New guidelines for KCs

Skin cancers

By Michael Woodhead

5 Dec 2019

Updated guidelines have been released for the management of keratinocyte cancers (KCs), with major revisions to reflect advances in therapy, especially those used in metastatic disease such as vismodegib (Erivedge) and sonidegib (Odomzo).

The “Clinical practice guidelines for keratinocyte cancer (basal cell carcinoma and cutaneous squamous cell carcinoma)” have been published online by Cancer Council Australia and endorsed by the NHMRC.

Professor Stephen Shumack, Chair of the Guidelines Working Group said that this was the first-time the guidelines had been updated since 2008, and the target audience included specialists as well as GPs managing patients with BCC and cutaneous SCC.

“These guidelines are intended for use by health professionals, including those advising the general population about risk and prevention of KCs, those advising patients who are at increased risk of KCs (e.g. due to immunosuppression or a previous history of KC) about the need for and timing of future skin checks and follow-up, and all those involved in making the diagnosis or treating patients with KC,” the guidelines state.

The new recommendations in the publication include:

  • New advice on immunotherapy to treat metastatic disease with advanced SCCs
  • When and how to use radiotherapy instead of surgery
  • The latest radiotherapy technologies (for instance volumetric modulated therapy)
  • Advice for patients at very high risk (e.g. organ transplant recipients)
  • The use of cryotherapy (which is no longer recommended for BCCs at high risk facial sites)
  • Topical treatments and photodynamic therapy
  • Considerations for out-of-pocket costs for patients

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