Superficial basal cell carcinoma

How well does it work?

98.6% cure rate (Liebovitch 2005)

97-98% cure rate (Holt 1988, Kuflik 1991)

Imiquimod: up to 82% cure rate for superficial basal cell carcinoma (Geisse 2004)

Studies have demonstrated higher cure rates for photodynamic therapy when compared with topical treatments or cryotherapy. (Morton 2006, Basset-Seguin 2008).

Note that in these studies, success rates for cryotherapy treatment were generally less than in trials where cryotherapy was not compared with PDT.

What are the side effects?

Short term: bleeding, bruising, swelling, pain, infection

Long term: scarring in almost all cases, wound breakdown, nerve damage

Short term: pain, blistering (including blood-filled blisters), swelling

Long term: changes in skin pigmentation. The treated area is commonly lighter or darker than the surrounding skin.

Short term: irritation of the treated area: redness, pain, blistering, crusts and pustules

Long-term: side effects are uncommon. Scarring sometimes occurs after severe reactions during treatment.

Short term: pain during and soon after treatment. irritation , redness, blistering and crusts of the the treated area.

Long term: side effects are uncommon. Sacrring sometimes occurs after severe skin reactions.

Side effects are less common and the long term cosmetic outcome is superior to treatment with either cryotherapy or topical treatments. (Morton 2006) 

How much does it cost?

The cost of excision varies, according to the size and the anatomical location of the skin cancer.

Spot Check Clinic generally charges at least $300 for surgical removal. The fee varies according to the size of the skin cancer and the location on the body. This fee is usually discounted for pensioners and Health Care Card holders so that there is minimal or no out of-pocket expense.

If the procedure is performed by a plastic surgeon and/or more complicated techniques such as Moh's surgery or skin flaps or grafts are used, the cost can be thousands of dollars.

Approximately $55.

Medicare may pay a rebate of approximately 85% of this amount, but only if the diagnosis has previously been confirmed by a biopsy.

In biopsy-proven cases of superficial basal cell carcinoma, the Pharmaceutical Benefits Scheme subsidises the cost of imiquimod. In these cases, the out-of-pocket expense is about $40 (less for pensioners and Health Care Card holders).

In cases where the PBS does not subsidise imiquimod, the typical cost is $120 or more.

Treatment costs are variable and are influenced by:

• whether skin preparation treatment (e.g. microneedling) is performed on the day of treatment
• amount of ALA cream used
• type of light used to activate the ALA (i.e. LED red light phototherapy vs intense pulsed light)
• whether post-treatment LED phototherapy sessions are used to speed wound healin

Costs generally vary between $600 to $1000 for treatment of a single skin cancer.

How convenient is it?

Surgical removal must be performed by a doctor. it usually takes 30-60 minutes.

After the procedure, there is a period of aftercare lasting several weeks. Activities and exercise may be restricted during this period.

Cryotherapy is performed by a doctor and takes a few minutes.

Cryotherapy aftercare is relatively simple and the wound is usually healed in about three weeks.

Imiquimod cream must be applied daily to the affected area and surrounding region daily, 5 days a week for six weeks.

Treatment can usually be completed in a single visit to the skin cancer clinic, lasting several hours.

Due to inflammation and pain after treatment, it may be necessary to limit work and other activities for several days after treatment.