From the Guidelines
Cryotherapy is a recommended treatment for superficial or early-stage Squamous Cell Carcinoma (SCC) lesions, with high cure rates and the advantage of being a simple, inexpensive, and quick method. According to the British Association of Dermatologists' guidelines for the management of squamous cell carcinoma in situ (Bowen's disease) 2014 1, cryotherapy has a strength of recommendation B and a level of evidence 1+, making it a viable option for treating SCC in situ. The guidelines suggest that clearance rates for cryotherapy vary widely, but high cure rates can be achieved with adequate cryotherapy, such as liquid nitrogen cryotherapy using a single freeze-thaw cycle of 30 seconds, two freeze-thaw cycles of 20 seconds with a thaw period, or up to three single treatments of 20 seconds at intervals of several weeks.
Some key points to consider when using cryotherapy for SCC include:
- The technique and regimen used can affect the clearance rates and recurrence rates
- Cryotherapy can cause discomfort and may cause ulceration, especially on the lower leg
- Recurrence rates with cryotherapy are similar or superior to those treated with curettage or photodynamic therapy (PDT)
- The treatment choice depends on factors including tumor size, location, depth, patient age, and comorbidities
It's also important to note that other treatment options, such as topical treatments (e.g., 5-fluorouracil cream or imiquimod 5% cream), surgical excision, Mohs micrographic surgery, curettage and electrodesiccation, and radiation therapy, may be more suitable for certain patients or lesion characteristics, as outlined in the British Association of Dermatologists' guidelines 1. However, cryotherapy remains a recommended treatment option for superficial or early-stage SCC lesions, particularly for patients who are poor surgical candidates or have lesions in areas with good healing potential.
From the Research
Description of Cryotherapy for SCC
- Cryotherapy, also known as cryosurgery, is a treatment that uses liquid nitrogen to freeze and destroy abnormal or damaged cells, including those found in squamous cell carcinoma (SCC) lesions 2, 3, 4, 5, 6.
- The treatment involves spraying or applying liquid nitrogen to the affected area, which causes the cells to freeze and eventually die.
- Cryotherapy can be used to treat superficial or early-stage SCC lesions, and it may be used in combination with other treatments, such as chemowraps or topical creams 2.
Recommended Treatment for Superficial or Early-Stage SCC Lesions
- According to recent studies, cryotherapy, in combination with curettage, is an effective treatment for superficial or early-stage SCC lesions, with lower recurrence rates compared to other non-excisional treatment modalities 3.
- Electrodessication and cryotherapy, in combination with curettage, have been shown to be more effective than photodynamic therapy, 5-fluorouracil, or imiquimod in treating SCC lesions 3.
- Cryotherapy may also be used to enhance the effectiveness of chemowrap treatment, by inducing edema and stripping the outer layers of skin, allowing for deeper penetration of topical creams 2.
Advantages and Disadvantages of Cryotherapy for SCC
- Advantages of cryotherapy for SCC include its ease of application, low cost, and good cosmetic results 5.
- Disadvantages of cryotherapy for SCC include the potential for adverse effects, such as hypopigmentation, and the need for repeated treatments 4.
- Cryotherapy may not be suitable for all types of SCC lesions, and the treatment should be individualized based on the patient's specific needs and medical history 6.