Systemic Chemotherapy for Basal and Squamous Cell Skin Cancers

Systemic chemotherapy (chemo) uses anti-cancer drugs that are given through an IV into a vein or taken by mouth. These drugs travel through the bloodstream to all parts of the body. Unlike topical chemotherapy, which is applied to the skin, systemic chemotherapy can attack cancer cells that have spread to lymph nodes and other organs.

Chemotherapy for squamous cell skin cancer

For squamous cell carcinomas (SCCs), chemo might be used along with radiation therapy if surgery isn’t a good option, and if radiation alone isn’t likely the get rid of the cancer completely.

Chemo might also be used (either by itself or with radiation) if the cancer has spread too far to be cured with surgery or radiation, although an immunotherapy drug is often used first.

The chemo drugs most often used to treat SCC include cisplatin, carboplatin, 5-fluorouracil (5-FU) and paclitaxel. Sometimes two of these drugs are combined (for example, carboplatin is often given with paclitaxel). These drugs are given into a vein (intravenously, or IV), usually once every few weeks. They can often slow the spread of these cancers and relieve some symptoms. In some cases, they might shrink tumors enough so that other treatments such as surgery or radiation therapy can then be used.

Chemotherapy for basal cell skin cancer

Basal cell carcinoma (BCC) very rarely reaches an advanced stage, so systemic chemotherapy is not typically used to treat these cancers. Advanced basal cell cancers are more likely to be treated with targeted therapy or immunotherapy.

Possible side effects of chemotherapy

Chemo drugs can cause side effects. These depend on the type and dose of drugs given and how long they are used. The side effects of chemo can include:

• Hair loss
• Mouth sores
• Loss of appetite
• Nausea and vomiting
• Diarrhea or constipation
• Increased risk of infection (from having too few white blood cells)
• Easy bruising or bleeding (from having too few blood platelets)
• Fatigue (from having too few red blood cells)

These side effects usually go away once treatment is finished. Some drugs can also have other side effects that aren’t listed above, so be sure to talk with your cancer care team about what you might expect.

There are often ways to lessen these side effects. For example, drugs can help prevent or reduce nausea and vomiting. Tell your medical team about any side effects or changes you notice while getting chemo so that they can be treated promptly.