Non-Melanoma Skin Cancer Increases in Seniors

An increasing non-melanoma skin cancer (NMSC) incidence rate in seniors requires providers to employ shared decision-making techniques with older adults and caregivers to help them make informed treatment decisions, reports Dermatology Times . Forefront Dermatology surgeon Molly Moye in Kentucky says NMSCs are often detected in seniors as an incidental finding when they are being seen for a different reason. A biopsy of all suspicious lesions is often supported as the only way to avoid overlooking a more serious tumor, and Moye suggests this risk should be limited by educating seniors and their families to monitor for troubling changes and the value of returning for regular follow-up. "There is reason to intervene if a lesion is symptomatic, such that it is bleeding, itching, or painful, or if it is reported to be growing rapidly," she says. "In the case of a lesion that is likely to be an indolent basal cell carcinoma and not bothersome . . . however, I consider . . . overall health status, life expectancy, and the likely consequences of treatment versus no treatment, and I have a conversation with the senior and his or her family to achieve shared decision making." In certain instances of high-risk or advanced NMSC, surgery may be refused or contraindicated for reasons that include comorbidity or the probability of significant disfigurement or functional impairment.