Michael R. Migden - Basal Cell Carcinoma: Advances in Treatment and Research

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We embarked on this journey to write about basal cell carcinoma not only because millions of individuals are affected by it every year but also there are many unanswered clinical questions faced by dermatologists and Mohs surgeons as well as other specialists. The treatment of this disease has largely been procedural: either with Mohs micrographic surgery, surgical excision, or destruction. Mohs micrographic surgery allows 100% of the tumor margin examined while sparing unnecessary tissue removal, and a step-by-step illustration of this surgical technique is detailed in this book. More recently, good options for patients with advanced basal cell carcinoma who are deemed poor surgical candidates have been developed. With the approval of vismodegib in 2012 and sonidegib in 2015 by the US Food and Drug Administration, patients with advanced basal cell carcinoma now have a viable alternative to disfiguring or morbid extensive surgery. Given the success of immunotherapy with program cell death 1 inhibitors in a wide variety of cancer types, multiple ongoing trials are investigating the efficacy and safety of immunotherapy for the treatment of advanced basal cell carcinoma.

We have assembled a multidisciplinary panel of specialists from diverse fields such as dermatology, dermatopathology, head and neck surgery, Mohs micrographic surgery, radiation oncology, and oculoplastic surgery to participate in the writing ofBasal Cell Carcinoma: Advances in Treatment and Research. This book provides an in-depth coverage of treatment for localized basal cell carcinomas including topical therapy, destruction, photodynamic therapy, local immunotherapy with interferon, and laser treatment. This book also includes an extensive review on combination therapies and comparative studies of various treatment modalities for basal cell carcinoma.

In cases of extensive, locally advanced basal cell carcinoma invading deeper structures, head and neck surgery offers highly effective deeper en bloc surgical extirpation for oncologic control. The role of radiation therapy as definitive or adjuvant therapy can be found in chapter Radiotherapy for Basal Cell Carcinoma. The chapter authors discuss different radiotherapy modalities such as orthovoltage irradiation, electron beam therapy and brachytherapy, as well as practical case studies of difficult-to-treat basal cell carcinomas.

Tumors located adjacent or within the orbit can present various challenges. These include higher risk for recurrence, higher complexity of reconstruction to preserve vision, and restoration of aesthetics. In chapter Special Consideration for Periocular Basal Cell Carcinoma, the authors share their clinical pearls in treatment of tumor and effective reconstruction of the orbital region.

Basal Cell Carcinoma: Advances in Treatment and Researchprovides the most comprehensive overview of evidence-based treatment approaches for basal cell carcinoma, the most common cancer worldwide. The first part of this book details epidemiology, risk factors, pathophysiology, and different histologic subtypes of basal cell carcinoma highlighted with high-resolution histopathology images. The second part of the book provides an in-depth review and practical pearls of different treatment modalities including topical therapy, local immunotherapy with interferon, cryotherapy, electrodesiccation and curettage, radiotherapy, and surgical approaches with Mohs micrographic surgery, head and neck surgery, and oculoplastic surgery. The final part of the book highlights the utilization of innovative technology such as photodynamic therapy and laser for the treatment of basal cell carcinoma as well as emerging systemic therapeutic options utilizing hedgehog pathway inhibitors and immunotherapy for the difficult-to-treat advanced disease states. It is our intention that this book will serve as an informative and evidence-based guide for physicians, mid-level providers, trainees, and healthcare personnel for years to come.