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Rational anatomical treatment of basal cell carcinoma with photodynamic therapy

Skin cancer is epidemic in the United States. A recent national cancer survey identified over 400,000 new cases of skin cancer in a single year and estimated that 40-50% of people who live to be 65 years of age will develop at least one skin cancer.1 The majority of these tumors are basal cell carcinomas. While current treatment modalities provide satisfactory cure rates for these lesions, the deformities following surgery can be devastating and provide an unsatisfactory quality of life. The author is aware of the anecdotal stories of two patients who have committed suicide following multiple surgical resections and irradiation for multifocal basal cell carcinoma. Photodynamic therapy (PDT) is a relatively new, experimental method of treatment for basal cell carcinomas that has been used by this author since 1 982. Because of its selective treatment nature, PDT has the potential to cause less deformity than surgery in certain patients by treating and preserving normal skin surrounding the areas of tumor that would necessarily be resected in the surgical margins.