examples can include infection, skin colour changes, bleeding, and pain or discomfort.
  • The cancer may come back.

Personal stories

Personal stories about considering surgery or medicated cream for basal cell skin cancer

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"Several people in my family have died of cancer. It wasn't skin cancer, but still, the word "cancer" just really scares me. I want the best possible cure rate, so I'm going to have surgery."

— Kes, 74

"I know this cancer isn't going to kill me. What really scares me is the whole idea of surgery, even minor surgery. If there's a way for me to avoid it, that's what I want."

— Chad, 57

"I'm not worried about scarring, because my cancer isn't where most people will ever see the scar. And I just want it over with. I'm going with surgery."

— Paula, 68

"I have a lot of my life still ahead of me, and I don't like the idea of carrying around a scar from surgery. I'm going to try a medicated cream. If that doesn't work, I can always try something else later."

— Wesley, 30

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have surgery

Reasons not to have surgery

The idea of having surgery doesn't bother me.

I want to avoid surgery if possible.

More important
Equally important
More important

I'm not worried about having a scar after treatment.

I worry about having scars on my skin.

More important
Equally important
More important

I don't want treatment that takes many weeks.

I don't mind if treatment takes a while.

More important
Equally important
More important

It's important for me to have the treatment that works best to keep the cancer from coming back.

I feel confident that whatever treatment I have will keep the cancer from coming back.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having surgery

Having a non-surgical treatment

Leaning toward
Undecided
Leaning toward

5. What else do you need to make your decision?

Check the facts

1. Having a non-surgical treatment for basal cell skin cancer means that my skin will look as good as new after treatment is done.

  • True
  • False
  • I'm not sure
You're correct. Although these treatments do not usually leave scars, they can leave the skin lighter or darker in the treated area.

2. Treating my basal cell skin cancer with a medicated cream will take longer than treating it with surgery.

  • True
  • False
  • I'm not sure
That's right. Surgery is done in the doctor's office, and then it's over. The cream is applied by you at home for 3 to 6 weeks.

3. Surgery works better than other treatments to keep the cancer from coming back.

  • True
  • False
  • I'm not sure
You're right. Surgery and other treatments work well for low-risk basal cell skin cancer. Surgery works better to keep the cancer from coming back.

Decide what's next

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure

2. Check what you need to do before you make this decision.

  • I'm ready to take action.
  • I want to discuss the options with others.
  • I want to learn more about my options.

3. Use the following space to list questions, concerns, and next steps.

Credits
ByHealthwise Staff
Primary Medical ReviewerPatrice Burgess MD - Family Medicine
Primary Medical ReviewerE. Gregory Thompson MD - Internal Medicine
Primary Medical ReviewerAdam Husney MD - Family Medicine
Primary Medical ReviewerKathleen Romito MD - Family Medicine
Primary Medical ReviewerMartin J. Gabica MD - Family Medicine
Primary Medical ReviewerRandall D. Burr MD - Dermatology
Primary Medical ReviewerLesley Ryan MD - Family Medicine
Primary Medical ReviewerMarco Mannarino MD - Family Medicine

References
Citations
  1. Thomson J, et al. (2020). Interventions for basal cell carcinoma of the skin. Cochrane Database of Systematic Reviews, 11: CD003412. DOI: 10.1002/14651858.CD003412.pub3. Accessed October 31, 2022.

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