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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.
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.
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.
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:
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.
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
Christensen SR, Wilson LD, Leffell DJ. Chapter 90: Cancer of the Skin. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2019.
Martins RG. Systemic treatment of advanced basal cell and cutaneous squamous cell carcinomas not amenable to local therapies. UpToDate. 2023. Accessed at https://www.uptodate.com/contents/systemic-treatment-of-advanced-basal-cell-and-cutaneous-squamous-cell-carcinomas-not-amenable-to-local-therapies on August 30, 2023.
National Comprehensive Cancer Network (NCCN). Practice Guidelines in Oncology: Basal Cell Skin Cancer. Version 1.2023. Accessed at https://www.nccn.org/professionals/physician_gls/PDF/nmsc.pdf on August 30, 2023.
National Comprehensive Cancer Network (NCCN). Practice Guidelines in Oncology: Squamous Cell Skin Cancer. Version 1.2023. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/squamous.pdf on August 30, 2023.
Xu YG, Aylward JL, Swanson AM, et al. Chapter 67: Nonmelanoma Skin Cancers. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier; 2020.
Last Revised: October 31, 2023
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