Topical cytotoxic drugs for skin cancer

The main types of primary skin cancer are basal-cell carcinoma (rodent ulcer), intra-epidermal carcinoma (Bowen’s disease) and squamous-cell carcinoma. In Britain surgery and radiotherapy are the commonly used methods of treating these conditions. Both methods have a high cure rate, over 95%, but both also have some drawbacks. Surgery may require admission to hospital, general anaesthesia and skin grafting; radiotherapy requires special facilities, and can occasionally cause troublesome scarring. Radiotherapy is often undesirable, and surgery not always practical for patients with multiple basal cell carcinomas such as are found after many years’ exposure to sunlight, and those with the basal cell naevus syndrome. Other methods of treatment worth considering include curettage and cautery, which can give excellent results,1 and topical use of cytotoxic drugs.